[Correlation analysis between intracranial air and electrode implantation accuracy in DBS]

Zhonghua Yi Xue Za Zhi. 2019 Nov 26;99(44):3471-3476. doi: 10.3760/cma.j.issn.0376-2491.2019.44.005.
[Article in Chinese]

Abstract

Objective: To analyze the correlation between intracranial air and electrode displacement after deep brain stimulation. Compared the accuracy of the electrodes on both sides while bilateral intracranial air. Methods: A total of 133 patients with bilateral DBS from February 2017 to February 2019 in neurosurgery department of the General Hospital of Northern Theater Command were included. A total of 266 electrodes were implanted, including 160 sides of subthalamic nucleus, 2 sides of ventromedial nucleus of thalamus and 104 sides of Globus pallidus interior. All patients underwent three-dimensional reconstruction of the head 2 hours after operation and 1 week after operation, which was fused with the preoperative surgical plan.The volume of the intracranial air is obtained by summing up the CT layer-by-layer measurements after surgery. The distance between the implanted electrode and the preoperative target on the X and Y axes in the target plane is measured.Values were expressed as means±SEM,and the t test was performed. Bivariate correlation analysis using linear correlation analysis.P<0.05 was considered statistically significant. Results: There was no statistically significant difference in the fusion error of the electrode between 2 hours and 1 week after surgery on the X-axis. But there was significant difference on the Y-axis. The difference between intracranial air volume and two fusion errors was not linearly correlated on X axis, but linearly positively correlated on Y axis. Conclusion: Intracranial air volume is an important factor affecting the accuracy of DBS surgery. The larger intracranial air volume, the larger the displacement of electrodes on Y axis.

目的: 对脑深部电刺激术(DBS)术后颅内积气(ICA)与电极移位进行相关性分析,并对双侧出现ICA的情况下,两侧电极的精度进行对比研究。 方法: 收集北部战区总医院神经外科2017年2月至2019年2月双侧DBS手术患者133例,共植入电极266侧,其中丘脑底核(STN)160侧,丘脑腹中间核(Vim)2侧,苍白球内侧部(Gpi)104侧。所有病例均于术后2 h和术后1周复查头部CT三维重建(0.625 mm),与术前手术计划融合,测量植入电极与手术计划相对应靶点在靶点平面X轴和Y轴上的偏差距离。ICA体积由术后复查CT逐层测量相加得出。计量资料采用x±s表示,行t检验,双变量关联性分析采用直线相关分析,P<0.05为差异有统计学意义。 结果: 两侧电极在术后1周与术后2 h复查CT与术前计划的融合误差在X轴上[术后2 h误差(0.01~1.75)mm,平均(0.44±0.33)mm;术后1周误差(0~1.17)mm,平均(0.40±0.13)mm]差异无统计学意义,在Y轴上差异具有统计学意义。术后ICA体积与两次融合误差的差值在X轴不具有线性相关关系,在Y轴上具有直线相关关系,且为正相关,差异具有统计学意义。 结论: ICA体积是影响DBS手术精度的重要因素,ICA体积越大,电极在Y轴上的移位越大。.

Keywords: Deep brain stimulation; Electrode accuracy; Intracranial air; Robot.

MeSH terms

  • Deep Brain Stimulation*
  • Electrodes, Implanted
  • Globus Pallidus
  • Humans
  • Magnetic Resonance Imaging
  • Parkinson Disease / therapy
  • Subthalamic Nucleus*