3.0 T MR ESWAN与T2像在帕金森病DBS术前靶点规划中作用比较

目的探讨3.0 T MR ESWAN与T2像显示的丘脑底核（STN）边界与微电极记录（MER）确定的边界在DBS术前规划中的价值。方法20例拟行丘脑底核脑深部电刺激术（STN-DBS ）治疗的原发性帕金森病患者，均行术前3.0 T MR 3D T1、T2及ESWAN扫描，将其融合后做术前规划设计靶点及针道。分别比较T2及ESWAN规划的背外侧界与MER的符合率；ESWAN规划的腹内侧界与MER的符合率。结果T2像能很好地显示STN背外侧界，与MER符合率达85.4%。ESWAN序列能很好地显示STN腹内侧，且与黑质有明确的分界，与MER符合率高达95.2%。结论3.0 T MR ESWAN与T2结合能提高STN-DBS术前靶点规划的精确性。术中结合MER及宏刺激结果可修正术前计划的不足，使最终植入的靶点更加合理。

Objective To explore the value between the boundary of subthalamic nucleus(STN) on 3.0 T MR ESWAN and T2WI with that determined by microelectrode recording(MER) in preoperative planning of deep brain stimulation(DBS). Methods 20 patients with primary Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation(STN-DBS) were scanned with 3.0 T MR 3D T1WI, T2WI and ESWAN before operation. The target and needle path were designed before operation. The coincidence rate between the upper outer boundary of T2WI and ESWAN planning and the MER were compared. The coincidence rate between the lower inner boundary of ESWAN planning and the MER were compared. Results T2WI could well show the lateral boundary of STN, and the coincidence rate with MER was 85.4%. ESWAN sequence could well display the boundary between the ventromedial STN and substantia nigra, and the coincidence rate with MER was as high as 95.2%. Conclusion 3.0 T MR ESWAN combined with T2WI can improve the accuracy of preoperative target planning for STN-DBS. The combination of intraoperative MER and macro stimulation results can correct the lack of preoperative planning and make the final target more reasonable.