在MRI引导的聚焦超声神经外科手术中使用来自MR温度成像的相位数据来可视化解剖结构
Using phase data from MR temperature imaging to visualize anatomy during MRI-guided focused ultrasound neurosurgery
摘要：
由于图像质量差，在经颅MRI引导聚焦超声（MRgFUS）热消融过程中识别丘脑中的神经外科目标可能具有挑战性。它们还邻近结构，如果损坏，可能会导致副作用。在这里，我们证明，在MRgFUS的MR温度成像（MRTI）的相位数据包含解剖信息，可能是有用的，在指导这一进程。在68例原发性震颤（ET）的丘脑切开术中评价了这种方法。我们发现，我们可以很容易地看到红核和丘脑底核，这些核团始终与超声处理目标坐标对齐。我们还可以持续地观察内囊，内囊需要受到热损伤的保护，以防止副作用。帕金森病患者的四个苍白球切开术的初步结果表明，这种方法也可能是有用的可视化视束除了内囊。总的来说，这种方法可以可视化解剖标志，这可能有助于完善基于图谱的MRgFUS靶向。由于相同的数据用于MRTI和解剖可视化，因此不存在由与先前获得的计划图像的配准或图像失真引起的误差，并且不需要额外的时间。
英文摘要：
Neurosurgery targets in the thalamus can be challenging to identify during transcranial MRI-guided focused ultrasound (MRgFUS) thermal ablation due to poor image quality. They also neighbor structures that can result in side effects if damaged. Here we demonstrate that the phase data obtained during MRgFUS for MR temperature imaging (MRTI) contains anatomic information that could be useful in guiding this procedure. This approach was evaluated in 68 thalamotomies for essential tremor (ET). We found that we could readily visualize the red nucleus and subthalamic nucleus, and those nuclei were consistently aligned with the sonication target coordinates. We also could consistently visualize the internal capsule, which needs to be protected from thermal damage to prevent side effects. Preliminary results from four pallidotomies in Parkinson's disease patients suggest that this approach might also be useful in visualizing the optic tract in addition to the internal capsule. Overall, this approach can visualize anatomic landmarks that may be useful to refine atlas-based targeting for MRgFUS. Since the same data is used for MRTI and anatomic visualization, there are no errors induced by registration to previously obtained planning images or image distortion, and no additional time is needed.
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