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Minim Invasive Neurosurg 2005; 48(1): 1-6
DOI: 10.1055/s-2004-830169
Original Article
© Georg Thieme Verlag Stuttgart · New York

Deep Brain Stimulation in Intraoperative MRI Environment - Comparison of Imaging Techniques and Electrode Fixation Methods

M.  W. Y.  Lee1 , A.  A. F.  De Salles1 , L.  Frighetto1 , R.  Torres1 , E.  Behnke1 , J.  M.  Bronstein2
  • 1Division of Neurosurgery, University of California Los Angeles School of Medicine, Los Angeles, USA
  • 2Department of Neurology, University of California Los Angeles School of Medicine, Los Angeles, USA
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Publication History

Publication Date:
04 March 2005 (online)

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Abstract

We performed 118 consecutive DBS cases from November 1999 to June 2002. Intraoperatively there were 10 cases studied with fluoroscopy, 73 with 0.2 Tesla (T) MRI and 35 with 1.5 T MRI. Ten electrodes were secured by Medtronic caps, 25 by methyl methacrylate with titanium miniplates, and 82 by Navigus caps. The 3-dimensional displacement between the planned target and actual electrode position (3DD) was determined by fusing the postoperative MRI with the preoperative imaging. The 3DD for using Medtronic caps, methyl methacrylate with miniplates, and Navigus caps were 4.80 ± 3.16, 2.64 ± 1.26 and 2.23 ± 1.15 mm (mean ± SD), respectively. Navigus caps had statistically significant accuracy (P = 0.03) in holding the electrode when compared with Medtronic caps, and it facilitated electrode revision. The fixation devices significantly affect the final vertical position of the electrode. The 3DD for fluoroscopy, 0.2 T and 1.5 T MRI cases were 4.80 ± 3.16, 2.31 ± 1.21 and 2.34 ± 1.14 mm (mean ± SD), respectively. No statistically significant difference (P = 0.91) in 3DD was demonstrated between 0.2 T and 1.5 T MRI cases. The presence of intraoperative 1.5 T MRI allowed near real-time electrode position confirmation and early detection of hemorrhagic complications. Satisfactory microelectrode recording was feasible in low-field 0.2 T and high-field 1.5 T MRI environments. Further studies on performing DBS in real-time intraoperative MRI are warranted.

Key words

Deep brain stimulation - electrode fixation device - intraoperative magnetic resonance imaging - stereotactic targeting

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Antonio A. F. De Salles, M.D., Ph. D. 

200 UCLA Medical Plaza

Suite 504, 718424

Los Angeles, CA 90095-7184

USA

Phone: +1-310-794-1221

Fax: +1-310-794-1848

Email: adesalles@mednet.ucla.edu

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