gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Article

Send article

Value of Susceptibility-Weighted Imaging (SWI) for Trajectory planning of Electrodes in Deep Brain Stimulation

Meeting Abstract

Search Medline for

  • M. Mahvash - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • D. Falk - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • O. Jansen - Institut für Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
  • H.M. Mehdorn - Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.10.04

doi: 10.3205/12dgnc247, urn:nbn:de:0183-12dgnc2476

Published: June 4, 2012

© 2012 Mahvash et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Deep brain stimulation (DBS) is an effective neurosurgical treatment of movement disorders. Susceptibility Weighted Imaging (SWI) is a relatively new MRI sequence used in diagnostic neuroradiology for better visualization of susceptibility differences between tissues, particularly of brain veins. The aim of this prospective study was to determine the value of SWI for trajectory planning of stereotactic electrode placement in DBS.

Methods: SWI was performed preoperatively in 30 patients undergoing DBS using an intraoperative MRI on the operation day. Indications for DBS were Parkinson disease in 24 patients, essential tremor in 3 and dystonia in 3 patients. The images were analyzed by post processing after operation and were co-registered with stereotactic, gadolinium enhanced T1-weighted MRI, which was used for trajectory planning. Vessels identified only with SWI within the planned trajectory corridor were counted and the diameters were measured. Postoperative MRI was performed in all patients to study electrode placement and verify postoperative complications.

Results: Data acquisition, post processing of the images and co-registration were possible in all cases. Neurophysiological microelectrode recording and test stimulation with up to five electrodes for each side was performed in all patients. In all cases, the planned trajectory passed through vessels visualized in SWI only (mean: 2.4 vessels, range 1–4 vessels for each side). The diameter of the vessels ranged between 0.8–2.1 mm (mean: 1.2 mm). Postoperative MRI showed the correct electrode position in all cases and detected small hemorrhages in two patients without any clinical relevance. The hemorrhage locations did not correlate with the visualized vessels in SWI in these two patients.

Conclusions: For trajectory planning in DBS, particularly brain veins can be visualized with SWI very well. SWI has its important value in diagnostic neuroradiology, particularly in preoperative evaluation for planning of DBS to screen vessel malformations or cerebral amyloid angiopathy. This study shows and visualizes that electrodes used for DBS can run through intracerebral veins with a diameter up to 2.1 mm several times without causing related complications.