Application Of The Neuronavigation And Image Fusion Technology During The Deep Brain Stimulation Of Parkinson's Disease

Objective:To explore the accuracy and advantage of using the neuronavigation technique to select the appropriate needle path and needle angle and the use of head CT and 3.0T nuclear magnetic resonance fusion images to calculate the coordinates of the thalamus nucleus in the deep brain stimulation of Parkinson's disease.Methods:In this paper,20 patients of bilateral brain stimulation with Parkinson's disease from the first affiliated hospital with Nanjing medical university were randomly divided into two groups:control group and image fusion group,each group were included 10 patients,and 20 electrodes,the control group using the direct 1.5T MRI images calculated target coordinates,image fusion group using thin slice CT and 3.0T MRI fusion image to calculate the target coordinates.The postoperative target deviation of the two groups was compared.The intraoperative microelectrode was used to record the length of the thalamus nucleus,the improvement rate of the UPDRS score and the time of imaging examination,and the statistical analysis.Before the operation craniotomy using neuronavigation technology to select the appropriate needle path and needle angle in order to avoid the sulcus and ventricle,reduce postoperative complications.Result:(1)The electrode mean deviation of the control group was 1.3±0.4mm,and the average deviation of the fusion group was 1.4±0,4mm.There was no significant difference between the two groups(P>0.05).(2)Intraoperative microelectrode recording typical STN length of comparison:the control group,the average length of 4.6±2.1mm,image fusion group average length 4.9± 1.8mm,there was no significant difference(P>0.05).(3)The average improvement rate of UPDRS exercise score after three months when neurostimulator open and Parkinson's drug "off" status was 54.2110.6%in the control group and 53.7110.5%in the image fusion group.There was no significant difference between the two groups(P>0.05).(4)Preoperative imaging time-consuming comparison:the control group on average 27.3± 1.4 minutes'image fusion group takes 8.6±0.2 minutes on average,image fusion group was significantly shorter than the control group(P<0.05).(5)Postoperative 1.5T MRI of both group patients with electrode implantation are satisfactory,no appearance bleeding over CT image.Conclusion:Compared to the traditional calculation method,application of thin layer of head CT and 3.0T MRI fusion image to calculate the subthalamic nuclei target coordinates in deep brain stimulation for Parkinson's disease,showed no evident difference in accuracy and clinical value,and can shorten the preoperative locating time,accelerate the process of operation.