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
