Objective
To realize the three-dimensional visualization of the subthalamic nucleus and stimulating electrode using CT and MRI in order to provide the basis for electrode location after deep brain stimulation (DBS).
Methods
From July 2014 to March 2015, 10 patients with Parkinson's disease performed subthalamic nucleus stimulation at the Department of Neurosurgery, Chinese PLA General Hospital were selected. Using preoperative high-resolution MRI and post-operative MRI or CT images, an effective registration achieved before and after procedure through the nonlinear algorithm. The threshold method was further used to determine the electrode position of the axial images. The straight line fitting method was used for three-dimensional reconstruction of electrode implantation path. The grayscale information of the standard brain atlas was used to separate the subthalamic nucleus and near important nucleus in order to realize three-dimensional visualization of the spatial structure of the subthalamic nucleus, and fused the electrode reconstruction results, obtaining the complete postoperative three-dimensional spatial structure information. Using this algorithm, the postoperative spatial structure of 3 different atlases (BGHAT, ATAG, and Accolla-2014 atlas) realized visualization.
Results
The average root mean square error of 16 reference points in whole brain range was 0.96 mm. It was smaller than a pixel. The reconstruction results were consistent with the head coronal images of the patients. Finally, they were verified by the multispectral data, and were compared and discriminated by a doctor. The results of visualization were consistent and could be used in clinical practice.
Conclusions
Using the preoperative MRI, postoperative CT or MRI images can realize the three-dimensional visualization of the subthalamic nucleus and stimulating electrode, provide intuitive and quantitative information for the postoperative electrode location of DBS, and provide guidance for the postoperative programmed stimulation parameter adjustment, thus it is helpful to improve the efficacy of DBS.
Key words:
Deep brain stimulation; Subthalamic nucleus; Visualization; Magnetic resonance imaging; Tomography, X-ray computed