Stereotactic imaging of the pallidal target
Identifieur interne : 006643 ( Main/Merge ); précédent : 006642; suivant : 006644Stereotactic imaging of the pallidal target
Auteurs : Hidehiro Hirabayashi [Japon] ; Magnus Tengvar [Suède] ; Marwan I. Hariz [Suède]Source :
- Movement disorders [ 0885-3185 ] ; 2002.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
Abstract
In 48 consecutive patients, we applied a new stereotactic imaging technique to individually visualize the pallidal target before surgery. A turbo spin-echo proton density sequence (acquisition time, 6 minutes 5 seconds) was used for 2-mm-thick contiguous axial scanning. Pallidocapsular border, medial putaminal border, and optic tract were visualised bilaterally in all patients. Boundaries of globus pallidus internus, globus pallidus externus, and lamina medullaris interna were clearly visualised in 71% of the patients. The anatomic target point was chosen in the middle of the visualized posteroventral pallidum, irrespective of the position of this point in relation to commissures. The lateralities of pallidocapsular border, lamina medullaris interna, and medial boundary of putamen were measured bilaterally in each patient, and the width of the posteroventral pallidum was assessed. The laterality of structures (measured from a point 2 mm anterior to midcommissural point and at a level 2-4 mm below anterior commissure-posterior commissure line) showed a wide range. The position of the pallidocapsular border varied by up to almost I cm between the most medial and the most lateral one. There were also variations in the position of the pallidal structures between left and right hemispheres in the same patients. The posteroventral pallidum was slightly more wide on the left than the right side. Given the significant inter- and intra-individual variabilities of the position of pallidal structures, it may be hazardous to rely solely on the atlas and the commissures for targeting. A magnetic resonance imaging sequence that enables visualization in each individual patient of the target area and its surroundings may contribute to less electrode passes during intraoperative physiological exploration and to more exact location of the lesion or chronic electrode in the posteroventral pallidum.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Stereotactic imaging of the pallidal target</title><author><name sortKey="Hirabayashi, Hidehiro" sort="Hirabayashi, Hidehiro" uniqKey="Hirabayashi H" first="Hidehiro" last="Hirabayashi">Hidehiro Hirabayashi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Nara Medical University</s1><s2>Nara</s2><s3>JPN</s3><sZ>1 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Nara</wicri:noRegion></affiliation></author><author><name sortKey="Tengvar, Magnus" sort="Tengvar, Magnus" uniqKey="Tengvar M" first="Magnus" last="Tengvar">Magnus Tengvar</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Radiologogy, MRI section, Sophiahemmet Hospital</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>2 aut.</sZ></inist:fA14><country>Suède</country><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Hariz, Marwan I" sort="Hariz, Marwan I" uniqKey="Hariz M" first="Marwan I." last="Hariz">Marwan I. Hariz</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurosurgery, University Hospital</s1><s2>Umeå</s2><s3>SWE</s3><sZ>3 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Umeå</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">02-0309279</idno><date when="2002">2002</date><idno type="stanalyst">PASCAL 02-0309279 INIST</idno><idno type="RBID">Pascal:02-0309279</idno><idno type="wicri:Area/PascalFrancis/Corpus">002807</idno><idno type="wicri:Area/PascalFrancis/Curation">000514</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002604</idno><idno type="wicri:doubleKey">0885-3185:2002:Hirabayashi H:stereotactic:imaging:of</idno><idno type="wicri:Area/Main/Merge">006643</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Stereotactic imaging of the pallidal target</title><author><name sortKey="Hirabayashi, Hidehiro" sort="Hirabayashi, Hidehiro" uniqKey="Hirabayashi H" first="Hidehiro" last="Hirabayashi">Hidehiro Hirabayashi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Nara Medical University</s1><s2>Nara</s2><s3>JPN</s3><sZ>1 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Nara</wicri:noRegion></affiliation></author><author><name sortKey="Tengvar, Magnus" sort="Tengvar, Magnus" uniqKey="Tengvar M" first="Magnus" last="Tengvar">Magnus Tengvar</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Radiologogy, MRI section, Sophiahemmet Hospital</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>2 aut.</sZ></inist:fA14><country>Suède</country><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Hariz, Marwan I" sort="Hariz, Marwan I" uniqKey="Hariz M" first="Marwan I." last="Hariz">Marwan I. Hariz</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurosurgery, University Hospital</s1><s2>Umeå</s2><s3>SWE</s3><sZ>3 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Umeå</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Exploration</term><term>Human</term><term>Instrumental stimulation</term><term>Nuclear magnetic resonance imaging</term><term>Pallidum</term><term>Parkinson disease</term><term>Stereotaxic surgery</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Stimulation instrumentale</term><term>Chirurgie stéréotaxique</term><term>Imagerie RMN</term><term>Pallidum</term><term>Exploration</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In 48 consecutive patients, we applied a new stereotactic imaging technique to individually visualize the pallidal target before surgery. A turbo spin-echo proton density sequence (acquisition time, 6 minutes 5 seconds) was used for 2-mm-thick contiguous axial scanning. Pallidocapsular border, medial putaminal border, and optic tract were visualised bilaterally in all patients. Boundaries of globus pallidus internus, globus pallidus externus, and lamina medullaris interna were clearly visualised in 71% of the patients. The anatomic target point was chosen in the middle of the visualized posteroventral pallidum, irrespective of the position of this point in relation to commissures. The lateralities of pallidocapsular border, lamina medullaris interna, and medial boundary of putamen were measured bilaterally in each patient, and the width of the posteroventral pallidum was assessed. The laterality of structures (measured from a point 2 mm anterior to midcommissural point and at a level 2-4 mm below anterior commissure-posterior commissure line) showed a wide range. The position of the pallidocapsular border varied by up to almost I cm between the most medial and the most lateral one. There were also variations in the position of the pallidal structures between left and right hemispheres in the same patients. The posteroventral pallidum was slightly more wide on the left than the right side. Given the significant inter- and intra-individual variabilities of the position of pallidal structures, it may be hazardous to rely solely on the atlas and the commissures for targeting. A magnetic resonance imaging sequence that enables visualization in each individual patient of the target area and its surroundings may contribute to less electrode passes during intraoperative physiological exploration and to more exact location of the lesion or chronic electrode in the posteroventral pallidum.</div></front></TEI><affiliations><list><country><li>Japon</li><li>Suède</li></country><region><li>Svealand</li></region><settlement><li>Stockholm</li></settlement></list><tree><country name="Japon"><noRegion><name sortKey="Hirabayashi, Hidehiro" sort="Hirabayashi, Hidehiro" uniqKey="Hirabayashi H" first="Hidehiro" last="Hirabayashi">Hidehiro Hirabayashi</name></noRegion></country><country name="Suède"><region name="Svealand"><name sortKey="Tengvar, Magnus" sort="Tengvar, Magnus" uniqKey="Tengvar M" first="Magnus" last="Tengvar">Magnus Tengvar</name></region><name sortKey="Hariz, Marwan I" sort="Hariz, Marwan I" uniqKey="Hariz M" first="Marwan I." last="Hariz">Marwan I. 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