重新定义心室通路地标:利用核磁共振成像和三维重建实现基恩点轨迹的新方法

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY
Shahin Naghizadeh, Maryam Zohrabi-Fard, Saeed Oraee-Yazdani
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引用次数: 0

摘要

简介:通过分流术进行脑脊液(CSF)分流是一种常见的神经外科干预措施。Keen's点是进入侧脑室三叉神经元的一个广泛使用的地标;然而,它缺乏临床验证。本研究使用磁共振成像(MRI)重新评估了Keen's Point头皮参数,以根据三维重建确定理想的分流入口点:方法:分析了 36 名计划接受脑深部刺激 (DBS) 的帕金森病患者的 MRI 数据。在轴向 MRI 图像上确定了最佳脑室穿刺点(A 点),并将其映射到头皮上。测量了从 A 点到外耳道(EAM;B 点)垂直线的距离,以及从 B 点到耳廓和外耳道的距离。计算胼胝体后角(PCA)以评估其与 A 点和 B 点之间距离的相关性。统计分析采用回归和 t 检验(P < 0.05):排除 PCA 在 70-100 度以外的患者后,剩下 24 名患者。B 点到 A 点的最佳距离从 25-30 毫米(如 Keen 所述)显著增加到 56.89 ± 1.36 毫米(p < 0.01)。平均 PCA 角度(85 度)与 57 毫米的距离相关,PCA 与 A 点到 B 点的距离之间呈显著负相关(r = -0.42,p < 0.03):结论:改良的基恩点是脑室造口术的可靠标志。将 PCA 纳入术前规划可提高导管置入的准确性,为在 Keen's Point 进行分流提供了一个显著的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Redefining Ventricular Access Landmarks: A Novel Approach Using Magnetic Resonance Imaging and 3-Dimensional Reconstructions for Keen's Point Trajectories.

Background: Cerebrospinal fluid diversion via shunt placement is a common neurosurgical intervention. Keen's Point is a widely used landmark for accessing the trigone of the lateral ventricle; however, it lacks clinical validation. This study re-evaluates Keen's Point scalp parameters using magnetic resonance imaging (MRI) to identify an ideal shunt entry point based on 3-dimensional reconstructions.

Methods: MRI data from 36 Parkinson disease patients scheduled for deep brain stimulation were analyzed. The optimal ventricular puncture site (A Point) was identified on axial MRI images and mapped to the scalp. Distances from A Point to a perpendicular line from the external auditory meatus (B Point) and from B Point to the pinna and external auditory meatus were measured. The Posterior Callosal Angle (PCA) was calculated to assess its correlation with the distance between A and B points. Statistical analysis used regression and t-tests (P < 0.05).

Results: After excluding patients with PCA outside 70°-100°, 24 patients remained. The optimal distance from B Point to A Point significantly increased from 25-30 mm (as described by Keen) to 56.89 ± 1.36 mm (P < 0.01). Average PCA angle (85°) correlates with a distance of ∼57 mm, and a significant negative correlation was found between PCA and the distance from A Point to B Point (r = -0.42, P < 0.03).

Conclusions: This modified Keen's Point is a reliable landmark for ventriculostomy. Incorporating PCA into preoperative planning enhances catheter placement accuracy, providing a prominent approach to shunting at Keen's Point.

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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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