论文部分内容阅读
目的分析MRI图像对书写痉挛症患者基底神经核团显示的特点。评价MRI扫描技术的优劣和扫描序列优化组合。寻找及评价前后连合。观察丘脑V0和Vim核团毁损术对书写痉挛症的疗效。方法搜集2008年9月至2009年8月之间我院收治的12例书写痉挛症患者,其中11例MRI脑内未见异常病灶;1例为右侧苍白球生殖细胞瘤。12例患者除单纯的书写困难外,无任何其他神经、运动系统症状和体征。采用瑞典Leksell定向仪和Surgiplan立体定向计划系统(简称SPS)。将固定的头环一并行MRI扫描,经SPS系统处理后找到靶点并行丘脑V0和Vim核团后进行毁损术。结果12例患者MRI扫描均在同一层面显示AC、PC;MRI定位误差平均0.6mm、最大1.1mm以内。SE双回波(TE14/85)序列应为首选;所有患者在毁损术中症状立即消失,术后无偏瘫、无永久性的构音障碍和感觉异常。11例患者观察2～12个月无复发,1例因属首例毁损范围不足并于术后2个月复发。结论MRI立体定向丘脑核团位置精准。丘脑核团立体定向射频毁损术治疗书写痉挛症安全、有效、基本无复发。
Objective To analyze the MRI features of basal ganglia in patients with written spasms. Evaluate the pros and cons of MRI scanning and scan sequence optimization. Looking for and evaluation before and after the joint. To observe the curative effect of thalamic V0 and Vim nucleus destruction on writing spasm. Methods A total of 12 patients with written spasms admitted in our hospital from September 2008 to August 2009 were collected. Among them, 11 patients had no abnormal lesions in the MRI brain and 1 patient had a right globus pallidum germ cell tumor. Twelve patients had no other neurological, motor system symptoms and signs other than simple writing difficulties. Using Swedish Leksell directional and Surgiplan stereotactic planning system (referred to as SPS). The fixed head of a parallel MRI scan, after processing by the SPS system to find the target parallel hypothalamic V0 and Vim nucleus after the destructive surgery. Results The MRI scan of 12 patients showed AC and PC on the same level. The average MRI location error was 0.6mm and the maximum was within 1.1mm. SE double echo (TE14 / 85) sequence should be the first choice; all patients disappear immediately in the damage surgery, no hemiplegia after surgery, no permanent dysarthria and sensory abnormalities. No recurrence was observed in 11 patients during 2 to 12 months. One patient was under-represented for the first time and relapsed two months after surgery. Conclusion MRI stereotactic thalamic nucleus accurate location. Stereotactic radiofrequency ablation of thalamic nucleus in the treatment of writing spasms is safe, effective and basically no recurrence.