帕金森病定向术后影像学分析

目的:总结立体定向丘脑毁损术治疗128例帕金森病的影像学改变及影响疗效的因素分析。方法:128例帕金森病病人均采用温控射频热凝制造丘脑腹外侧核毁损灶。结果:本组病例症状完全控制95例(74.21％),症状控制伴有肢体麻木、情感、智能障碍27例(21.09％),无效5例(3.90％),恶化1例(0.78％)。结论:经统计学处理显示CT定位靶点法与脑室造影定位法对疗效影响无显著性差异。靶点定位、毁损灶大小与手术疗效、并发症密切相关。

Analysis of the CT and MRI features after stereotactic surgery in Parkinson disease

The purpose of this paper is to summarize the imaging changes after stereotactic thalamotomy in 128 patients with Parkinson disease , and to analyse the influential factors of the surgical result. Method: Radiofrequency coagulation with controlled temperature was used to destroy the ventral lateral nucleus thalamus in 128 patients with Parkinson disease. Result: In 128 cases, there were markedly improved in 95 cases (74. 21%), and have some effect in 27 cases (21.09%). Among the 27 effective cases, 14 cases had limbs numbness, emotional and intellectual impediment due to the targets were behind the ventral lateral nucleus. In 4 of 5 ineffective cases the destroyed targets could not be revealed by CT scan. Conclusion: Accurate localization of destroyed target is one of the most important influential factors. The proper degree and size is also important for reducing operative complications and improving the surgical result. There was no significant statistical difference between CT and ventriculography localization method with regard to the surgical results.