在尸体标本上使用高强度聚焦超声瞄准扣带回的可行性:说明性案例。
Feasibility of targeting the cingulate gyrus using high-intensity focused ultrasound on a cadaveric specimen: illustrative case.
发表日期:2024 Jul 15
作者:
Francesco Sammartino, James Mossner, Hunter Stecko, Nihaal Reddy, Brian Dalm
来源:
MEDICINE & SCIENCE IN SPORTS & EXERCISE
摘要:
癌症通常与疼痛有关。对于患有晚期癌症和顽固性疼痛的患者,消融性神经外科手术可以显着改善疼痛并使患者脱离住院环境。这些手术通常是侵入性的,这对该人群构成了重要的风险。据报道,扣带回切开术可以改善疼痛感知,并大大提高患有顽固性疼痛的癌症患者的生活质量。该装置使用了一个新鲜的人类尸体标本。使用术中磁共振图像定位扣带回,并在与术前头部计算机断层扫描共同配准后校正骨畸变。考虑到鼻窦、膜褶皱和钙化后,总共有 737 个元件可用于热超声消融。在高功率超声处理中,传递的总能量在右扣带皮中达到 57°C(15,050 J,350 W,45 秒)的峰值温度,在左扣带皮中达到 52°C(13,000 J,405 W,46 秒)的峰值温度尽管使用尸体模型存在局限性(温度、血管化),但使用高强度聚焦超声进行扣带回切开术似乎是可行的。 https://thejns.org/doi/10.3171/CASE2459。
Cancer is commonly associated with pain. For patients with advanced cancer and intractable pain, ablative neurosurgical procedures can significantly improve pain and transition patients out of inpatient settings. These procedures are normally invasive, and this poses an important risk in this population. Cingulotomy has been reported to improve pain perception and contribute substantially to the quality of life of cancer patients with refractory pain.One fresh human cadaver specimen was used for the setup. The cingulate gyrus was targeted using intraoperative magnetic resonance images, and osseous aberrations were corrected after coregistration with the preoperative head computed tomography. After accounting for sinuses, membrane folds, and calcifications, a total of 737 elements were available for thermal ultrasound ablation. On high-power sonications, the total energy delivered reached a peak temperature of 57°C (15,050 J, 350 W, 45 seconds) in the right cingulate and 52°C (13,000 J, 405 W, 46 seconds) in the left cingulate.Despite the limitations of using a cadaver model (temperature, vascularization), cingulotomy appears to be feasible using high-intensity focused ultrasound. https://thejns.org/doi/10.3171/CASE2459.