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首页> 外文期刊>Journal of neurosurgery. >Gamma Knife surgery for arteriovenous malformations in the brain: integration of time-resolved contrast-enhanced magnetic resonance angiography into dosimetry planning. Technical note.
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Gamma Knife surgery for arteriovenous malformations in the brain: integration of time-resolved contrast-enhanced magnetic resonance angiography into dosimetry planning. Technical note.

机译:伽玛刀手术治疗脑动静脉畸形:将时间分辨的对比增强磁共振血管造影术纳入剂量测定计划。技术说明。

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OBJECT: The aim of this study was to develop an algorithm for the integration of time-resolved contrast-enhanced magnetic resonance (MR) angiography into dosimetry planning for Gamma Knife surgery (GKS) of arteriovenous malformations (AVMs) in the brain. METHODS: Twelve patients harboring brain AVMs referred for GKS underwent intraarterial digital subtraction (DS) angiography and time-resolved MR angiography while wearing an externally applied cranial stereotactic frame. Time-resolved MR angiography was performed on a 1.5-tesla MR unit (Achieva, Philips Medical Systems) using contrast-enhanced 3D fast field echo sequencing with stochastic central k-space ordering. Postprocessing with interactive data language (Research Systems, Inc.) produced hybrid data sets containing dynamic angiographic information and the MR markers necessary for stereotactic transformation. Image files were sent to the Leksell GammaPlan system (Elekta) for dosimetry planning. RESULTS: Stereotactic transformation of the hybrid data sets containing the time-resolved MR angiography information with automatic detection of the MR markers was possible in all 12 cases. The stereotactic coordinates of vascular structures predefined from time-resolved MR angiography matched with DS angiography data in all cases. In 10 patients dosimetry planning could be performed based on time-resolved MR angiography data. In two patients, time-resolved MR angiography data alone were considered insufficient. The target volumes showed a notable shift of centers between modalities. CONCLUSIONS: Integration of time-resolved MR angiography data into the Leksell GammaPlan system for patients with brain AVMs is feasible. The proposed algorithm seems concise and sufficiently robust for clinical application. The quality of the time-resolved MR angiography sequencing needs further improvement.
机译:目的:本研究的目的是开发一种算法,用于将时间分辨的对比增强磁共振(MR)血管造影术整合到脑动静脉畸形(AVM)的伽玛刀手术(GKS)的剂量规划中。方法:十二名因GKS转诊的脑AVM患者在佩戴外部颅骨立体定向支架的同时进行了动脉内数字减影(DS)血管造影和时间分辨MR血管造影。时间分辨MR血管造影是在1.5特斯拉MR装置(Achieva,飞利浦医疗系统)上进行的,采用具有增强的3D快速场回波定序和随机中心k空间排序的技术。使用交互式数据语言(Research Systems,Inc.)进行后处理可生成包含动态血管造影信息和立体定向转换所必需的MR标记的混合数据集。图像文件已发送到Leksell GammaPlan系统(Elekta)以进行剂量测定计划。结果:在所有12例病例中,都可能对包含时间分辨MR血管造影信息并自动检测MR标记的混合数据集进行立体定向转换。在所有情况下,根据时间分辨的MR血管造影预定义的血管结构的立体定向坐标与DS血管造影数据相匹配。在10位患者中,可以根据时间分辨的MR血管造影数据进行剂量规划。在两名患者中,仅时间分辨MR血管造影数据被认为不足。目标数量显示模式之间中心的显着变化。结论:对于脑AVM患者,将时间分辨MR血管造影数据整合到Leksell GammaPlan系统中是可行的。所提出的算法看起来简洁并且对于临床应用而言足够健壮。时间分辨MR血管造影测序的质量需要进一步提高。

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