Abstract
When performing deep brain stimulation (DBS) of the subthalamic nucleus, practitioners should interpret the magnetic resonance images (MRI) correctly so they can place the DBS electrode accurately at the target without damaging the other structures. The aim of this study is to provide a real color volume model of a cadaver head that would help medical students and practitioners to better understand the sectional anatomy of DBS surgery. Sectioned images of a cadaver head were reconstructed into a real color volume model with a voxel size of 0.5 mm × 0.5 mm × 0.5 mm. According to preoperative MRIs and postoperative computed tomographys (CT) of 31 patients, a virtual DBS electrode was rendered on the volume model of a cadaver. The volume model was sectioned at the classical and oblique planes to produce real color images. In addition, segmented images of a cadaver head were formed into volume models. On the classical and oblique planes, the anatomical structures around the course of the DBS electrode were identified. The entry point, waypoint, target point, and nearby structures where the DBS electrode could be misplaced were also elucidated. The oblique planes could be understood concretely by comparing the volume model of the sectioned images with that of the segmented images. The real color and high resolution of the volume model enabled observations of minute structures even on the oblique planes. The volume models can be downloaded by users to be correlated with other patients’ data for grasping the anatomical orientation.
Highlights
Deep brain stimulation (DBS) of the subthalamic nucleus is used for treating Parkinson’s disease and essential tremor [1,2]
In DBS surgery, the neurosurgeon navigates from the skin to the target structures of the deep brain based on magnetic resonance images (MRIs) in a probe’s eye and trajectory planes with classical planes
To produce a volume model that could be handled by a personal computer, the voxel size of the sectioned images and segmented images was adjusted to 0.5 mm × 0.5 mm × 0.5 mm and converted to the DICOM format in Photoshop
Summary
Deep brain stimulation (DBS) of the subthalamic nucleus is used for treating Parkinson’s disease and essential tremor [1,2]. In DBS surgery, the neurosurgeon navigates from the skin to the target structures of the deep brain (e.g., the subthalamic nucleus) based on magnetic resonance images (MRIs) in a probe’s eye (vertical plane on a DBS electrode) and trajectory (parallel plane on the DBS electrode) planes with classical (horizontal, coronal, and sagittal) planes. On the other hand, owing to the small size of the target structures for the DBS, even a minute misplacement of the electrode can have adverse effects [7]. For successful DBS surgery, the practitioners have to be well informed of the anatomy of the deep brain
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