Details

Autor(en) / Beteiligte

• Keil, Vera C.
• Borger, Valeri
• Purrer, Veronika
• Groetz, Simon F.
• Scheef, Lukas
• Boecker, Henning
• Schild, Hans H.
• Kindler, Christine
• Schmitt, Angelika
• Solymosi, Laszlo
• Wüllner, Ullrich
• Pieper, Claus C.

Titel

MRI follow-up after magnetic resonance-guided focused ultrasound for non-invasive thalamotomy: the neuroradiologist’s perspective

Ist Teil von

• Neuroradiology, 2020-09, Vol.62 (9), p.1111-1122

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2020

Quelle

SpringerLink

Beschreibungen/Notizen

• Purpose Magnetic resonance-guided focused ultrasound (MRgFUS) systems are increasingly used to non-invasively treat tremor; consensus on imaging follow-up is poor in these patients. This study aims to elucidate how MRgFUS lesions evolve for a radiological readership with regard to clinical outcome. Methods MRgFUS-induced lesions and oedema were retrospectively evaluated based on DWI, SWI, T2-weighted and T1-weighted 3-T MRI data acquired 30 min and 3, 30 and 180 days after MRgFUS ( n  = 9 essential tremor, n  = 1 Parkinson’s patients). Lesions were assessed volumetrically, visually and by ADC measurements and compared with clinical effects using non-parametric testing. Results Thirty minutes after treatment, all lesions could be identified on T2-weighted images. Immediate oedema was rare ( n  = 1). Lesion volume as well as oedema reached a maximum on day 3 with a mean lesion size of 0.4 ± 0.2 cm 3 and an oedema volume 3.7 ± 1.2 times the lesion volume. On day 3, a distinct diffusion-restricted rim was noted that corresponded well with SWI. Lesion shrinkage after day 3 was observed in all sequences. Lesions were no longer detectable on DWI in n  = 7/10, on T2-weighted images in n  = 4/10 and on T1-weighted images in n  = 4/10 on day 180. No infarcts or haemorrhage were observed. There was no correlation between lesion size and initial motor skill improvement ( p  = 0.99). Tremor reduction dynamics correlated strongly with lesion shrinkage between days 3 and 180 ( p  = 0.01, R  = 0.76). Conclusion In conclusion, cerebral MRgFUS lesions variably shrink over months. SWI is the sequence of choice to identify lesions after 6 months. Lesion volume is arguably associated with intermediate-term outcome.