Localization of the subthalamic nucleus: optimization with susceptibility-weighted phase MR imaging

AJNR Am J Neuroradiol. 2009 Oct;30(9):1717-24. doi: 10.3174/ajnr.A1669. Epub 2009 Jun 9.

Abstract

Background and purpose: On clinical MR images, the subthalamic nuclei (STN) are poorly delineated from adjacent structures, impeding safe direct targeting for placement of electrodes in the treatment of Parkinson disease. Susceptibility-weighted MR phase imaging offers improved contrast and spatial resolution at reduced imaging times relative to clinically used T2-weighted spin-echo imaging for STN visualization. Our purpose was to assess STN visibility by using phase imaging, comparing phase and magnitude images obtained concurrently by using susceptibility-weighted imaging (SWI). The goal was to identify an efficient scanning protocol for high-quality phase images of STN.

Materials and methods: Seventy-eight SWI scans were acquired at 3T by using different TEs and acceleration factors. STN visibility and delimitation from adjacent structures were scored from 0 (not interpretable) to 5 (excellent). Regression analyses assessed the relationship of STN visibility to scanning parameters

Results: STN were identified at all studied TEs on phase images. Visibility and delimitation of STN were consistently superior on phase images compared with magnitude images. Good visualization (score of >or=4) of STN on phase imaging occurred at a mean TE of 20.0 ms and a sensitivity encoding (SENSE) of 1.40. Scores of STN visualization on phase images were dependent on SENSE (P < .002) and TE (P < .031). Good delimitation of the STN on phase imaging occurred at a mean TE of 21.6 ms and a SENSE of 1.36.

Conclusions: Visualization and delimitation of STN was superior on phase images and was achieved at 3T in <2.5 minutes. A TE of 20 ms and an acceleration factor of <or=1.5 are recommended to visualize STN by using this method.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms*
  • Artificial Intelligence
  • Female
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods*
  • Information Storage and Retrieval / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Pattern Recognition, Automated / methods*
  • Quality Control
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Subthalamic Nucleus / anatomy & histology*
  • Young Adult