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Published on: August 12, 2019
Preoperative Magnetic Resonance Image Quality in Motion Disorder Patients Scheduled for Deep Brain Stimulation
Elsa M Ronde1,2, Marja Silvasti-Lundell1, Johanna Pekkola3
1Department of Anesthesia, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Background:
To obtain magnetic resonance (MR) images of good quality for accurate target localization in deep brain stimulation (DBS) surgery, sedation or anesthesia may be used, although their usefulness has not been proven.
Objective:
To assess whether sedation or general anesthesia (GA) improve the quality of MR imaging (MRI).
Methods:
The records of DBS procedures for Parkinson's disease (PD), dystonia, and essential tremor in our tertiary neurosurgical unit between January 2011 and June 2016 were reviewed. Adult patients with preoperative MR images were included. Patient records concerning MRI, surgery, adverse events, and clinical outcome were retrospectively scrutinized and analyzed. MR image quality was assessed by two independent radiologists.
Results:
A total of 215 preoperative MR images for 177 DBS procedures were analyzed. The MRI sequences performed under GA were superior to those performed without anesthesia or under sedation (p < 0.01). Virtually all images captured under GA were of good quality, while the proportions among those captured with sedation or without anesthesia were <65%. Good image quality was not associated with better clinical outcome (>50% improvement in the Unified Parkinson's Disease Rating Scale III score) among patients with PD.
Conclusion:
GA was associated with better MRI sequences than intravenous sedation or no anesthesia.
