Subthalamic Nucleus Location: Relationships between Stereotactic AC-PC-Based Diagrams and MRI Anatomy-Based Contours

Caire, François; Ouchchane, Lemlih; Coste, Jérôme; Gabrillargues, Jean; Derost, Philippe; Ulla, Miguel; Durif, Franck; Lemaire, Jean‐Jacques

doi:10.1159/000236367

Cited by 18 publications

(15 citation statements)

References 98 publications

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“…Our findings are consistent with those of Caire et al [8], who found significant discordance between MRI-based polygons and AC-PC-based images and that the subthalamic nucleus was more posterior, medial, and slightly inferior on MRI images. Because of the small size, the convex lens shape, and the oblique path of the subthalamic nucleus, precise localization of the nucleus by imaging studies is rather challenging.…”

Section: Discussionsupporting

confidence: 93%

MRI localization of the subthalamic nucleus in normal adults and its relation with age

Geng²,

Zhu³

et al. 2015

NeuroReport

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The subthalamic nucleus regulates motor and neurocognitive functions. Because of its small size and close proximity to other small subcortical structures, it has been a challenge to localize and visualize it using MRI. Here, we sought to define the optimal MRI scan method and visualization plane for locating the subthalamic nucleus on MRI images and to further delineate the geometric dimensions of the subthalamic nucleus and their correlation with age, laterality, and sex. Healthy volunteers received axial, sagittal, and coronal T2_3D_DRIVE CLEAR, coronal T1-WI, coronal T2FLAIR, coronal T2, and coronal SWI sequence. The coronal T2-3D-DRIVE CLEAR images were compared with the Schaltenbrand-Wahren Atlas for Stereotaxy of the Human Brain for localizing the subthalamic nucleus. The best visualization plane with the largest sectional area and the most distinct outline was obtained and region of interest was delineated manually on the basis of the contours of the bilateral subthalamic nuclei in T2-WI images. T2-3D-DRIVE CLEAR in the coronal view showed optimal visualization of the subthalamic nucleus and indicated that the subthalamic nucleus showed three morphological types: the double convex lens type (172, 64%), the ram's horn type (62, 23%), and the willow leaf type (34, 13%). There were no statistically significant differences because of laterality, sex, and age in the sectional area, and maximal long and short diameter of the subthalamic nucleus. On the basis of our results, the current study has shown that T2-3D-DRIVE CLEAR in the coronal view provides optimal visualization of the subthalamic nucleus, which shows three distinct morphological types on MRI images, and there is no statistically significant difference in the geometric dimensions of the subthalamic nucleus because of laterality, sex, and age in normal individuals.

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Section: Discussionsupporting

confidence: 93%

MRI localization of the subthalamic nucleus in normal adults and its relation with age

Geng²,

Zhu³

et al. 2015

NeuroReport

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“…Caire et al [21] aimed to compare the STN position localized on MRIs with standard stereotactic diagrams. The STN was manually contoured on MRIs (22 PD patients); boundaries were simplified in a schematic polygonal form.…”

Section: Discussionmentioning

confidence: 99%

Anatomy of the Human Subthalamic Nucleus: A Combined Morphometric Study

Mavridis

Boviatsis

Anagnostopoulou

2013

Anatomy Research International

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Purpose. Our purpose was to provide a combined clinically oriented study focused on the detailed anatomy of the human STN, with great respect to its targeting. Methods. For our imaging study, we used cerebral magnetic resonance images (MRIs) from 26 neurosurgical patients and for our anatomic study 32 cerebral hemispheres from 18 normal brains from cadaver donors. We measured and analyzed the STN dimensions (based on its stereotactic coordinates). Results. At stereotactic level Z = −4, the STN length was 7.7 mm on MRIs and 8.1 mm in anatomic specimens. Its width was 6 mm on MRIs and 6.3 mm in anatomic specimens. The STN was averagely visible in 3.2 transverse MRI slices and its maximum dimension was 8.5 mm. The intercommissural distance was 26.3 mm on MRIs and 27.3 mm in anatomic specimens. We found statistically significant difference of the STN width and length between individuals <60 and ≥60 years old. Conclusion. The identification of the STN limits was easier in anatomic specimens than on MRIs and easier on T2 compared to T1-weighted MRIs sections. STN dimensions appear slightly smaller on MRIs. Younger people have wider and longer STN.

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“…The anteroposterior coordinate of the STN center is indeed -3.8 8 1.3 mm from the MCP for Richter et al [10] , -1.26 8 1.06 mm for Schlaier et al [11] , -1.1 8 2.3 mm (right side) and -0.6 8 1.8 mm (left side) for Slavin et al [8] , and -2.6 8 0.9 mm for Caire et al [12] .…”

Section: Direct Identification Of the Stn On High-field Axial Mr Imagmentioning

confidence: 96%

The Mamillothalamic Tract Is a Good Landmark for the Anterior Border of the Subthalamic Nucleus on Axial MR Images

Caire

Maubon

Moreau³

et al. 2011

Stereotact Funct Neurosurg

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Background:Identification of the subthalamic nucleus (STN) on MR images is difficult, and the use of external landmarks could be of interest for STN targeting in deep brain stimulation (DBS). Objectives:Our aim was to explore the relationship between the anteroposterior coordinates of (1) the center of the mamillothalamic tract and (2) the anterior border of the STN on axial MR images. Patients and Methods:The brains of 16 healthy volunteers were imaged on a 3T MR system. Four millimeters under the anterior-posterior commissure plane, we noted the y coordinates of (1) the center of the mamillothalamic tract and (2) the anterior border of the STN. Results:The coordinates were y_STN = 14.7 ± 1.23 mm and y_Tmth = 14.3 ± 1.13 mm from the posterior commissure for the STN and the mamillothalamic tract, respectively. The mean difference was 0.4 mm (range 0–1 mm). Pearson’s coefficient was 0.97 (p < 0.01). Conclusion:We observed a strong correlation between the anteroposterior coordinates of the mamillothalamic tract and the anterior border of the STN (which is located between 0 and 1 mm in front of the mamillothalamic tract). The mamillothalamic tract could be a good anterior landmark for STN targeting. It could also be tested for target determination in DBS for severe obsessive-compulsive disorder.

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Subthalamic Nucleus Location: Relationships between Stereotactic AC-PC-Based Diagrams and MRI Anatomy-Based Contours

Cited by 18 publications

References 98 publications

MRI localization of the subthalamic nucleus in normal adults and its relation with age

MRI localization of the subthalamic nucleus in normal adults and its relation with age

Anatomy of the Human Subthalamic Nucleus: A Combined Morphometric Study

The Mamillothalamic Tract Is a Good Landmark for the Anterior Border of the Subthalamic Nucleus on Axial MR Images

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