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Medically refractory Parkinson's or dystonia conditions are often treated with deep brain stimulation (DBS) that are managed with the help of very restricted MRI due to safety concerns. The resulting MR images are often suboptimal but are still considered valuableto assess post-surgical complications as well as electrode placement accuracy. Absorbed radiofrequency power near the DBS electrodes during an MRI could produce tissue burns and,therefore, are subjected to strong conditional guidance from FDA and DBS manufacturers. We developed a comprehensive brain MRI protocol (including T1 MPRAGE, FSET2, DTI and FSE IR with modified refocusing flip angles and stretched RF pulses) for 10 Parkinson’s and 5 dystonia patients with implanted electrodes. This included low power 2D and 3D MR pulse sequences that preserved the expected tissue contrast, minimizedsignal artifacts and offered better tissue visualization near electrode edges. Low power images were judged as adequate for stereotactic planning in 12/15 patients while for the rest the neurosurgeons had to resort to additional landmarks. Radiologic diagnostic quality was also equivalent in tissue contrast and pathology detection as compared to high power routine MRI prior to electrode implantation. The white matter fiber tracks in DTI maps were virtually unchanged with minimal interference from the

iosr journal of dental and medical sciences

Low Power MRI Techniques for Neurosurgical Planning and Post-surgical Assessment of Deep Brain Stimulators in Patients with Medically Refractory Parkinson’s Disease or Dystonia