Article Figures & Data
Figures
- Fig 1.
Schematic representation of zones I, II, and III visualized on T2-weighted imaging and the corresponding T2-weighted image of the lesion. On T2-weighted imaging, the patient developed 3 concentric zones at the site of lesioning: a hypointense zone I at the center; a strongly hyperintense zone II demarcated by a hypointense rim; and finally, a fuzzy, slightly hyperintense zone III at the periphery.
- Fig 2.
Average diameters of zone I and thicknesses of zones II and III, as seen on T2-weighted imaging, at 24 hours, 1 week, 1 month, and 3 months after the MR imaging–guided focused sonography treatment, all expressed in millimeters.
- Fig 3.
A 76-year-old, right-handed woman with essential tremor treated with MR imaging–guided focused sonography lesioning of the left Vim of the thalamus (thermography image obtained during the treatment is in the left upper corner). On T2-weighted imaging, the patient developed 3 concentric zones at the site of lesioning. Zone II corresponds to vasogenic edema and was seen at 24 hours and 1 week and then resolved. Zones I and II evolved into a round cavity in which diffusion was restricted by 24 hours after treatment. Diffusion pseudonormalized by 1 month when the cavity collapsed. T1 shortening was observed at 1 month and 3 months. Very mild enhancement was seen at 24 hours, likely resulting from the reversible alteration of the blood-brain barrier caused by the focused sonography treatment. Enhancement reappeared by 1 week and peaked at 1 month, by then likely representing neoangiogenesis. No major bleed occurred at any time point, but blood products responsible for susceptibility artifacts were seen within zones I and II at all time points.
Tables
- Table 1:
Clinical outcome in the 15 patients enrolled in the trial, measured in terms of the Clinical Rating Scale for Tremora
Time Point Mean SD Minimum Maximum Baseline CRST 54.9 14.4 38 87 24-Hour CRST 19.3 10.8 5 43 1-Week CRST 18.5 11.0 6 43 1-Month CRST 18.7 12.0 2 39 3-Month CRST 20.3 11.0 6 37 Outcomes (difference between baseline and 3-month CRST) 34.6 10.4 13 50 ↵a Lower score is favorable; higher score is unfavorable.
- Table 2:
Diameters of zone I and thicknesses of zones II and III (mean in millimeters) after MR imaging–guided focused ultrasound treatment
T2 Imaging Zone I Zone II Zone III 24 Hours 2.7 ± 1.4 2.2 ± 1.0 3.0 ± 1.1 1 Week 4.0 ± 1.6 1.8 ± 0.8 2.7 ± 1.8 1 Month 2.1 ± 1.4 1.2 ± 0.9 0.1 ± 0.3 3 Months 0.5 ± 0.7 0.1 ± 0.4 0.0 ± 0.0
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