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1.
Fig. 4

Fig. 4. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Axial MR image used to define the target in the dorsolateral STN (black arrow indicates right STN; MR protocol 3).

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
2.
Fig. 5

Fig. 5. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Coronal MR image used to define the coordinates of the pivot points for the trajectory guides, prior to aligning the alignment stem (MR protocol 4).

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
3.
Fig. 8

Fig. 8. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Final lead location as assessed on T1-weighted volumetric MR images. A: Axial image at 4 mm inferior to the commissures. B: Reformatted oblique image in the sagittal plane along the lead trajectory (MR protocol 8).

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
4.
Fig. 6

Fig. 6. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Rapid acquisition oblique coronal (A) and sagittal (B) images passing through the target and pivot point after the trajectory guide has been aligned (MR protocol 5). Black arrows show the predicted trajectory of the DBS lead.

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
5.
Fig. 9

Fig. 9. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Bar graph showing the distribution of lead tip errors (3D or vector error) in STN DBS placed using iMR imaging versus frame-based stereotaxy. Comparison data are from Starr et al., 2002.

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
6.
Fig. 1

Fig. 1. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Intraoperative photograph showing the position of the patient’s head in an MR-compatible headholder with placement of radiofrequency surface coils. The connection between the endotracheal tube and ventilator is led through the anterior coil. The posterior coil, placed under the headholder, is hidden under a towel.

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
7.
Fig. 3

Fig. 3. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Intraoperative photographs demonstrating surgical draping and trajectory guides. A: Patient’s head is shown at the back of the MR bore, with a sterile drape. B: Trajectory guides with alignment stems are shown. C: Trajectory guides with multilumen insert and peel-away sheath prior to advancing the sheath into the brain. The flexible radiofrequency receiving coils are covered with sterile blue towels.

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
8.
Fig. 7

Fig. 7. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

A and B: Axial T2-weighted MR images obtained 4 mm below the commissures, showing sheath and ceramic stylet assembly at target (MR protocol 3). Close up (B) showing the stylets in the target region, with the desired targets indicated by the centers of the white circles. The right lead has a radial error of 0.5 mm in the medial direction. The left lead has a radial error of 0.2 mm in the lateral direction.

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.
9.
Fig. 2

Fig. 2. From: Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy.

Magnetic resonance images showing the method of trajectory planning using reformatted oblique slices passing through the target, angled to exclude the lateral ventricle (MR protocol 1). A: First step. On a coronal plane passing through the target, an oblique sagittal plane is defined (white line) that avoids the lateral ventricle. B: Second step. The oblique sagittal plane selected in panel A is constructed on the MR console, and a safe trajectory (black line) to the target is planned.

Philip A. Starr, et al. J Neurosurg. ;112(3):479-490.

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