Abstract：
To analyze the relationship between trajectory-skull angle and stereoelectroencephalography electrode implantation accuracy in drug-resistant epilepsy patients, aiming to guide clinical electrode placement and enhance surgical precision and safety.
We conducted a retrospective analysis of medical records and surgical characteristics of 32 consecutive patients diagnosed with drug-resistant epilepsy, who underwent stereoelectroencephalography procedures at our center from June 2020 to June 2023. To evaluate the accuracy of electrode implantation, we utilized preoperative and postoperative computed tomography scans fused with SinoPlan software-planned trajectories. Entry radial error and target vector error were assessed as measurements of electrode implantation accuracy.
After adjusting for confounders, we found a significant positive correlation between trajectory-skull angle and entry radial error (β = 0.02, 95% CI: 0.01-0.03, P < 0.001). Likewise, a significant positive correlation existed between trajectory-skull angle and target vector error in all three models (β = 0.03, 95% CI: 0.01-0.04, P < 0.001). Additionally, a U-shaped relationship between trajectory-skull angle and target vector error was identified using smooth curve fitting. This U-shaped pattern persisted in both frame-based and robot-guided stereotactic techniques. According to the two-piecewise linear regression model, the inflection points were 9° in the frame-based group and 16° in the robot-guided group.
This study establishes a significant positive linear correlation between trajectory-skull angle and entry radial error, along with a distinctive U-shaped pattern in the relationship between trajectory-skull angle and target vector error. Our findings suggest that trajectory-skull angles of 9° (frame-based) and 16° (robot-guided) may optimize the accuracy of target vector error.
We conducted a retrospective analysis of medical records and surgical characteristics of 32 consecutive patients diagnosed with drug-resistant epilepsy, who underwent stereoelectroencephalography procedures at our center from June 2020 to June 2023. To evaluate the accuracy of electrode implantation, we utilized preoperative and postoperative computed tomography scans fused with SinoPlan software-planned trajectories. Entry radial error and target vector error were assessed as measurements of electrode implantation accuracy.
After adjusting for confounders, we found a significant positive correlation between trajectory-skull angle and entry radial error (β = 0.02, 95% CI: 0.01-0.03, P < 0.001). Likewise, a significant positive correlation existed between trajectory-skull angle and target vector error in all three models (β = 0.03, 95% CI: 0.01-0.04, P < 0.001). Additionally, a U-shaped relationship between trajectory-skull angle and target vector error was identified using smooth curve fitting. This U-shaped pattern persisted in both frame-based and robot-guided stereotactic techniques. According to the two-piecewise linear regression model, the inflection points were 9° in the frame-based group and 16° in the robot-guided group.
This study establishes a significant positive linear correlation between trajectory-skull angle and entry radial error, along with a distinctive U-shaped pattern in the relationship between trajectory-skull angle and target vector error. Our findings suggest that trajectory-skull angles of 9° (frame-based) and 16° (robot-guided) may optimize the accuracy of target vector error.
摘要：
目的：分析耐药性癫痫患者的轨迹-颅骨角度与立体脑电图（SEEG）电极植入准确性之间的关系，旨在指导临床电极放置，提高手术精度和安全性。
方法：我们对32例连续诊断为耐药性癫痫的患者的病历和手术特点进行了回顾性分析，他们于2020年6月至2023年6月在我们中心接受了SEEG程序。为了评估电极植入的准确性，我们利用术前和术后CT扫描融合SinoPlan软件计划轨迹.评估进入径向误差和目标矢量误差作为电极植入精度的测量值。
结果：调整混杂因素后，我们发现轨迹-颅骨角度与进入径向误差之间存在显着正相关（β=0.02，95％CI：0.01-0.03，P<0.001）。同样，在所有三个模型中，轨迹-颅骨角度与目标矢量误差之间存在显着正相关（β=0.03，95％CI：0.01-0.04，P<0.001）。此外,使用平滑曲线拟合确定了轨迹-颅骨角度与目标矢量误差之间的U形关系。这种U形模式在基于框架和机器人引导的立体定向技术中都持续存在。根据两分段线性回归模型，在基于框架的组中，拐点为9°，在机器人引导组中为16°。
结论：这项研究建立了轨迹-颅骨角度与进入径向误差之间的显着正线性相关，以及轨迹-头骨角度与目标矢量误差之间的关系中独特的U形图案。我们的发现表明，9°（基于框架）和16°（机器人引导）的轨迹-头骨角度可以优化目标矢量误差的准确性。
方法：我们对32例连续诊断为耐药性癫痫的患者的病历和手术特点进行了回顾性分析，他们于2020年6月至2023年6月在我们中心接受了SEEG程序。为了评估电极植入的准确性，我们利用术前和术后CT扫描融合SinoPlan软件计划轨迹.评估进入径向误差和目标矢量误差作为电极植入精度的测量值。
结果：调整混杂因素后，我们发现轨迹-颅骨角度与进入径向误差之间存在显着正相关（β=0.02，95％CI：0.01-0.03，P<0.001）。同样，在所有三个模型中，轨迹-颅骨角度与目标矢量误差之间存在显着正相关（β=0.03，95％CI：0.01-0.04，P<0.001）。此外,使用平滑曲线拟合确定了轨迹-颅骨角度与目标矢量误差之间的U形关系。这种U形模式在基于框架和机器人引导的立体定向技术中都持续存在。根据两分段线性回归模型，在基于框架的组中，拐点为9°，在机器人引导组中为16°。
结论：这项研究建立了轨迹-颅骨角度与进入径向误差之间的显着正线性相关，以及轨迹-头骨角度与目标矢量误差之间的关系中独特的U形图案。我们的发现表明，9°（基于框架）和16°（机器人引导）的轨迹-头骨角度可以优化目标矢量误差的准确性。
