Magnetic resonance artifact induced by the electrode Activa 3389: an in vitro and in vivo study

Background. The electrode Activa 3389 is widely implanted for deep brain stimulation (DBS) and MRI is often used to control the position of the electrode. However, induced distorsion artifacts may result in imprecise localization and may lead to misinterpretations of the clinical effects and mechanisms of DBS. Methods. In vitro 3D MR study: the proximal and distal contacts of one electrode were spotted by two localizers. The maximal artifact height (MAH) and width (MAW: measured on distal contact), and the distances between the artifact and the localizers (proximal, distal and lateral) were measured on 2 transverse and sagittal MR sequences with 90 degrees rotation of frequency-encoded gradient and phase direction. In vivo 3D MR study: coronal and sagittal reconstructions along the main axis of the electrode were performed on 10 postoperative MR (20 electrodes) to measure MAH and MAW. A Student t test was used to compare in vitro and in vivo measurements. Findings. In vitro study: A MAH of 10.35 mm (+/-0.23) and MAW of 3.6 mm (+/-0.2) were found. We measured symmetrical extensions of the artifact over the distal contact. In vivo study: A MAH of 10.36 mm (+/-0.44) and MAW of 3.56 mm (+/-0.30) were obtained. No significant different artifact dimensions were measured between in vitro and in vivo studies (p<0.0001). Interpretation. Precise 3D localization of the electrode in implanted patients is provided by MR identification of the limits of the distal contact artifact. The position of the other contacts is deduced given the size of the contacts and the intercontact distance.