Figure 1
(a) CT-scan originally done during the work-up process. (b) T2-weighted Axial MRI demonstrating the AVM at the right frontal lobe. (c) T1-weighted sagittal MRI of the AVM at the right frontal lobe. (d) T1-weighed coronal MRI of the AVM at the right frontal lobe.
Figure 2
A and B depicts the procedural demonstration of transducer element summaries with the no pass zones of the AVM outlined in red. C depicts the subsequent postoperative T2-weighted axial MRI demonstrating the thalamotomy lesion in the right thalamus. Images D and E are post-procedural susceptibility weighted imaging demonstrating an unchanged right frontal AVM (D) and the right thalamotomy (E), with no additional evidence of hemorrhage.
Table 1
The operative characteristics of the MRI-guided focused ultrasound procedures at the initial stage and the second stage at postoperative day five.
| SONICATION NUMBER | TARGET COORDINATES | PROCEDURE STEP | SONICATION PARAMETERS | PRESCRIBED DOSE (J) | DELIVERED DOSE (J) | AVERAGE TEMPERATURE (°C) | MAXIMUM TEMPERATURE (°C) | |||
|---|---|---|---|---|---|---|---|---|---|---|
| X | Y | Z | POWER (W) | TIME (s) | ||||||
| 1 | 15 | 7.5 | 1.5 | align | 192 | 12 | 2,200 | 2,217 | 43 | 44 |
| 2 | 15 | 7.5 | 1.5 | align | 290 | 12 | 3,300 | 3,316 | 43 | 44 |
| 3 | 15 | 7.5 | 1.5 | align | 336 | 12 | 3,850 | 3,881 | 44 | 49 |
| 4 | 15 | 7.5 | 1.5 | align | 335 | 14 | 4,550 | 4,099 | 47 | 52 |
| 5 | 15 | 8.5 | 1.5 | verify | 578 | 16 | 8,400 | 8,458 | 50 | 51 |
| 6 | 15 | 8.5 | 1.5 | verify | 605 | 7 | 12,350 | 43,335 | 40 | 39 |
| 7 | 15 | 8.5 | 1.5 | verify | 635 | 20 | 12,350 | 12,289 | 52 | 55 |
| 8 | 15 | 8.5 | 1.5 | treat | 818 | 36 | 28,798 | 28,830 | 56 | 57 |
| 9 | 15 | 9.5 | 3 | treat | 817 | 39 | 31,339 | 31,343 | 52 | 55 |
Figure 3
The left panel demonstrates the preoperative evaluation of the patient’s tremors. The right panel demonstrates the patient’s one-year postoperative display improvement with decreased intrusions.