Artikel
Preoperative 3D reconstruction of bridging veins from conventional MRI navigation sequences
Präoperative und dreidimensionale Rekonstruktion der Brückenvenen anhand herkömmlicher Navigationssequenzen
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Autoren
Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
To investigate the usefullness of the preoperative reconstruction of bridging veins for planning midline surgical approaches.
Methods
10 patients with lesions close to the midline were operated microneurosurgically. Preoperatively, a standard Gadolinium enhanced navigation sequence of the cranium was obtained that covered head, brain, and the attached surface radiographic fiducials (3DFFE, 2mm, axial, 75 slices). The data were transferred to a navigation system. A 3D reconstruction of the superficial veins, brain and tumor was obtained using the volume-rendering mode. Based on two-dimensional triplanar views (axial, coronal, sagittal) the surgeon had to define the surgical approach based on the topography of the cortical bridging veins. He further had to define a second path, based on the additional information from the three-dimensional reconstruction. Changes in the surgical approaches were noted. To further investigate the feasibility of the system to visualize bridging veins from standard MRI navigation sequences on a regular basis, we reviewed 135 additional navigation sequences that had been used during operations between 2001 and 2003.
Results
In over 95% of the reviewed navigation sequences, the visualization of the bridging veins was possible. In 4 out of 10 patients (40%), the preoperative information about bridging veins’ anatomy led to a change of the surgical path to the lesion.
Conclusions
Reconstruction of bridging veins may be superior to MR angiography and conventional angiography, since it displays the tumour and the venous anatomy simultaneously and can be rotated according to the patient’s placement in the operating room. 3-D reconstruction of the bridging veins has the potential to reduce surgical morbidity.