Use of Three-Dimensional Curved-Multiplanar Reconstruction Images for Sylvian Dissection in Microsurgery of Middle Cerebral Artery Aneurysms.
10.3349/ymj.2017.58.1.241
- Author:
Taek Kyun NAM
1
;
Yong Sook PARK
;
Jun Soo BYUN
;
Seung Won PARK
;
Jeong Taik KWON
Author Information
1. Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea. cuttage@cau.ac.kr
- Publication Type:Original Article
- Keywords:
Aneurysm;
middle cerebral artery;
microsurgery;
dissection;
image reconstruction
- MeSH:
Adult;
Aged;
Cerebral Aqueduct/*surgery;
Female;
Humans;
Imaging, Three-Dimensional/*methods;
Intracranial Aneurysm/*surgery;
Male;
Microdissection/*methods;
Microsurgery/methods;
Middle Aged;
Middle Cerebral Artery/*surgery
- From:Yonsei Medical Journal
2017;58(1):241-247
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to introduce a method of using three-dimensional (3D) curved-multiplanar reconstruction (MPR) images for sylvian dissection during microsurgical treatment of middle cerebral artery (MCA) aneurysms. MATERIALS AND METHODS: Forty-nine patients who had undergone surgery for MCA aneurysms were enrolled. We obtained the 3D curved-MPR images along the sphenoid ridge using OsiriX MD™ imaging software, compared sylvian dissection time according to several 3D MPR image factors, and investigated the correlations between these images and intraoperative findings. RESULTS: Utilizing preoperative information of the sylvian fissure (SF) and peri-aneurysmal space on 3D curved-MPR images, we could predict the feasibility of sylvian dissection for a safe surgery. 3D curved-MPR images showed several features: first, perpendicular images to the sylvian surface in the same orientation as the surgeon's view; second, simultaneous visualization of the brain cortex, vessels, and cisternal space; and third, more accurate measurement of various parameters, such as depth of the MCA from the sylvian surface and the location and width of the SFs. CONCLUSION: In addition to conventional image studies, 3D curved-MPR images seem to provide useful information for Sylvian dissection in the microsurgical treatment of MCA aneurysms.
