In this paper, we describe a study on visualization of SW atlases. Firstly, data structures in axial, coronal and sagittal directions are generated by SW atlases' raw data after pre-processing. Secondly, we produce 3D SW atlases through setting gray intensity and spaces between slices. Thirdly, we integrate the atlas into the neurosurgery navigation system and realize the visualization of SW atlases. Finally, we realize brain anatomy structures labeling and real-time display in neurosurgery navigation system.
Anatomy, Artistic ; Brain Mapping ; Humans ; Neuronavigation ; methods ; Neurosurgery ; methods

OBJECTIVETo review the history, development, and reality of neuronavigation surgery in China and to discuss the future of neuronavigation surgery.

DATA SOURCESPubMed, the China Knowledge Resource Integrated Database, and the VIP Database for Chinese Technical Periodicals were searched for papers published from 1995 to the present with the key words "neuronavigation," functional navigation," "image-guided," and "stereotaxy." Articles were reviewed for additional citations, and some information was gathered from Web searches.

STUDY SELECTIONArticles related to neuronavigation surgery in China were selected, with special attention to application to brain tumors.

RESULTSSince the introduction of neurosurgical navigation to China in 1997, this core technique in minimally invasive neurosurgery has seen rapid development. This development has ranged from brain structural localization to functional brain mapping, from static digital models of the brain to dynamic brain-shift compensation models, and from preoperative image-guided surgery to intraoperative real-time image-guided surgery, and from application of imported equipment and technology to use of equipment and technology that possess Chinese independent intellectual property rights.

CONCLUSIONSThe development and application of neuronavigation techniques have made neurological surgeries in China more safe, precise and effective, and less invasive, and promoted the quality of Chinese neurosurgical practice to the rank of the most advance and excellence in the world.

Animals ; Brain ; pathology ; China ; Humans ; Neuronavigation ; methods ; Neurosurgical Procedures ; methods

At present, navigation path deviation caused by brain shift is the main factor that affects the accuracy of neurosurgical navigation. A new method of near infrared spectroscopy (NIRS) based neurosurgical navigation is presented in the paper. The correlation between NIRS optical parameters and medical image is used and the gray information of navigation path is regarded as the priori knowledge, sample-points curvatures are calculated by Hermite interpolation and the Mean Hausdorff distance as measurement criterion is used to match feature segments, then the real-time correction model is established. The algorithm of the given model is simple and can realize the best match within the error, it provides an effective method for real-time navigation path correction.
Algorithms ; Artificial Intelligence ; Calibration ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Neuronavigation ; methods ; Spectroscopy, Near-Infrared ; methods ; Surgery, Computer-Assisted ; methods

BACKGROUNDDespite the presigmoid transpetrosal approach has been used by different researchers in various ways, the surgical injury rate remains high. Applying a minimally invasive keyhole idea, we devised a presigmoid transpetrosal keyhole approach (PTKA), classified and quantitatively assessed their approach to the petroclival area on a cadaver model by using a neuronavigation system.

METHODSThe presigmoid transpetrosal keyhole approach was divided into four increasingly morbidity-producing steps: retrolabyrinthine, partial labyrinthectomy with petrous apicectomy, translabyrinthine and transcochlear keyhole approaches. Six latex-injected cadaveric heads (twelve sides) underwent dissection in which a neuronavigation system was used. An area of exposure 10 cm superficial to a central target (working area) was calculated. The area of clival exposure with each subsequent dissection was also calculated.

RESULTSThe retrolabyrinthine keyhole approach (RLK) spares hearing and facial function in theory but provides for only a small window of upper clival exposure. The view afforded by partial labyrinthectomy with petrous apicectomy keyhole approach (PLPAK) provides for up to four times this exposure. The translabyrinthine keyhole approach (TLK) and transcochlear keyhole approach (TCK), although producing more morbidity, add little in terms of a larger petroclival window. However, with each step, the surgical freedom for manipulation of instruments increases.

CONCLUSIONSThe presigmoid transpetrosal keyhole approach to the petroclival area is feasible and useful. The RLK has relatively limited utility. For lesions without bone invasion, the PLPAK provides a much more versatile exposure with an excellent chance of hearing and facial nerve preservation. The TLK provides for greater versatility in treating lesions but clival exposure is not greatly enhanced. The TCK adds little in terms of intradural exposure but should be reserved for cases in which access to the petrous carotid artery is necessary.

Cadaver ; Cranial Fossa, Posterior ; surgery ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Neuronavigation ; Petrous Bone ; surgery

BACKGROUNDImage-guided neurosurgery, endoscopic-assisted neurosurgery and the keyhole approach are three important parts of minimally invasive neurosurgery and have played a significant role in treating skull base lesions. This study aimed to investigate the potential usefulness of coupling of the endoscope with the far lateral keyhole approach and image guidance at the ventral craniocervical junction in a cadaver model.

METHODSWe simulated far lateral keyhole approach bilaterally in five cadaveric head specimens (10 cranial hemispheres). Computed tomography-based image guidance was used for intraoperative navigation and for quantitative measurements. Skull base structures were observed using both an operating microscope and a rigid endoscope. The jugular tubercle and one-third of the occipital condyle were then drilled, and all specimens were observed under the microscope again. We measured and compared the exposure of the petroclivus area provided by the endoscope and by the operating microscope. Statistical analysis was performed by analysis of variance followed by the Student-Newman-Keuls test.

RESULTSWith endoscope assistance and image guidance, it was possible to observe the deep ventral craniocervical junction structures through three nerve gaps (among facial-acoustical nerves and the lower cranial nerves) and structures normally obstructed by the jugular tubercle and occipital condyle in the far lateral keyhole approach. The surgical area exposed in the petroclival region was significantly improved using the 0° endoscope (1147.80 mm(2)) compared with the operating microscope ((756.28 ± 50.73) mm(2)). The far lateral retrocondylar keyhole approach, using both 0° and 30° endoscopes, provided an exposure area ((1147.80 ± 159.57) mm(2) and (1409.94 ± 155.18) mm(2), respectively) greater than that of the far lateral transcondylar transtubercular keyhole approach ((1066.26 ± 165.06) mm(2)) (P < 0.05).

CONCLUSIONSWith the aid of the endoscope and image guidance, it is possible to approach the ventral craniocervical junction with the far lateral keyhole approach. The use of an angled-lens endoscope can significantly improve the exposure of the petroclival region without drilling the jugular tubercle and occipital condyle.

Adult ; Endoscopes ; Humans ; Neuronavigation ; methods ; Skull Base ; anatomy & histology ; surgery ; Surgery, Computer-Assisted

Surgical navigation system is a system that processes medical images by computer graphics and image processing technique, reconstructs 2D or 3D medical image models. It builds a real-time loop among the eyes of doctor, the surgical device and the head of patient by several of space localization technique, so that to realize displaying the localization of surgical devices real-time. The history and research status of surgical navigation system is summarized and the system configuration and the key techniques are expatiated emphatically in this paper. The key techniques include localization in space, image processing and displaying technique, system registration technique and head location technique. At last the progress direction of navigation systems is given.
Computer Graphics ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Neuronavigation ; methods ; Stereotaxic Techniques ; Surgery, Computer-Assisted ; methods

OBJECTIVETo analyze the anesthetic management for neurosurgery using intraoperative magnetic resonance imaging (iMRI).

METHODSThirty patients with intracranial tumor received MRI for preoperative safety screening and the operation was performed with general anesthesia and support by MRI-compatible machines. The operative time, frequency and duration of MRI, MRI-related time (from the preparation for MRI to the beginning of the surgery), time delay by MRI, body temperature at the initial iMRI and special issues related to the scanning and perioperative anesthesia were recorded.

RESULTSThirty patients successfully completed the operations without any incidents related to anesthesia or scanning. The mean frequency of MRI was 1.8, the mean duration of MRI was 29.24 ∓ 10.10 min, and the MRI-related time was 43.83 ∓ 10.23 min; the time delay MRI was 92.63 ∓ 28.31 min, and the body temperature was significantly higher at 2 h after MRI than that after induction.

CONCLUSIONIn the anesthetic management for neurosurgery with iMRI, the anesthesiologists should focus on the safety precaution and anesthetic modulation according to the special environment and procedure of iMRI.

Adolescent ; Adult ; Anesthesia ; methods ; Brain Neoplasms ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Monitoring, Intraoperative ; instrumentation ; methods ; Neuronavigation ; methods ; Neurosurgery ; Neurosurgical Procedures ; methods ; Young Adult

OBJECTIVETo evaluate the utility of neuronavigation in the microsurgery for cerebral cavernous malformations.

METHODSIn a retrospective study, 47 patients with cavernous malformations were involved from January 1995 to December 2010. Fourteen cases admitted into hospital from January 1995 to December 2002 were treated without neuronavigation (conventional group), the focus localization was based on magnetic resonance imaging (MRI) images, anatomic landmarks, and the experiences of the neurosurgeon. In the other 33 cases admitted after February 2002 to December 2010, surgeries were performed with neuronavigation using the Medtronic Stealth Station TREON or TRIA system (neuronavigation group). Excision of the cavernomas were all performed microsurgically, surrounding gliotic rim and hemosiderin stained tissue were resected in the case of epilepsy, and a few patients underwent extended hippocampal resection or multiple subpial transection.

RESULTSWith the use of neuronavigation, the extent of craniotomy reduced from 5.2 cm to 3.6 cm (P < 0.01), and deeper cavernoma focuses could be treated surgically. There were no changes with regard to the mean size of the cavernomas, the mean time of surgery and hospital stay (P > 0.05), but the mean time of anaesthesia was prolonged from 164 min to 197 min (P < 0.01). Cavernomas were resected completely in all 47 cases, which was confirmed by postoperative MRI recheck. The conditions of all patients were improved or remain unchanged, and no significant differences in the clinical outcome could be evaluated between the two groups.

CONCLUSIONSApplication of neuronavigation-assisted microsurgery of intracranial cavernous malformations surgery, helps reduce the surgical trauma, and has security and reliability.

Adolescent ; Adult ; Female ; Hemangioma, Cavernous, Central Nervous System ; surgery ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Neuronavigation ; Retrospective Studies ; Young Adult

OBJECTIVETo evaluate the applied value of magnetoencephalography (MEG) localization in microsurgery of brain tumors in the region of motor cortex.

METHODSFrom January 2003 to April 2005, 36 patients with 19 meningomas, 14 gliomas, 2 metastases and 1 cavernous angioma underwent MEG and MRI before operation. These individualized functional brain maps were integrated into a neuronavigation system. Preoperative mapping of somatosensory and/or motor cortex was performed, and sites were compared, and all tumors were resected microsurgerically.

RESULTSA space-occupying lesion could change the region of motor cortex in all the patients. Thirty-four cases were resected totally. The patient's myodynamia after operation improved in 19 cases, unchanged in 15 cases, descended in 2 cases.

CONCLUSIONSMEG is an effective localization method of function, providing the relationship between the region of motor cortex and the tumor. And it is valuable for accurate planning in the treatment of brain tumors in the region of motor cortex.

Adolescent ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; surgery ; Female ; Humans ; Magnetoencephalography ; Male ; Microsurgery ; Middle Aged ; Neuronavigation ; Neurosurgical Procedures ; methods ; Treatment Outcome

Image guided surgery (IGS) means that computers are used for modeling the position of patients and providing the surgeons with image guidance for invasive procedures. In this paper, we introduce the composition and the work flow of IGS, analyze the process and principle of Registration, which is regarded as a process to combine the actual position of patients and the visual position of models. Seeing that the precision of the registration determines the precision of the IGS system directly, we conduct a study on the registration algorithm precision, feasibility as well as robustness. Combined with the actual requirements in clinical IGS, we also analyze the influence of changes in the number and position of markers on registration precision.
Algorithms ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; methods ; Neuronavigation ; Pattern Recognition, Automated ; methods ; Stereotaxic Techniques ; Surgery, Computer-Assisted