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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Preoperative 3D reconstruction of bridging veins from conventional MRI navigation sequences

Präoperative und dreidimensionale Rekonstruktion der Brückenvenen anhand herkömmlicher Navigationssequenzen

Meeting Abstract

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  • corresponding author Volker Arnd Coenen - Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
  • J. Halter - Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
  • P. Spangenberg - Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
  • S. Dammert - Neuroradiologie, Universitätsklinikum Aachen, Aachen
  • J. M. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
  • V. Rohde - Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 08.79

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0362.shtml

Published: April 23, 2004

© 2004 Coenen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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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.