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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Combination of multimodal intraoperative imaging for functional monitoring during surgery in eloquent regions: fusion of neuronavigation, intraoperative ultrasound and neuromonitoring

Kombinierung verschiedener intraoperativer Bildgebungs- und Monitoringtechniken bei Operationen in eloquenten Hirnarealen durch Fusion von Neuronavigation, intraoperativem Ultraschall und Neuromonitoring

Meeting Abstract

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  • corresponding author D. M. Schulte - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • W. Tirakotai - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • T. Riegel - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • U. Sure - Klinik für Neurochirurgie, Philipps-Universität Marburg
  • H. Bertalanffy - Klinik für Neurochirurgie, Philipps-Universität Marburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP043

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0311.shtml

Published: May 4, 2005

© 2005 Schulte 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

Text

Objective

Surgery in eloquent regions of the brain remains a challenge because of the pronounced risk of postoperative deficit. Application of all available information, intraoperative availability and combination of different modalities might provide the means for more acurate surgery.

Methods

A newly developed device enables intraoperative fusion of realtime ultrasound images with the high resolution and the well known display of the neuronavigation system. Incorporation of functional data like fMRI or ECOG as well as marking of phase reversal at the central sulcus or position marking of subdural electrodes is possible.

Results

This combined method was especially helpful in tumors and vascular or epileptogenic lesions near eloquent regions. The critical cortical areas and surrounding vessels could be reliably displayed in the neuronavigation data, changes due to brain shift were updated by the fusion with intraoperative ultrasound. The prevention of a neurological deficit after resection of lesions in or next to eloquent regions was possible. Fusion and integration of anatomical and functional data can easily be obtained and requires only minor additional effort of time and equipment.

Conclusions

Integration of the different modalities provides a synergism in addition to the combination of information alone. The anatomical, functional or intraoperative potency of the different methods complement one another beneficially. A better postoperative result compensates the increased intraoperative effort.