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58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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A study on the venous anatomy in the living: Identification of venous variations in the pineal region with preoperative CT and MRI 3D-navigation using CT and MRI

Untersuchungen zur venösen Anatomie am Lebenden: Identifikation der Häufigkeit venöser Variationen im Bereich der Pinealisregion mit präoperativer 3D-CT und 3D-MRT-Navigation

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  • corresponding author W. O. Luedemann - International Neuroscience Institute, Klinik für Neurochirurgie, Hannover, Deutschland
  • M. Giordano - Seconda Universita´degli Studi di Napoli, Department of Neurosurgery, Italy
  • K. H. Wrede - International Neuroscience Institute, Klinik für Neurochirurgie, Hannover, Deutschland
  • L. H. Stieglitz - International Neuroscience Institute, Klinik für Neurochirurgie, Hannover, Deutschland
  • M. Samii - International Neuroscience Institute, Klinik für Neurochirurgie, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.10.09

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc202.shtml

Published: April 11, 2007

© 2007 Luedemann 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.

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Objective: To delineate the anatomy and variation patterns of the venous complex in the pineal region in preoperative MRI, we used software assisted 3-D-reconstruction with a neuronavigation system. Afterwards this data were compared with previous anatomical findings to show the resolution and accuracy of the system.

Methods: In retrospective we reviewed 100 patients with intracranial lesions (50 CT scans with contrast medium and 50 MRI scans with Gadolinium) using a 3D-neuronavigation workstation for reconstruction. Particular attention was paid to the Internal cerebral vein (ICV), basal vein (BV), vein of Galen, superior vermian veins complex (SVV) and internal occipital vein (IOV). The various connection patterns between the major vessels were classified and statistically analyzed.

Results: The venous system of the pineal region shows a wide range of variations. The distribution between the different types of drainage is similar to previous anatomical data. We visualized the ICV in 100% of the cases. The last part of the BV was depicted in 170 sites (85%), in the remaining 30 sides (15%) the BV was found not to be present. The SVV and its tributaries were delineated in 42 (42%) subjects and the IOV was depicted in 99 sites (49.5%). Thus, the ability for depicting even small vessels is similar to angiography. In females, the absence of the BV (type 0) is significantly more frequent than in males.

Conclusions: The study illustrates the possibility of depicting the venous drainage patterns in the pineal region for all studied cases utilizing 3D-neuronavigation software without the need of additional examinations. This tool provides important information for surgical planning.