Artikel
Intraoperative 3D ultrasound coregistered with rotational DSA data detects non-visible flow alterations during aneurysm surgery
Durch Fusion von intraoperativem 3D-Ultraschall mit dem Volumendatensatz einer präoperativen Rotationsangiographie können Flussänderungen im Rahmen von Aneurysmaoperationen auch in entfernten, operativ nicht einsehbaren Arealen detektiert werden
Suche in Medline nach
Autoren
-
M. Kirsch
- Klinik und Poliklinik für Neurochirurgie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
-
D. Podlesek
- Klinik und Poliklinik für Neurochirurgie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
-
T. Meyer
- Klinik und Poliklinik für Neurochirurgie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
-
O. Sergeeva
- Klinik und Poliklinik für Neurochirurgie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
-
U. Morgenstern
- Institut für Biomedizinische Technik, Technische Universität Dresden
-
G. Schackert
- Institut für Biomedizinische Technik, Technische Universität Dresden
| Veröffentlicht: | 11. April 2007 |
|---|
Gliederung
Text
Objective: The intraoperative assessment of all relevant vessels during aneurysm clipping is often difficult. The purpose of our study is to evaluate the use of high-resolution 3D ultrasound imaging during vascular procedures as well as the coregistration of preoperative imaging data with intraoperative ultrasound data.
Methods: Intraoperative ultrasound was used in 12 cases of anterior or middle cerebral artery aneurysms to visualize the vascular tree before and after clipping. Volume scans were obtained using the Voluson 730 ultrasound system (GE Healthcare, formerly Kretz) and a 5-9 MHz-probe. Three-dimensional reconstruction was performed using the integrated workstation and an external computer for matching of preoperatively obtained rotational DSA volume data and intraoperative ultrasound Doppler data. In addition, velocity measurements were monitored by conventional microdoppler (16 MHz micro-Doppler probe, diameter 1 mm, DWL). To validate intraoperative findings, post-operative control-DSA results were matched with the intraoperative ultrasound 3D volume.
Results: Intraoperative velocity was easily assessed by 3D-doppler ultrasonography and correlated well with conventional microdoppler recordings. All vessels were identifiable and amendable to flow and Doppler assessment. Even those vessel that were not in the operative field, behind the aneurysm, or within the parenchyma were analysed. Matching with the preoperative rDSA facilitated the correct anatomical analyses of the ultrasound data.
Conclusions: This study demonstrates the value of intraoperative 3D ultrasound to visualize all pertinent vessels before and after aneurysm clipping. This technique allows parallel assessment of blood velocity and of 3D vessel configuration. Although resolution is lower than for standard DSA, this method provides immediate intraoperative feedback of the perfusion status of all vessels including penetrating vessels. However, even three-dimensional ultrasound and the reconstruction of 3D-doppler data is difficult to interprete. Only concomitant fusion and coregistration to the rDSA data allowed for detailed analyses of the reconstructed vessel tree.
