gms | German Medical Science

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

Intraoperative observation of pial microcirculation during brain tumor surgery using orthogonal polarisation spectral imaging

Intraoperative Analyse der pialen Mikrozirkulation während der Operation von Hirntumoren mit dem Orthogonal Polarisation Spectral Imaging-Verfahren

Meeting Abstract

  • corresponding author Eberhard Uhl - Neurochirurgische Klinik, Ludwig-Maximilians-Universität, München
  • J. Lehmberg - Neurochirurgische Klinik, Albert-Ludwigs-Universität, Freiburg
  • H.-J. Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität, Düsseldorf
  • K. Messmer - Institut für Chirurgische Forschung, Ludwig-Maximilians-Universität, München

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 08.87

The electronic version of this article is the complete one and can be found online at:

Published: April 23, 2004

© 2004 Uhl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Aim of the current study was to test the feasibility of the orthogonal polarisation spectral imaging (OPSTM) for observation of pial microcirculation during neurosurgical procedures


9 patients (8 male, 1 female, mean age 48.7±13 years) with a malignant brain tumor (5 glioblastomas, 4 astrocytomas WHO III) were included in the study. Intraoperative intravital microscopy was performed using the CYTOSCANTM A/R (Cytometrics Inc., Philadelphia, PA, U.S.A.) equipped with a lens of 5x magnification and a CCD camera. The technique allows visualisation of haemoglobin-carrying structures. Online observations of the microvessels of the brain were performed immediately after opening the dura and after resection of the tumor at 5 sites of interest adjacent to the tumor edge. The images were stored on video tape for off-line analysis of vessel diameters, red blood cell velocity and functional capillary density.


Initial functional capillary density was 80.3±7.8cm-1 (mean±SEM) and increased after resection of the tumor to 113.7±11.2 cm-1. The venuous diameters increased slightly from 39.7±3.0 to 55.0±15.4 μm. Arteriolar diameters remained unchanged. The number of venules with a red blood cell velocity under2mm/s increased from 34.4% to 54.0% indicating a better venous outflow after resection of the tumor.


CYTOSCANTM A/R is a suitable device for intraoperative observation of human brain microcirculation. Our data indicate that microcirculatory perfusion increases after removal of the tumor either because of the reduced local compression, the surgical manipulation or the loss of cerebrospinal fluid. Whether the technique would be useful for monitoring of microcirculatory parameters during other procedures such as temporary clipping in aneurysm surgery or resection of arteriovenous malformations remains to be elucidated.