Musolino A, Munari C, Betti O, Landre E, Broglin D, Demierre B, Missir O, Daumas-Duport C, Chodkiewicz J P
Rev Electroencephalogr Neurophysiol Clin. 1987 Mar;17(1):11-24. doi: 10.1016/s0370-4475(87)80111-9.
The neuroradiological stereotactic examinations provide indispensable information to localize many intracranial lesions: the data obtained by the CT-Scan are complementary of the stereotactic ones. The transfer of the routine CT-Scan transverse axial slices into the Talairach stereotactic system needs a precise definition of the inclination of the plan of the slices and a correct evaluation of the mean magnification factor. The inclination of the slices is appreciated using the bony, vascular and ventricular landmarks clearly identified on the CT-Scan and stereoscopic stereotactic images. We compared the spatial "reconstructed" CT-Scan data with the histopathological findings obtained by serial stereotactic biopsies in 48 tumor patients. The error varied from 1.5 to 4.6% (m: 2.7 +/- 1.2) on the sagittal plane; from 1.3 to 10% (m: 5.8 +/- 3.4) on the transversal plane; from 2.5 to 4.3% (m: 3.5 +/- 0.7) on the axial plane. The mean global error was 3.7% +/- 2.3. The CT-Scan directly performed under stereotactic conditions (acrylic frame) seems to be the more useful procedure. Nevertheless considering the good precision obtained with our methodology applied to the Talairach's system, we consider it suitable when: a) the gantry of the CT-Scan apparatus is too narrow for the acrylic frame; b) the exploitation of previous CT-Scan examinations is necessary; c) patient refuses the discomfort of the acrylic frame.
CT扫描所获得的数据与立体定向数据互补。将常规CT扫描的横向轴向切片转换到Talairach立体定向系统需要精确确定切片平面的倾斜度并正确评估平均放大倍数。利用在CT扫描和立体定向立体图像上清晰识别的骨骼、血管和脑室标志来判断切片的倾斜度。我们将48例肿瘤患者经连续立体定向活检获得的组织病理学结果与空间“重建”的CT扫描数据进行了比较。矢状面上的误差在1.5%至4.6%之间(平均值:2.7±1.2);横断面上的误差在1.3%至10%之间(平均值:5.8±3.4);轴向上的误差在2.5%至4.3%之间(平均值:3.5±0.7)。平均总体误差为3.7%±2.3。在立体定向条件下(丙烯酸框架)直接进行的CT扫描似乎是更有用的方法。然而,考虑到我们应用于Talairach系统的方法所获得的良好精度,我们认为在以下情况下它是合适的:a)CT扫描设备的机架对于丙烯酸框架来说太窄;b)有必要利用先前的CT扫描检查;c)患者拒绝使用丙烯酸框架带来的不适。