O'Kelly Cian J, Rempel Jeremy, Ashforth Rob, Darsaut Tim, Chow Michael
Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Department of Radiology, University of Alberta, Edmonton, Alberta, Canada.
World Neurosurg X. 2021 Dec 21;13:100116. doi: 10.1016/j.wnsx.2021.100116. eCollection 2022 Jan.
Micro-arteriovenous malformations (AVMs) can present challenges to neurosurgeons with respect to localization during resection. We sought to describe a novel method that merges super-selective 3-dimensional angiographic images with magnetic resonance imaging (MRI) sequences to facilitate frameless stereotaxic navigation during AVM surgery.
A retrospective analysis was performed comprising cases that employed merging of angiographic and MRI images for navigation purposes. Baseline clinical and imaging features were recorded. The technique and operative experiences were analyzed descriptively and presented alongside detailed illustrative cases.
During the review period, 11 cases were identified where this technique was employed. Successful image acquisition and merging was possible in all cases. Complete obliteration of the target pathology was achieved in all cases. Precise localization of the micro-AVMs minimized dissection in eloquent cortex.
Superselective 3-dimensional angiographic images merged to baseline MRI sequences facilitates planning and navigation during surgery for micro-AVMs.
对于神经外科医生而言，在切除过程中，微动静脉畸形（AVM）的定位可能具有挑战性。我们试图描述一种将超选择性三维血管造影图像与磁共振成像（MRI）序列相结合的新方法，以促进AVM手术中的无框架立体定向导航。
进行了一项回顾性分析，纳入了为导航目的而采用血管造影和MRI图像融合的病例。记录基线临床和影像学特征。对该技术和手术经验进行了描述性分析，并与详细的示例病例一起展示。
在回顾期间，确定了11例采用该技术的病例。所有病例均成功获取并融合了图像。所有病例均实现了目标病变的完全闭塞。微AVM的精确定位使在明确的皮质中的解剖操作减到最少。
与基线MRI序列融合的超选择性三维血管造影图像有助于微AVM手术期间的规划和导航。
