Prediction of Surgical View of Neurovascular Decompression Using Interactive Computer Graphics

Kin, Taichi; Oyama, Hiroshi; Kamada, Kazuhiro; Aoki, Shigeki; Ohtomo, Kuni; Saito, Nobuhito

doi:10.1227/01.neu.0000347890.19718.0a

Cited by 64 publications

(35 citation statements)

References 18 publications

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“…To diagnose this type of neurovascular compression, the use of an advanced 3D MFVI technique was useful and reliable. Although numerous reports have suggested 3D imaging analysis based on MRI data for the evaluation of NVC [11][12][13][14][15][16] , we present the first report of an attempt to use 3D MFVI with the integration of arterial and venous information obtained by MDCT. Presently, this analysis must be the best method to visualize the precise 3D anatomy consisting of cranial nerves and vasculatures in the cistern.…”

Section: Discussionmentioning

confidence: 99%

“…Especially in MVD surgery, precise knowledge of structural relations in the cistern of the CPA region is required because of numerous variations in the microsurgical anatomy of this region in individual patients. Several authors employed and developed the 3D imaging techniques in the presurgical evaluation for MVD [11][12][13][14][15][16] . Recently, the quality of imaging has improved to a greater extent than before [12,16] .…”

Section: Discussionmentioning

confidence: 99%

“…Application of the recent 3-dimensional (3D) image-analyzing techniques has enabled a precise understanding of the anatomical relationship of structures in the cerebellopontine angle (CPA) region, which was difficult to understand from 2-dimensional (2D) images [11][12][13][14][15][16] . Recently, 3D computed tomographic angiography (CTA) with a multidetector row CT (MDCT) system has been used to demonstrate the 3D vascular information of the arterial and venous phase separately [17,18] .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Trigeminal Neuralgia Associated with the Specific Bridging Pattern of Transverse Pontine Vein: Diagnostic Value of Three-Dimensional Multifusion Volumetric Imaging

Oishi

Fukuda

Noto

et al. 2011

Stereotact Funct Neurosurg

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Objectives: We report the specific bridging pattern of a transverse pontine vein (TPV) associated with trigeminal neuralgia (TN), which was evaluated by 3-dimensional (3D) multifusion volumetric imaging (MFVI). Methods: In 3 cases with TN (V1 or V1–2 territory), constructive interference in steady state (CISS) imaging confirmed no arterial compression but indicated a vein draining into Meckel’s cave. Virtual endoscopic (VE) analysis for CISS images and 3D MFVI (in 2 cases) including venous information was obtained by a multidetector row computed tomography (MDCT) system. Additionally, we investigated the bridging pattern of veins around Meckel’s cave on 3D MFVI of 50 cerebellopontine angle (CPA) regions without any lesions. Results: In all 3 patients, VE of CISS or 3D MFVI identified a bridging vein from the TPV causing the focal deformity of the trigeminal nerve near Meckel’s cave. All those patients achieved a pain-free state after surgically coagulating and cutting the vein. In investigating 3D MFVI of 50 CPA regions, this type of the bridging vein was found in 4 (8%) including the presented 2 cases. Conclusions: The specific bridging pattern of the TPV draining into Meckel’s cave can be associated with TN. The 3D MFVI analysis using venous information obtained by MDCT was useful to evaluate surgical anatomy including the offending vein which can be missed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trigeminal Neuralgia Associated with the Specific Bridging Pattern of Transverse Pontine Vein: Diagnostic Value of Three-Dimensional Multifusion Volumetric Imaging

Oishi

Fukuda

Noto

et al. 2011

Stereotact Funct Neurosurg

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“…Combination of such 3D images can provide very useful virtual reality simulations for surgical procedures. 13) Currently, we can create an actual-sized elastic hollow model of individual aneurysms from the preoperative 3D images. These models were very useful in deciding how to apply clips to occlude the closure line of the aneurysm and combination of aneurysm clips for complex-shaped aneurysms.…”

Section: Standards In Managing Unruptured Intracranial Aneurysmsmentioning

confidence: 99%

Unruptured Intracranial Aneurysms: Current Perspectives on the Origin and Natural Course, and Quest for Standards in the Management Strategy

Morita

Kimura

Shojima

et al. 2010

Neurol. Med. Chir.(Tokyo)

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Unruptured intracranial aneurysms are relatively common, and can cause subarachnoid hemorrhage. Management of unruptured intracranial aneurysms requires knowledge of the natural course and management risks of individual aneurysms. Current knowledge on the natural course and management risks is summarized and our current management strategy presented. Extensive literature review was conducted to identify risk factors influencing the natural course and management outcome of unruptured intracranial aneurysms. Our consecutive surgical series from October 2006 through June 2009 were reviewed retrospectively. The risk factors for rupture were size and location, as well as history of subarachnoid hemorrhage in small aneurysms. Management morbidity was significantly influenced by the size, location, and patient's age. Since 2006, we have monitored motor evoked potentials in all surgeries of cerebral aneurysms and utilized endoscope control, and skull base and bypass techniques in selected cases. In 133 consecutive surgeries, two patients (1.5%) suffered severe neurological morbidity. Unruptured intracranial aneurysms have various clinical characteristics and we need to stratify management strategy according to the aneurysm features such as size, location, shape, and patient's clinical status. In Japan, with national efforts to elevate management standards, morbidity associated with the treatment of the unruptured intracranial aneurysms is relatively low. To improve future care further, we need to continue seeking better and less invasive management modalities and technique.

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“…1,[3][4][5]20 Sophisticated CG created for professional software has provided strikingly high-quality and realistic 3D visualization of microsurgical anatomies. 7,8 Not only for surveying 3D data visually but also for using simulation with realistic tactile sensations, a unique surgical simulation method applying haptic feedback through a specific handy device has also been demonstrated.…”

mentioning

confidence: 99%

Interactive presurgical simulation applying advanced 3D imaging and modeling techniques for skull base and deep tumors

Oishi

Fukuda

Yajima

et al. 2013

JNS

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S urgical removal of tumors located in the skull base or deep intracranial regions requires a high order of anatomical knowledge that can be obtained only through a large number of surgical experiences and has therefore been recognized as a challenging category in the neurosurgical field. Object. In this paper, the authors' goal was to report their novel presurgical simulation method applying interactive virtual simulation (IVS) using 3D computer graphics (CG) data and microscopic observation of color-printed plaster models based on these CG data in surgery for skull base and deep tumors.Methods. For 25 operations in 23 patients with skull base or deep intracranial tumors (meningiomas, schwannomas, epidermoid tumors, chordomas, and others), the authors carried out presurgical simulation based on 3D CG data created by image analysis for radiological data. Interactive virtual simulation was performed by modifying the 3D CG data to imitate various surgical procedures, such as bone drilling, brain retraction, and tumor removal, with manipulation of a haptic device. The authors also produced color-printed plaster models of modified 3D CG data by a selective laser sintering method and observed them under the operative microscope.Results. In all patients, IVS provided detailed and realistic surgical perspectives of sufficient quality, thereby allowing surgeons to determine an appropriate and feasible surgical approach. Surgeons agreed that in 44% of the 25 operations IVS showed high utility (as indicated by a rating of "prominent") in comprehending 3D microsurgical anatomies for which reconstruction using only 2D images was complicated. Microscopic observation of color-printed plaster models in 12 patients provided further utility in confirming realistic surgical anatomies.Conclusions. The authors' presurgical simulation method applying advanced 3D imaging and modeling techniques provided a realistic environment for practicing microsurgical procedures virtually and enabled the authors to ascertain complex microsurgical anatomy, to determine the optimal surgical strategies, and also to efficiently educate neurosurgical trainees, especially during surgery for skull base and deep tumors. (http://thejns.org/doi/abs/10.3171/2013.3.JNS121109) keY WorDs • neurosurgery • presurgical simulation • skull base tumor • surgical anatomy • 3D imaging • oncology Abbreviations used in this paper: CAD = computer-aided designing; CG = computer graphics; CN = cranial nerve; CPA = cerebellopontine angle; CTA = CT angiography; DSA = digital subtraction angiography; IAC = internal auditory canal; IVS = interactive virtual simulation; MRA = MR angiography.

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Prediction of Surgical View of Neurovascular Decompression Using Interactive Computer Graphics

Cited by 64 publications

References 18 publications

Trigeminal Neuralgia Associated with the Specific Bridging Pattern of Transverse Pontine Vein: Diagnostic Value of Three-Dimensional Multifusion Volumetric Imaging

Trigeminal Neuralgia Associated with the Specific Bridging Pattern of Transverse Pontine Vein: Diagnostic Value of Three-Dimensional Multifusion Volumetric Imaging

Unruptured Intracranial Aneurysms: Current Perspectives on the Origin and Natural Course, and Quest for Standards in the Management Strategy

Interactive presurgical simulation applying advanced 3D imaging and modeling techniques for skull base and deep tumors

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