Synthesized surface anatomy scanning (SSAS) for surgical planning of brain metastasis at the sensorimotor region: Initial experience with 5 patients

Abstract

Surface anatomy scanning (SAS) is a powerful technique that uses T2-weighted magnetic resonance images (MRI) to visualize brain surface structures, and to precisely localize subcortical lesions. To overcome technical limitations of this method, synthesized SAS (SSAS) superimposes MR angiography (MRA) data on the SAS images. We describe our initial experience with surgical planning for the resection of metastases at the sensorimotor region in 5 patients using SSAS. Neurological deficits were assessed before and after surgical resection. Although 4 of 5 patients had mild to severe neurological deficits before surgery, three became symptom-free and no patient had an increased deficit after surgery. Our results undoubtedly provide palliative surgery for sensorimotor metastases. As SSAS is non-invasive and requires a short scanning time, this method could become a useful technique for the routine pre-operative simulation for surgery on brain surface lesions such as sensorimotor metastases.

Importance of Veins for Neurosurgery as Landmarks Against Brain Shifting Phenomenon: An Anatomical and 3D-MPRAGE MR Reconstruction of Superficial Cortical Veins

“…Preoperative knowledge of the cerebral cortex anatomy, and of the veins running on it, helps the surgeons plan and FIGURE 9 | Frequency of the different drainage types (according to Erös et al) in our study's patient population. Chiro, 1962;Kaplan and Browder, 1974;Katada, 1990;Lüders, 1992;Imai et al, 1996;Kikinis et al, 1996;Nakajima et al, 1997;Hawkes, 1998;Tsuchiya et al, 1998Tsuchiya et al, , 1999aTsuchiya et al, ,b, 2002Kettenbach et al, 1999;Kubota et al, 2001;Nabavi et al, 2001;Kaminogo et al, 2002;Murphy et al, 2004). To reconstruct the cortical anatomy of the cerebral hemispheres, we used a strongly T1-weighted MPRAGE sequence (Padget, 1956;Sugita et al, 1982;Lanzieri et al, 1987;Liang et al, 2001).…”

“…We used a magnetic resonance tomograph Magnetom Vision R 1.5T (Siemens AG) (Andeweg, 1996;Siemens, 2000). We examined the patients with two different sequences: MPRAGE sequences, which are TurboFLASH sequences extended to 3D and allow high-contrast imaging of the brain, were acquired natively, and FLASH-2D-TOF angiography, to visualize the venous vessels in as high a contrast as possible (Perese, 1958;Stephens and Stilwell, 1969;Strother et al, 1994;Stevenson et al, 1995;Imai et al, 1996;Hunerbein et al, 1997;Liang et al, 2001;Immonen et al, 2004). We oriented the layers to be as perpendicular to the brain surface as possible in the relevant area.…”

Topography of Sylvian Fissure and Central Sulcus as Neurosurgical Landmarks: an Anatomical Study Using Cadaveric Specimens in Iran

“…Although brain wrinkles become more visible in imaging techniques such as MRI [5][6][7][8][9][10][11][12][13][14], they sometimes have inaccuracies [15][16][17][18][19]. Furthermore, recognizing them during surgery is very difficult due to being covered by vessels and arachnoid and small accessible space to the brain surface [20].…”