The Intersection Between the Oculomotor Nerve and the Internal Carotid Artery to Distinguish Extracavernous and Intracavernous Paraclinoid Aneurysms Using Anatomic Dissections–A New 3T Magnetic Resonance Imaging Protocol Confirmed by Three-Dimensionally Printed Biomodels

A New Paradigm: How to Study the Exact Location of a Paraclinoid Aneurysm and the Cavernous Sinus in the Preoperative Stage through Imaging

“…The internal carotid arteries were dissected in their clinoid topography of 10 cadaveric specimens, totaling 20 cerebral hemispheres. Magnetic resonance images and 3D biomodels of 42 aneurysms from 34 patients were analyzed [47].…”

“…High-resolution images were acquired, following the established protocol, in 2D Coronal T2 Fast Spin Echo (FSE) sequences with thin sections, intracranial arterial magnetic AngioMRI in the 3D TOF technique with and without gadolinium, for vascular analysis. The detailed protocol of imaging studies can be found in [47].…”

“…Of the 34 patients participating in the study, with a total of 42 intracranial aneurysms, 20 patients, totaling 23 aneurysms, underwent intracranial vascular microsurgery for clipping the paraclinoid aneurysm. In the comparative analysis between the [47]).…”

“…It is contained in a curved dural plane that projects inferomedially between the median crest of the Comparison between the classification of paraclinoidal aneurysms by the two neuroradiologists, in a blind and independent manner, and the classification by the printed three-dimensional biomodel. The radiologists, blindly and independently, classified the aneurysms according to their relationship between the aneurysmal neck and the intersection between the ON and the ICA, as superior, transitional, or inferior to the superior limit of the III cranial nerve, while the author of the work classified the aneurysms based on the processing of CT, MR and Angio RM 3 Tesla images and analysis of the three-dimensional biomodel from the 3D printing (Modification and Publication authorized by Dr. Hugo Doria, MD PhD [47]).…”

“…In B: evidence of IA classified as intracavernous or inferior to the upper limit of the ON at its intersection with the ICA. In transparent acrylic, the supports for supporting the anatomical structures in their exact anatomical positions after three-dimensional printing were printed (images kindly provided by Dr. Hugo Doria, MD PhD [47]). DOI: http://dx.doi.org/10.5772/intechopen.110492 exact location of the paraclinoid aneurysms, showing high compatibility for the location of the analyzed paraclinoid aneurysms.…”