Preoperative imaging of cervical spine hemangioblastomas using three-dimensional fusion digital subtraction angiography

2006 ◽  
Vol 5 (1) ◽  
pp. 96-100 ◽  
Author(s):  
Daniel M. Sciubba ◽  
Gaurav G. Mavinkurve ◽  
Philippe Gailloud ◽  
Ira M. Garonzik ◽  
Pablo F. Recinos ◽  
...  
Keyword(s):  
Cervical Spine ◽  
High Resolution ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Reconstruction Algorithm ◽  
Vascular Supply ◽  
Vascular Lesions ◽  
Preoperative Imaging ◽  
Digital Subtraction

✓ Angiography is often performed to identify the vascular supply of hemangioblastomas prior to resection. Conventional two-dimensional (2D) digital subtraction (DS) angiography and three-dimensional (3D) DS angiography provides high-resolution images of the vascular structures associated with these lesions. However, such 3D DS angiography often does not provide reliable anatomical information about nearby osseous structures, or when it does, resolution of vascular anatomy in the immediate vicinity of bone is sacrificed. A novel angiographic reconstruction algorithm was recently developed at The Johns Hopkins University to overcome these inadequacies. By combining two separate sequences of images of bone and blood vessels in a single 3D representation, 3D fusion DS (FDS) angiography provides precise topographic information about vascular lesions in relation to the osseous environment, without a loss of resolution. In this paper, the authors present the cases of two patients with cervical spine hemangioblastomas who underwent preoperative evaluation with FDS angiography and then successful gross-total resection of their tumors. In both cases, FDS angiography provided high-resolution 3D images of the hemangioblastoma anatomy, including each tumor’s topographic relationship with adjacent osseous structures and the location and size of feeding arteries and draining veins. These cases provide evidence that FDS angiography represents a useful adjunct to magnetic resonance imaging and 2D DS angiography in the preoperative evaluation and surgical planning of patients with vascular lesions in an osseous environment, such as hemangioblastomas in the spinal cord.

scholarly journals Vascular Supply of the Human Spiral Ganglion: Novel Three-Dimensional Analysis Using Synchrotron Phase-Contrast Imaging and Histology

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xueshuang Mei ◽  
Rudolf Glueckert ◽  
Annelies Schrott-Fischer ◽  
Hao Li ◽  
Hanif M. Ladak ◽  
...  
Keyword(s):  
Blood Supply ◽  
Phase Contrast ◽  
Spiral Ganglion ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Helical Structure ◽  
Vascular Supply ◽  
Phase Contrast Imaging ◽  
Contrast Imaging ◽  
Temporal Bones

AbstractHuman spiral ganglion (HSG) cell bodies located in the bony cochlea depend on a rich vascular supply to maintain excitability. These neurons are targeted by cochlear implantation (CI) to treat deafness, and their viability is critical to ensure successful clinical outcomes. The blood supply of the HSG is difficult to study due to its helical structure and encasement in hard bone. The objective of this study was to present the first three-dimensional (3D) reconstruction and analysis of the HSG blood supply using synchrotron radiation phase-contrast imaging (SR-PCI) in combination with histological analyses of archival human cochlear sections. Twenty-six human temporal bones underwent SR-PCI. Data were processed using volume-rendering software, and a representative three-dimensional (3D) model was created to allow visualization of the vascular anatomy. Histologic analysis was used to verify the segmentations. Results revealed that the HSG is supplied by radial vascular twigs which are separate from the rest of the inner ear and encased in bone. Unlike with most organs, the arteries and veins in the human cochlea do not follow the same conduits. There is a dual venous outflow and a modiolar arterial supply. This organization may explain why the HSG may endure even in cases of advanced cochlear pathology.

scholarly journals Treatment of Inverted Nipple with Subareolar Abscess: Usefulness of High-Resolution MRI for Preoperative Evaluation

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Sayaka Enomoto ◽  
Kyoichi Matsuzaki
Keyword(s):  
High Resolution ◽  
Preoperative Evaluation ◽  
Extent Of Resection ◽  
Preoperative Imaging ◽  
Inverted Nipple ◽  
Imaging Evaluation ◽  
High Resolution Mri ◽  
Inverted Nipples ◽  
Fistula Site

Background. Inverted nipples with subareolar abscesses can recur due to insufficient resection. It is important to provide reliable curative treatment after determination of the extent of resection by preoperative imaging evaluation. Methods. Ten patients were treated for inverted nipples with subareolar abscess. Sonography and high-resolution MRI were used as preoperative imaging modalities. The endpoints of preoperative imaging evaluation were defined as the identification of the abscess site, isolated fistula site, and extent of inflammation. Results. In all patients, sonography confirmed the presence of abscesses but their locations could not be identified. Sonography could not confirm the presence of isolated fistula or inflammation. In contrast, high-resolution MRI not only confirmed the presence of abscesses but also revealed their positional relationships with the nipples. In addition, high-resolution MRI confirmed the presence of isolated fistulas and inflammation as well as revealed their positional relationships with the nipples. In all patients, no recurrence was observed, and satisfactory surgical results were obtained. Conclusion. High-resolution MRI is useful in determination of the extent of resection of subareolar abscess associated with inverted nipple.

Frameless neuronavigation based only on 3D digital subtraction angiography using surface-based facial registration

2014 ◽  
Vol 121 (3) ◽  
pp. 745-750 ◽  
Author(s):  
David A. Stidd ◽  
Joshua Wewel ◽  
Ali J. Ghods ◽  
Stephan Munich ◽  
Anthony Serici ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Vascular Anatomy ◽  
Water Soluble ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Cerebrovascular Lesions ◽  
Data Set ◽  
Surface Anatomy ◽  
Neuronavigation System ◽  
Image Set

Object Cerebrovascular lesions can have complicated abnormal anatomy that is not completely characterized by CT or MR angiography. Although 3D rotational angiography provides superior spatial and temporal resolution, catheter angiograms are not easily registered to the patient, limiting the use of these images as a source for neuronavigation. However, 3D digital subtraction angiography (DSA) contains not only vascular anatomy but also facial surface anatomy data. The authors report a novel technique to register 3D DSA images by using only the surface anatomy contained within the data set without having to fuse the DSA image set to other imaging modalities or use fiducial markers. Methods A cadaver model was first created to assess the accuracy of neuronavigation based on 3D DSA images registered by facial surface anatomy. A 3D DSA scan was obtained of a formalin-fixed cadaver head, with acquisitions of mask and contrast runs. The right common carotid artery was injected prior to the contrast run with a 45% contrast solution diluted with water-soluble red liquid latex. One week later, the head was registered to a neuronavigation system loaded with the 3D DSA images acquired earlier using facial surface anatomy. A right pterional craniotomy was performed and 10 different vascular landmarks were identified and measured for accuracy using the neuronavigation system. Neuronavigation based only on 3D DSA was then used to guide an open clipping procedure for a patient who presented with a ruptured distal lenticulostriate aneurysm. Results The accuracy of the measurements for the cadaver model was 0.71 ± 0.25 mm (mean ± SE), which is superior to the 1.8–5 mm reported for neuronavigation. The 3D DSA–based navigation-assisted surgery for the distal lenticulostriate aneurysm aided in localization, resulting in a small craniotomy and minimal brain dissection. Conclusions This is the first example of frameless neuronavigation based on 3D catheter angiography registered by only the surface anatomy data contained within the 3D DSA image set. This is an easily applied technique that is beneficial for accurately locating vascular pathological entities and reducing the dissection burden of vascular lesions.

Cervical Transforaminal/Nerve Root Injections: Fluoroscopy

2016 ◽  
Author(s):  
Jeffrey D. Petersohn
Keyword(s):  
Cervical Spine ◽  
Digital Subtraction Angiography ◽  
Nerve Root ◽  
Preoperative Evaluation ◽  
Digital Subtraction ◽  
Radiographic Features

This chapter reviews relevant anatomic features of the cervical spine. Discussion of details of preoperative evaluation, operative positioning, and necessary optimization of radiographic features with c-arm manipulation follows. Details of technique including use of radiocontrast injection and digital subtraction angiography are discussed in the context of optimal techniques to avoid and minimize complications. Lastly, efficacy and outcomes are discussed briefly.

Three-Dimensional Vascular Anatomical Study of the Tensor Fasciae Latae Muscle and Perforators

2019 ◽  
Vol 35 (06) ◽  
pp. 389-394
Author(s):  
Abeer Kalandar ◽  
Steven F. Morris
Keyword(s):  
Femoral Artery ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Vascular Supply ◽  
Whole Body ◽  
External Diameter ◽  
Arterial Blood ◽  
Circumflex Femoral Artery ◽  
The Mean ◽  
Tensor Fasciae Latae

Background To harvest any flap on the lateral circumflex femoral artery (LCFA) including tensor fasciae latae (TFL) muscle, a precise description of the vascular anatomy is required. There have been conflicting reports of the vascular supply of TFL and its overlying skin. The objective of this study was to evaluate the anatomy of the TFL muscle according to the location, origin, type, caliber, and length of vessels that supply the muscle. Methods This study was performed on human cadavers (n = 16 thighs) that were injected with a mixture of lead oxide and gelatin through the femoral artery. Whole body computed tomography scans were performed. Three-dimensional images of the arterial anatomy were created using Materialise Interactive Medical Image Control Software (MIMICS). Anatomical dissection of all cadaver thighs was performed to visualize the arterial blood supply of the muscle and its regional perforators. Results Sixteen thighs were included in the study. The main arterial supply of the TFL muscle was in all cases, the ascending branch of the LCFA (LCFA-asc) artery. The mean external diameter of the LCFA-asc artery was 2.7 mm ± 0.4 and the mean length was 3.6 cm ± 0.6. The distance from the anterior superior iliac spine to point where the vascular pedicle reaches the muscle ranged from 6.7 to 10.2 cm. The average number of cutaneous perforators was 10.9 ± 4. There were musculocutaneous perforators in all of our dissections (n = 16) and 14 of our specimens had septocutaneous perforators. Conclusion The main vascular supply to the TFL muscle is the ascending branch of the LCFA, which also gives rise to septocutaneous and musculocutaneous perforators. MIMICS provides excellent three-dimensional anatomical information about the vascular supply of the TFL.

Imaging the Cerebrovascular Tree in the Cadaveric Head for Planning Surgical Strategy

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1222-1228 ◽  
Author(s):  
Jin-Cheng Zhao ◽  
Chi Chen ◽  
Sami S. Rosenblatt ◽  
Joel R. Meyer ◽  
Robert R. Edelman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Contrast Agent ◽  
Skull Base ◽  
Surgical Planning ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Surgical Anatomy ◽  
Vascular Lesions ◽  
Preoperative Imaging ◽  
Computed Tomographic

Abstract OBJECTIVE The objective of the study was to identify whether an integration of cadaveric dissections with preoperative imaging information may enable a better understanding of pathological anatomy, especially vascular lesions, and thus allow for greater precision in surgical planning. METHODS We selected a computed tomographic contrast agent and experimentally determined the proportion of it that could mix compatibly with the silicone compound. The resultant mixture was injected into the cerebrovascular systems of six fresh human cadaveric heads. The specimens underwent computed tomography for the purpose of digital virtual exposures in parallel with laboratory dissections performed on these specimens. RESULTS The 1:8 ratio of contrast agent to silicone rubber was determined to be appropriate for both computed tomography and subsequent laboratory dissection of the specimens. The blood vessels in computed tomographic scans demonstrated a higher attenuation than surrounding soft tissues. The opacity consistency of the injected vessels was a critical parameter for a clear three-dimensional rendering of the vascular structures in the natural surroundings of the skull base. Static and dynamic three-dimensional images of the cadaveric vascular tree were obtained as viewed through surgical corridors of various skull base approaches. CONCLUSION We demonstrated a new cadaveric preparation model for imaging and dissection. This model allows for static and dynamic three-dimensional examination of the surgical anatomy from a neurosurgeon's perspective. It may facilitate the study of cerebrovascular system morphology/pathology in relation to the skull base as a tool for surgical planning.

scholarly journals Contribution of Transvaginal High-Resolution Ultrasound in Fetal Neurology

2011 ◽  
Vol 5 (2) ◽  
pp. 93-99 ◽  
Keyword(s):  
High Resolution ◽  
Three Dimensional ◽  
Fetal Brain ◽  
Vascular Anatomy ◽  
First Trimester ◽  
3D Ultrasound ◽  
Resonance Imaging ◽  
Neurological Prognosis ◽  
Transabdominal Sonography ◽  
Arteries And Veins

ABSTRACT Transvaginal high-resolution ultrasound and three-dimensional (3D) ultrasound have been establishing sonoembryology as well as neurosonography in the first trimester. Fetal brain is rapidly developing and changing its appearance week by week during pregnancy. The most important organ, but it is quite hard to observe detailed structure of this organ by conventional transabdominal sonography. It is possible to observe the whole brain structure by magnetic resonance imaging in the post half of pregnancy, but it is difficult in the first half gestation, and transvaginal high-resolution 3D ultrasound is the most powerful modality. As for brain vascularization, main arteries and veins have been demonstrated and evaluated in various CNS conditions. Transvaginal high-resolution 3D ultrasound can demonstrate cerebral fine vascular anatomy, such as medullary vessels and it is greatly expected to estimate neurological prognosis relating with vascular development during fetal period.

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