Refine
Has Fulltext
- yes (21)
Is part of the Bibliography
- yes (21)
Year of publication
Document Type
- Journal article (21)
Language
- English (21)
Keywords
- Medizin (4)
- metabolism (3)
- neuroprotection (3)
- 3D fluoroscopy (2)
- SAH (2)
- Subarachnoid hemorrhage (2)
- fluoroscopy (2)
- intraoperative imaging (2)
- subarachnoid hemorrhage (2)
- 3 D rotational fluoroscopy (1)
- Animal models (1)
- Bevacizumab (1)
- Bone chips (1)
- Brain edema (1)
- Brain ischemia (1)
- CBF (1)
- COVID-19 (1)
- Cerebral Ischemia (1)
- Cerebral blood flow (1)
- Cerebral vasospasm (1)
- Cisterna magna (1)
- Delayed cerebral infarction (1)
- Delayed ischemic neurological deficit (1)
- Double hemorrhage model (1)
- Fibrin glue (1)
- Glioblastoma (1)
- Irradiation (1)
- Lateral suboccipital craniectomy (1)
- Neuroprotection (1)
- Osteogeneration (1)
- PDH (1)
- Phase II trials (1)
- Rat (1)
- Spinal dissemination (1)
- Subarachnoid (1)
- Temozolomide (1)
- aerobic glycolysis (1)
- aneurysm (1)
- aneurysm surgery (1)
- angiography (1)
- brain (1)
- cerebrovascular disorders (1)
- cervical spine (1)
- clinical trials (1)
- clip control (1)
- contrast (1)
- craniovertebral junction (1)
- delayed cerebral infarction (1)
- early brain injury (1)
- frameless systems (1)
- image quality (1)
- inflammation (1)
- intraoperative (1)
- liponeurocytoma (1)
- magnesium (1)
- medulloblastoma (1)
- meningioma (1)
- methylprednisolone (1)
- minimally invasive (1)
- minocycline (1)
- molecular signature (1)
- neurocytoma (1)
- neurological complications (1)
- neurology (1)
- neuronavigation (1)
- neurosurgery (1)
- neurovascular disorders (1)
- pedicle screws (1)
- post-processing (1)
- secondary brain damage (1)
- spinal tumor operation (1)
- spine (1)
- stereotaxy (1)
- subarachnoid hemorrhage (SAH) (1)
- therapy (1)
- thromboinflammation (1)
- vertebral pedicles (1)
- vessel patency (1)
Institute
- Neurochirurgische Klinik und Poliklinik (15)
- Neurologische Klinik und Poliklinik (8)
- Institut für diagnostische und interventionelle Neuroradiologie (ehem. Abteilung für Neuroradiologie) (5)
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (2)
- Pathologisches Institut (2)
- Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik) (1)
- Klinik und Poliklinik für Nuklearmedizin (1)
- Medizinische Klinik und Poliklinik I (1)
Background
Mobile 3D fluoroscopes have become increasingly available in neurosurgical operating rooms. In this series, the image quality and value of intraoperative 3D fluoroscopy with intravenous contrast agent for the evaluation of aneurysm occlusion and vessel patency after clip placement was assessed in patients who underwent surgery for intracranial aneurysms.
Materials and methods
Twelve patients were included in this retrospective analysis. Prior to surgery, a 360° rotational fluoroscopy scan was performed without contrast agent followed by another scan with 50 ml of intravenous iodine contrast agent. The image files of both scans were transferred to an Apple PowerMac® workstation, subtracted and reconstructed using OsiriX® free software. The procedure was repeated after clip placement. Both image sets were compared for assessment of aneurysm occlusion and vessel patency.
Results
Image acquisition and contrast administration caused no adverse effects. Image quality was sufficient to follow the patency of the vessels distal to the clip. Metal artifacts reduce the assessability of the immediate vicinity of the clip. Precise image subtraction and post-processing can reduce metal artifacts and make the clip-site assessable and depict larger neck-remnants.
Conclusion
This technique quickly supplies images at adequate quality to evaluate distal vessel patency after aneurysm clipping. Significant aneurysm remnants may be depicted as well. As it does not require visual control of all vessels that are supposed to be evaluated intraoperatively, this technique may be complementary to other intraoperative tools like indocyanine green videoangiography and micro-Doppler, especially for the assessment of larger aneurysms. At the momentary state of this technology, it cannot replace postoperative conventional angiography. However, 3D fluoroscopy and image post-processing are young technologies. Further technical developments are likely to result in improved image quality.