Cerebral Angiography for Multimodal Surgical Planning in Epilepsy Surgery: Description of a New Three-Dimensional Technique and Literature Review

被引:65
作者
Cardinale, Francesco [1 ]
Pero, Guglielmo [2 ]
Quilici, Luca [2 ]
Piano, Mariangela [2 ]
Colombo, Paola [3 ]
Moscato, Alessio [3 ]
Castana, Laura [1 ]
Casaceli, Giuseppe [1 ]
Fuschillo, Dalila [1 ]
Gennari, Luciana [2 ]
Cenzato, Marco [4 ]
Lo Russo, Giorgio [1 ]
Cossu, Massimo [1 ]
机构
[1] Osped Niguarda Ca Granda, Claudio Munari Ctr Epilepsy & Parkinson Surg, Milan, Italy
[2] Osped Niguarda Ca Granda, Dept Neuroradiol, Milan, Italy
[3] Osped Niguarda Ca Granda, Dept Med Phys, Milan, Italy
[4] Osped Niguarda Ca Granda, Dept Neurosurg, Milan, Italy
关键词
Cone beam computed tomography; Digital subtraction angiography; Epilepsy surgery; Image processing; Intracerebral electrodes; StereoElectroEncephaloGraphy; O-ARM; STEREOTACTIC PLACEMENT; DEPTH ELECTRODES; STEREOELECTROENCEPHALOGRAPHY; IMPLANTATION; METHODOLOGY; EXPERIENCE; ACCURACY;
D O I
10.1016/j.wneu.2015.03.028
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: Cerebrovascular imaging is critical for safe and accurate planning of Stereo-ElectroEncephaloGraphy (SEEG) electrode trajectory. We developed a new technique for Cone Beam Computed Tomography (CBCT) Three-Dimensional Digital Subtraction Angiography (30 OSA). METHODS: The workflow core is the acquisition of computed tomography datasets without (hone mask) and with selective injection of contrast medium in the main brain-feeding arteries, followed by dataset registration and subtraction. The images were acquired with the 0-arrnTM 1000 System (Medtronic). Images were postprocessed with FSL software package. We retrospectively analyzed 191 3D OSA procedures and qualitatively analyzed the quality of each 3D DSA dataset. RESULTS: The quality of 30 DSA was good in 150 procedures, sufficient in 37, and poor in 4. 30 rendering of the vascular tree was helpful for both SEEG implantation and resective surgery planning. Angiography complications occurred in only one procedure that was aborted due to a major allergic reaction to contrast medium. No other complications directly related to 3D DSA occurred. Minor intracerebral hemorrhage occurred in 2/191 patients after SEEG implantation, with no permanent sequelae. CONCLUSIONS: CBCT 30 OSA is a safe diagnostic procedure for SEEG electrode trajectory planning and for 3D reconstructions of the vascular tree in multimodal scenes for resections. The high fidelity and geometric accuracy contribute to the safety of electrode implantation.
引用
收藏
页码:358 / 367
页数:10
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