The use of magnetic resonance angiography in stereotactic neurosurgery.
The use of magnetic resonance angiography in stereotactic neurosurgery.
复制标题
磁共振血管造影在立体定向神经外科中的应用。
作者：
J. Michiels;H. Bosmans;B. Nuttin;M. Knauth;R. Verbeeck;D. Vandermeulen;G. Wilms;G. Marchal;P. Suetens;J. Gybels
作者讨论了在立体定向神经外科手术中使用磁共振（MR）血管造影图像的优点和缺点。目前的计算机程序设计，以协助神经外科医生在规划立体定向神经外科干预使用动脉内数字减影血管造影图像，以可视化血管。磁共振血管造影术是一种新的技术，与数字减影方法相比具有许多优点：它侵入性较小，不易发生并发症;它提供了可以从任何方向观察的真正三维数据集;并且它可以使用相同的成像设备和定位器框架可视化静止和流动的组织。尽管数字减影图像在对比度和血管细节方面仍具有上级优势，但最先进的高分辨率MR血管造影序列可为计划手术提供足够的血管细节。对比增强MR血管造影图像采集使用自适应梯度回波序列，以补偿流动引起的失真;采集后失真校正是不必要的。讨论了五种方法来整合和检查MR血管造影数据中可能的轨迹。8例患者的初步临床经验得出结论，MR血管造影是一种有价值的成像方式，可以可靠地集成到立体定向神经外科计划程序中。
The authors discuss the advantages and disadvantages of the use of magnetic resonance (MR) angiography images in stereotactic neurosurgery. Current computer programs designed to assist the neurosurgeon in the planning of stereotactic neurosurgical interventions use intraarterial digital subtraction angiography images to visualize the blood vessels. Magnetic resonance angiography is a recent technique with a number of advantages over the digital subtraction method: it is less invasive and less prone to complications; it provides truly three-dimensional data sets that can be viewed from any direction; and it can visualize both stationary and flowing tissues with the same imaging device and localizer frame. Although digital subtraction images are still superior in contrast and vascular detail, state-of-the-art high-resolution MR angiography sequences provide sufficient vascular detail for planning surgery. Contrast-enhanced MR angiography images were acquired using adapted gradient-echo sequences to compensate for flow-induced distortions; postacquisition distortion correction was not necessary. Five methods to integrate and inspect a possible trajectory in the MR angiography data are discussed. Initial clinical experience with eight patients led to the conclusion that MR angiography is a valuable imaging modality that can be integrated reliably into a stereotactic neurosurgery planning procedure.