Abstract
In arteriovenous malformation (AVM) surgery, vessel structures should be well evaluated with angiography. However, with conventional angiography, it is sometimes difficult to distinguish each feeder and its feeding territory in the nidus. In this study, we used two software systems to create three-dimensional (3D) fusion images using multiple imaging modalities and evaluated their clinical use. In the AVM patient, data were obtained from 3D rotational angiography, rotational venography, computed tomography (CT), and magnetic resonance imaging (MRI) and superimposed into 3D fusion images using imaging software (iPLAN and Avizo). Virtual surgical fields that were quite similar to the real ones were also created with these software programs. Compared with fusion images by iPLAN, those by Avizo have higher resolution and can demarcate not only each feeder but also its supplying territory in the nidus with different colors.In conclusion, 3D fusion images in AVM surgery are helpful for simulation, even though it takes time and requires special skill to create them.
Highlights
In AVM surgery, evaluation of angiostructure is essential to make a good surgical strategy
Each feeder and its supplying territory in the nidus are distinguished, and surgical simulation becomes possible after adding the magnetic resonance imaging (MRI) (FLAIR) and comported tomography (CT) images (Fig. 2)
In the real surgical field, we have to dissect the nidus from the brain, and the feeders may be found on the brain surface or in the sulci or fissures; it is necessary to evaluate the anatomical relationship between the AVM and the brain
Summary
In AVM surgery, evaluation of angiostructure is essential to make a good surgical strategy. With conventional two- dimensional digital subtraction angiography (DSA), it is sometimes difficult to understand AVM structure stereoscopically. Three-dimensional rotational angiography (3D-RA) gives us much more precise information about the relationships of each feeder, drainer, and nidus, but when the AVM is supplied by a multiple vascular territory (e.g., middle cerebral artery and posterior cerebral artery), all the details cannot be seen in one image. The location of the nidus in the brain is important so as to decide the surgical approach. Recent image fusion technologies have helped surgeons create virtual surgical fields, especially in brain tumors [1–3]. In this article the authors introduced 3D fusion images in AVM surgeries and evaluated their clinical use
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call