• Giacomo Bertolini, Emanuele La Corte, Domenico Aquino, Elena Greco, Zefferino Rossini, Andrea Cardia, Federico Nicolosi, Dario Bauer, Maria Grazia Bruzzone, Paolo Ferroli, and Graziano Serrao.
• Department of Health Sciences, University of Milan, Milan, Italy; Department of Neurosurgery, Foundation IRCCS Neurological Institute "Carlo Besta", Milan, Italy. Electronic address: giacomo.bertolini1@studenti.unimi.it.
• World Neurosurg. 2019 May 1; 125: 198-206.

ObjectiveModern neuroanatomic education should be based on interdisciplinary methods that allow an understanding of the cerebral circuitry, which is at the base of the structural connectivity. Ex-vivo MRI-guided dissection is an essential method for developing and refining the knowledge of complex 3-dimensional brain anatomy and the mutual relationships between structures and architecture of the white matter bundles. The aim of this technical note is to present a new and innovative method of studying human brain white matter.MethodsFour adult human cerebral hemispheres were prepared according to the Klinger's method. T1-weighted and T2-weighted and fluid attenuated inversion recovery images were obtained with a 3T magnetic resonance machine. The dissection was performed in a dedicated neurosurgical laboratory equipped with a microscope and an electromagnetic neuronavigation system that guided the whole white matter dissection.ResultsGyri and sulci morphology were studied in detail. The relations between superficial and inner structures were observed before and after the dissection. Gray matter was carefully removed with blunt dissectors, and the U-fibers were exposed. Afterwards, deeper association and projection fibers, such as the arcuate fasciculus, superior and inferior longitudinal fasciculus, corona radiata, extreme and external capsule, claustrum, anterior commissure, and internal capsule were visualized under high magnification. The neuronavigation system was crucial for continuously checking the whole dissection procedure to avoid any accidental excision of fibers.ConclusionImage-guided neuronavigated dissection can significantly improve the quality of white matter dissection and represents a valid tool for learning the 3-dimensional anatomy of the human brain tracts.Copyright © 2019 Elsevier Inc. All rights reserved.

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