Articles: neuronavigation.
-
Acta neurochirurgica · Jun 2004
Review Comparative StudyIntra-operative magnetic resonance imaging in neurosurgery.
Intra-operative MRI (iMRI) has been incorporated into modern neurosurgical operating rooms as a guide for neurosurgical interventions for almost ten years. This technology has been shown to be a useful modality in brain tumour surgery and biopsy; its use in spine, vascular and epilepsy surgery has been evolving. ⋯ We evaluate currently available iMRI systems and their applications in neurosurgery. Future possibilities related to iMRI systems are mentioned in the light of current advances.
-
Neuronavigation provides intraoperative orientation to the surgeon, helps in planning a precise surgical approach to the targetted lesion and defines the surrounding neurovascular structures. Incorporation of the functional data provided by functional MRI and magnetoencephalography (MEG) with neuronavigation helps to avoid the eloquent areas of the brain during surgery. An intraoperative MRI enables radical resection of the lesions, the possibility of immediate control for tumor remnants and updates of neuronavigation with intraoperative images to compensate for brain shift. ⋯ The simultaneous use of intraoperative MRI to look for the remaining tumor was done in 159 patients and the update of navigational data was carried out in 17 patients. The mean system accuracy obtained by using both the fiducial registration as well as anatomical landmark-surface fitting computer algorithm was 1.81 mm. This study reviews the relative merits and demerits of the pointer and microscope based navigational systems and also highlights the role of functional brain mapping and intraoperative MRI, when integrated with neuronavigation, in the surgical decision-making to offer the chances of more radical resections with minimal morbidity.