Preoperative Simulation of Cerebrovascular Surgery Using Fusion Image of Three-dimensional Digital Subtraction Angiography and Magnetic Resonance Imaging

Abstract

We present our three-dimensional digital subtraction angiography (3DDSA)-magnetic resonance imaging (MRI) fusion method and an assessment of its usefulness in the preoperative simulation of craniotomy. In three patients (2 with arteriovenous malformation [AVM] and 1 with distal middle cerebral artery aneurysm), 3DDSA-MRI fusion was performed for preoperative simulation. In the AVM cases, fusion imaging visualized lesion localization and the positional relationship between the lesion and the eloquent area. In the aneurysm case, fusion imaging contributed to the target bypass and selection of the approach route to the aneurysm.