2020 年 48 巻 3 号 p. 173-178
Background and Objective: Preoperative imaging of the structures adjacent to intracranial aneurysms is vital for safe and effective surgery. Although computed tomography angiography (CTA) can be used to evaluate arterial, venous, and bony structures, it is unable to depict the surface of the brain parenchyma. This has precluded practical simulation of operative findings. Contrast-enhanced magnetic resonance imaging (MRI) visualizes both the venous structures and brain surface. There-fore, MRI may be able to contribute to optimal preoperative simulation imaging. In this article, we evaluated the validity of contrast-enhanced MRI in the preoperative assessment of unruptured intracranial aneurysm clipping.
Methods: For 2 cases with unruptured intracranial aneurysms, contrast-enhanced MRI was obtained, and virtual endoscopic processing was performed. We compared this imaging with the intraoperative findings, focusing on the relationships between the aneurysm, venous structures, and brain parenchyma.
Results: Virtual endoscopic imaging with contrast-enhanced MRI helped in the visualization of a deep vein crossing the arterial structures and brain parenchyma overlying the aneurysm. Moreover, virtual endoscopic imaging provided a practical 3D-like simulation of the surgical approach.
Conclusion: Virtual endoscopic processing of contrast-enhanced MRI was effective in predicting the intraoperative findings of unruptured intracranial aneurysm clipping.
