Preoperative Magnetic Resonance and Intraoperative Computed Tomography Fusion for Real-Time Neuronavigation in Intramedullary Lesion Surgery

2016 ◽  
Vol 13 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Francesco Costa ◽  
Alessandro Ortolina ◽  
Andrea Cardia ◽  
Marco Riva ◽  
Martina Revay ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
Real Time ◽  
Ct Scanning ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Intramedullary Lesion ◽  
Preoperative Magnetic Resonance ◽  
Dural Opening

Abstract BACKGROUND: Image-guided surgery techniques in spinal surgery are usually based upon fluoroscopy or computed tomography (CT) scan, which allow for a real-time navigation of bony structures, though not of neural structures and soft tissue remains. OBJECTIVE: To verify the effectiveness and efficacy of a novel technique of imaging merging between preoperative magnetic resonance imaging (MRI) and intraoperative CT scan during removal of intramedullary lesions. METHODS: Ten consecutive patients were treated for intramedullary lesions using a navigation system aid. Preoperative contrast-enhanced MRI was merged in the navigation software, with an intraoperative CT acquisition, performed using the O-armTM system (Medtronic Sofamor Danek, Minneapolis, Minnesota). Dosimetric and timing data were also acquired for each patient. RESULTS: The fusion process was achieved in all cases and was uneventful. The merged imaging information was useful in all cases for defining the exact area of laminectomy, dural opening, and the eventual extension of cordotomy, without requiring exposition corrections. The radiation dose for the patients was 0.78 mSv. Using the authors’ protocol, it was possible to merge a preoperative MRI with navigation based on intraoperative CT scanning in all cases. Information gained with this technique was useful during the different surgical steps. However, there were some drawbacks, such as the merging process, which still remains partially manual. CONCLUSION: In this initial experience, MRI and CT merging and its feasibility were tested, and we appreciated its safety, precision, and ease.

Combined Image Guidance and Intraoperative Computed Tomography in Facilitating Endoscopic Orientation within and around the Paranasal Sinuses

2008 ◽  
Vol 22 (6) ◽  
pp. 635-641 ◽  
Author(s):  
Sarah K. Wise ◽  
Richard J. Harvey ◽  
John C. Goddard ◽  
Patrick O. Sheahan ◽  
Rodney J. Schlosser
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Paranasal Sinus ◽  
Image Guidance ◽  
Sinus Surgery ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Significant Difference ◽  
Preoperative Ct ◽  
Anatomic Region

Background The utility of image guidance (image-guided surgery [IGS]) and intraoperative computed tomography (CT) scanning as a tool for less experienced endoscopic surgeons to aid in localization of paranasal sinus and skull base anatomic structures was evaluated. Methods Partial endoscopic dissection was performed on cadaver specimens by three fellowship trained rhinologists. Anatomic sites within and around the sinuses were tagged with radio-opaque markers. Otolaryngology residents identified tagged anatomic sites using four successive levels of technology: endoscopy alone (simulating outpatient clinic), endoscopy plus preoperative CT (simulating endoscopic sinus surgery [ESS] without IGS), endoscopy plus IGS registered to preoperative CT (simulating current ESS with IGS), and endoscopy plus IGS registered to real-time intraoperative CT. Responses were graded as follows: consensus rhinologist answer (4 points), close answer without clinically significant difference (3 points), within anatomic region but definite clinical difference (2 points), outside of anatomic region (1 point), no answer (0 points). Results Eleven residents participated. Of 20 specific anatomic sites, IGS-intraoperative CT provided the most accurate anatomic identification at 16 sites. For 8 sites, IGS-intraoperative CT had a significantly higher score than endoscopy alone (p < 0.05; eta2 = 0.29-0.67). For 6 sites, IGS-preoperative CT scan had a significantly higher score than endoscopy alone (p < 0.05; eta2 = 0.30-0.67). All participants found that IGS-intraoperative CT scan made them most comfortable in identifying anatomy. Conclusion Combined IGS and intraoperative CT scan technology may be an instructional adjunct for less experienced paranasal sinus surgeons for dissection and evaluation of unfamiliar or distorted anatomy.

Computerized tomography is not reliable in the diagnosis of brainstem infection

2002 ◽  
Vol 116 (3) ◽  
pp. 211-212 ◽  
Author(s):  
Peter Walshe ◽  
Paul Brennan ◽  
Michael Walsh ◽  
Rory McConn Walsh
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
Computerized Tomography ◽  
Magnetic Resonance Image ◽  
Ct Scanning ◽  
Mri Scan ◽  
Bulbar Palsy ◽  
History Of ◽  
Rigid Oesophagoscopy

The case of a 17-year-old girl who presented with a two-day history of absolute dysphagia secondary to a bulbar palsy due to a pre-pontine abscess is described. Rigid oesophagoscopy was normal and a neurology consultation suggested a central cause for her dysphagia. However the diagnosis was delayed because a computed tomography (CT) scan of her brain and brainstem was reported as normal. A subsequent magnetic resonance image (MRI) scan revealed a pre-pontine abscess. CT scanning is not as reliable as MRI in the diagnosis of infective lesions of the brainstem/brain, especially early in the course of the infection.

scholarly journals The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases

2016 ◽  
Vol 7 (04) ◽  
pp. 598-602 ◽  
Author(s):  
Stefan Linsler ◽  
Sebastian Antes ◽  
Sebastian Senger ◽  
Joachim Oertel
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Skull Base ◽  
Imaging Data ◽  
Navigation Surgery ◽  
Ct Guided ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Resection Control ◽  
Special Cases

ABSTRACT Objective: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. Materials and Methods: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated. In this case, we performed an endonasal transsphenoidal approach for debulking the adenoma and for chiasma decompression. We used an MRI neuronavigation (Medtronic Stealth Air System) which was registered via intraoperative CT scan (Siemens CT Somatom). Preexisting MRI studies (navigation protocol) were fused with the intraoperative CT scans to enable three-dimensional navigation based on MR and CT imaging data. Intraoperatively, we did a further CT scan for resection control. Results: The intraoperative accuracy of the neuronavigation was excellent. There was an adjustment of <1 mm. The navigation was very helpful for orientation on the destroyed skull base in the sphenoid sinus. After opening the sellar region and tumor debulking, we did a CT scan for resection control because the extent of resection was not credible evaluable in this huge infiltrating adenoma. Thereby, we were able to demonstrate a sufficient decompression of the chiasma and complete resection of the medial part of the adenoma in the intraoperative CT images. Conclusions: The use of intraoperative CT/MRI-guided neuronavigation for transsphenoidal surgery is a time-effective, safe, and technically beneficial technique for special cases.

scholarly journals Role of intraoperative computed tomography scanner in modern neurosurgery – An early experience

2020 ◽  
Vol 11 ◽  
pp. 247
Author(s):  
Mohammad Ashraf ◽  
Nabeel Choudhary ◽  
Syed Shahzad Hussain ◽  
Usman Ahmad Kamboh ◽  
Naveed Ashraf
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
External Ventricular Drain ◽  
Colloid Cyst ◽  
Ventricular Catheter ◽  
Low Grade ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Multiloculated Hydrocephalus ◽  
Wide Range

Background: Intraoperative imaging addresses the limitations of frameless neuronavigation systems by providing real-time image updates. With the advent of new multidetector intraoperative computed tomography (CT), soft tissue can be visualized far better than before. We report the early departmental experience of our intraoperative CT scanner’s use in a wide range of technically challenging neurosurgical cases. Methods: We retrospectively analyzed the data of all patients in whom intraoperative CT scanner was utilized. Out of 31 patients, 24 (77.4%) were cranial and 8 (22.6%) spinal cases. There were 13 male (41.9%) and 18 (58.1%) female patients, age ranged from 1 to 83 years with a mean age of 34.29 years ±17.54 years. Seven patients underwent spinal surgery, 2 cases were of orbital tumors, and 16 intra-axial brain tumors, including 5 low- grade gliomas, 10 high-grade gliomas, and 1 colloid cyst. There were four sellar lesions and two multiloculated hydrocephalus. Results: The intraoperative CT scan guided us to correct screw placement and was crucial in managing four complex spinal instabilities. In intracranial lesions, 59% of cases were benefitted due to intraoperative CT scan. It helped in the precise placement of ventricular catheter in multiloculated hydrocephalus and external ventricular drain for a third ventricular colloid cyst. Conclusion: Intraoperative CT scan is safe and logistically and financially advantageous. It provides versatile benefits allowing for safe and maximal surgery, requiring minimum changes to an existing neurosurgical setup. Intraoperative CT scan provides clinical benefit in technically difficult cases and has a smooth workflow.

Diagnostic Accuracy of Magnetic Resonance Imaging and Computed Tomography Scan in Young Athletes With Spondylolysis

2019 ◽  
Vol 58 (6) ◽  
pp. 671-676
Author(s):  
Amy M. West ◽  
Pierre A. d’Hemecourt ◽  
Olivia J. Bono ◽  
Lyle J. Micheli ◽  
Dai Sugimoto
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Ct Scan ◽  
False Negative ◽  
False Negative Rate ◽  
Ct Scans ◽  
Resonance Imaging ◽  
Young Athletes ◽  
Negative Rate

The objective of this study was to determine diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT) scans in young athletes diagnosed with spondylolysis. A cross-sectional study was used. Twenty-two young athletes (14.7 ± 1.5 years) were diagnosed as spondylolysis based on a single-photon emission CT. Following the diagnosis, participants underwent MRI and CT scan imaging tests on the same day. The sensitivity and false-negative rate of the MRI and CT scans were analyzed. MRI test confirmed 13 (+) and 9 (−) results while CT test showed 17 (+) and 5 (−) results. The sensitivity and false-negative rate of MRI were, respectively, 59.1% (95% confidence interval [CI] = 36.7% to 78.5%) and 40.9% (95% CI = 21.5% to 63.3%). Furthermore, the sensitivity and false-negative rate of CT scan were 77.3% (95% CI = 54.2% to 91.3%) and 22.7% (95% CI = 0.09% to 45.8%). Our results indicated that CT scan is a more accurate imaging modality to diagnose spondylolysis compared with MRI in young athletes.

Evaluation of Tarsal Navicular Stress Fracture Fixation Using Intraoperative O-arm Computed Tomography

2014 ◽  
Vol 7 (6) ◽  
pp. 515-521 ◽  
Author(s):  
Andrew R. Hsu ◽  
Simon Lee
Keyword(s):  
Computed Tomography ◽  
Stress Fracture ◽  
Guide Wire ◽  
Weight Bearing ◽  
Fracture Site ◽  
Stress Fractures ◽  
Functional Impairments ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Anatomic Reduction

Stress fractures of the tarsal navicular are high-risk injuries that can result in displacement, avascular necrosis, malunion, and nonunion. Delayed diagnosis and improper treatment can lead to long-term functional impairments and poor clinical outcomes. Increased shear stress and decreased vascularity in the central third of the navicular can complicate bony healing with often unpredictable return times to activity using conservative management in a non-weight-bearing cast. There recently has been increasing debate regarding the effectiveness of treatment options with a trend toward surgical management to anatomically reduce and stabilize navicular stress fractures in athletes. However, anatomic reduction and fixation of the navicular can be difficult despite direct visualization and intraoperative fluoroscopy. We report a case of a chronic navicular stress fracture in a high-level teenage athlete treated with open reduction internal fixation (ORIF) and calcaneus autograft using intraoperative computed tomography (CT) (O-arm®, Medtronic, Minneapolis, MN) for real-time evaluation of fracture reduction and fixation. Intraoperative CT was fast, reliable, and allowed for confirmation of guide wire orientation, alignment, and length across the fracture site. Anatomic fixation of navicular stress fractures can be challenging, and it is important for surgeons to be aware of the potential advantages of using intraoperative CT when treating these injuries. Levels of Evidence: Therapeutic, Level IV: Case Report

scholarly journals Role of Radiologic Computed Tomography in Evaluating Coronavirus (COVID-19) Patients

2021 ◽  
pp. 39-44
Author(s):  
Mwahib Sayed Ahmed Aldosh
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Ct Scanning ◽  
Viral Disease ◽  
Human Beings ◽  
Complementary Method ◽  
High Incidence ◽  
High Incidence Rate ◽  
The Common

Objective: Coronavirus (Covid 19) is a dangerous viral disease that principally targets the respiratory system of human beings. The main objective of this study is to evaluate the significant effects resulting from Covid19 using radiologic CT scanning technology. Methods: The recent study was conducted in order to evaluate covid19 among the local public. The sample size for this study consisted of two hundred and thirty (230) patients diagnosed with coronavirus and underwent a chest computed tomography scan. The study was conducted at Najran city, between the period from September to December 2020. Results: The results showed that it is possible to diagnose the complications of coronavirus that affects the respiratory tract in an accurate manner using chest CT imaging and the main results revealed that coronavirus COVID-19 affected all, but males more than female. (50-60) Age group was the big distribution while acute respiratory failure is the most common clinical etiology. The CT scan findings revealed that bilateral pneumonia was the common complication with a high incidence rate of 32% percent and blood coagulation achieved 5% percent as the minimum distribution result. Conclusion: The sensitivity of the CT scans in assessing COVID-19 was significantly high, it has the efficiency to assess complications of COVID-19 in an accurate manner, and therefore it has been proposed to use CT scan as a complementary method in covid-19 diagnosis. More studies on coronavirus disease were recommended by the author.

scholarly journals Use of Intraoperative Computed Tomography in Complex Craniofacial Trauma: An Example of On-Table Change in Management

2014 ◽  
Vol 7 (4) ◽  
pp. 298-301 ◽  
Author(s):  
Clinton S. Morrison ◽  
Helena O. Taylor ◽  
Scott Collins ◽  
Adetokunbo Oyelese ◽  
Stephen R. Sullivan
Keyword(s):  
Ct Scanning ◽  
Fracture Repair ◽  
Anatomic Reconstruction ◽  
Facial Skeleton ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Computed Tomographic ◽  
Craniofacial Trauma ◽  
Secondary Operations

The primary goals in repairing complex craniofacial fractures are restoration of occlusion and mastication, and anatomic reconstruction of a symmetric facial skeleton. Failure to accomplish these goals may result in the need for secondary operations. Recognition of malreduction may not be appreciated until review of a postoperative computed tomographic (CT) scan. Intraoperative CT scanning enables immediate on-table assessment of reduction and fixation, allowing alteration of the surgical plan as needed. We report using intraoperative CT scanning while repairing a panfacial injury in which malreduction was appreciated intraoperatively and corrected. Intraoperative CT can be used to improve outcomes and quality of complex facial fracture repair.

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