Three-dimensional computed tomographic reconstruction: planning tool for surgery of skull base pathologies.
Three-dimensional (3-D) computed tomographic (CT) reconstruction of the skull base region has added a different perspective to the data set usually presented in axial or coronal slices. It simultaneously demonstrates the spatial relationship of bones, tumors, vessels, and ventricles in a single illustration. Forty-nine patients with skull base lesions (44 with neoplastic and 5 with vascular pathologies) were examined with a spiral CT and 3-D reconstruction prior to surgery. A scanner and a maximum of 95 mL of iodized contrast media were used to enhance either tumor or vessels according to the specific pathology. Preoperative 3-D reconstruction was performed. It rendered a spatial representation of the pathology using data similar to that usually acquired in routine preoperative diagnostics. Complex anatomy can be visualized with only a handful of pictures. It was possible to easily compare various surgical approaches to the lesion on the basis of the 3-D computer model and to simulate the surgeon's view. The short time span (1 h average) necessary for reconstruction and editing allows the application of this method as a routine preoperative procedure for selected skull base pathologies.
Department of Neurosurgery, Hospital Nordstadt, Hannover, Germany. Elolf@t-online.de
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Elolf
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Tatagiba
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Samii
D000328:Adult; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D002426:Cavernous Sinus / Q000601:surgery; D014695:Cerebral Ventriculography; D003198:Computer Simulation; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007454:Iodides; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000601:surgery; D008579:Meningioma / Q000601:surgery; D008875:Middle Aged; D010347:Patient Care Planning; D011856:Radiographic Image Enhancement / Q000379:methods; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D013813:Therapy, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007454:Iodides