title: Usefulness of constructive interference in steady-state magnetic resonance imaging in the presurgical examination for lumbosacral lipoma.
abstract: OBJECTIVE
  The aim of this study was to evaluate three-dimensional Fourier transformation constructive interference in steady-state (CISS) imaging as a preoperative investigation of anatomical structures around the lumbosacral lipoma for surgical untethering of the spinal cord and debulking of the lipoma.
  
  
  METHODS
  The CISS imaging was used to visualize neural structures around the lumbosacral lipoma in 13 cases and was compared with conventional magnetic resonance imaging. In all cases, CISS images demonstrated the fine structure of the spinal cord and nerve roots, with good contrast between subarachnoid spaces and lipomas. The CISS findings were closely correlated with microscopic observation and electrophysiological investigation during surgery. In three of eight patients whose CISS images demonstrated abundant nerve roots embedded in the lipoma, untethering of the conus medullaris was not satisfactorily achieved. These three cases had obliteration of the subarachnoid space by the lipomas at the bilateral sides of the cord. In two cases with the vertebral misalignments scoliosis and lordosis, curvilinear reconstruction of CISS images along the spinal cord clearly demonstrated a neuroanatomy around the complicated lipomas.
  
  
  CONCLUSIONS
  Using CISS imaging is useful for establishing precise neuroanatomical information around lumbosacral lipomas and for predicting the level of surgical difficulty.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Hashiguchi
authors.forename: Takato
authors.initials: T
authors.lastname: Morioka
authors.forename: Kimiko
authors.initials: K
authors.lastname: Fukui
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Futoshi
authors.initials: F
authors.lastname: Mihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiura
authors.forename: Shinji
authors.initials: S
authors.lastname: Nagata
authors.forename: Tomio
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005583:Fourier Analysis; D006706:Homeostasis; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008067:Lipoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D016343:Monitoring, Intraoperative; D009436:Neural Tube Defects / Q000150:complications / Q000601:surgery; D011300:Preoperative Care; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*