Use of 3DFT-CISS sequences and virtual MR endoscopy for the neuroendoscopic treatment of unilateral hydrocephalus: case illustration.
OBJECTIVE
Intraventricular virtual MR endoscopic imaging of the foramen of Monro region by using three-dimensional Fourier transformation constructive interference in steady state (3DFT-CISS) magnetic resonance imaging in a patient with a unilateral congenital obstruction of the foramen of Monro by a transparent membranous septum was performed to enhance the orientation, achieve a better understanding of the pathology, and plan the surgical intervention in an endoscopic approach to the lateral ventricles.


METHODS
3DFT-CISS sequences and virtual MR endoscopic imaging were performed in a patient before and after endoscopic fenestration procedures, to communicate the lateral ventricle to the third ventricle for the treatment of unilateral ventricular enlargement.


RESULTS
Preoperative 3DFT-CISS imaging demonstrated unilateral membranous septa in the localization of the left foramen of Monro which were not observed with routine T2-weighted imaging. 3DFT-CISS imaging and T2-weighted imaging were equally useful for monitoring postoperative changes in the size of the ventricles or cysts and the presence of flow voids after fenestration procedures, but only 3DFT-CISS imaging clearly demonstrated the area of fenestration.


CONCLUSIONS
Virtual MR endoscopy by using 3DFT-CISS sequences is a feasible method in the planning of intraventricular real-time endoscopic surgery, for the enhancement of orientation in a surgical field, and to achieve a better understanding of the pathology.
Aydin
K
K
Department of Neurosurgery, Ondokuzmayis University, Medical Faculty, Samsun, Turkey. kaydin@omu.edu.tr
Cokluk
C
C
Gokce
E
E
Diren
B
B
Iyigun
O
O
Rakunt
C
C
Celik
F
F
D000328:Adult; D002552:Cerebral Ventricles / Q000473:pathology; D004724:Endoscopy / Q000379:methods; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D020547:Lateral Ventricles / Q000033:anatomy & histology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D044583:Neuroendoscopy / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000295:instrumentation / Q000379:methods; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014584:User-Computer Interface; D014696:Ventriculostomy / Q000295:instrumentation / Q000379:methods*