Advantages and limitations of intraoperative 3D ultrasound in neurosurgery. Technical note.
Three-dimensional ultrasound (US) technology is supposed to help combat some of the orientation difficulties inherent to two-dimensional US. Contemporary navigation solutions combine reconstructed 3D US images with common navigation images and support orientation. New real-time 3D US (without neuronavigation) is more time effective, but whether it further assists in orientation remains to be determined. An integrated US system (IGSonic, VectorVision, BrainLAB, Munich Germany) and a non-integrated system with real-time 3D US (iU22, Philips, Bothell, USA) were recently compared in neurosurgical procedures in our group. The reconstructed navigation view was time-consuming, but images were displayed in familiar planes (e.g., axial, sagittal, coronal). Further potential applications of US angiography and pure US navigation are possible. Real-time 3D images were displayed without the need for an additional acquisition and reconstruction process, but spatial orientation remained challenging in this preliminary testing phase. Reconstructed 3D US navigation appears to be superior with respect to spatial orientation, and the technique can be combined with other imaging data. However, the potential of real-time 3D US imaging is promising.
Department of Neurosurgery, University Hospital, Frauenklinikstrasse 10, 8091 Zürich, Switzerland. oliver.bozinov@usz.ch
Oliver
O
Bozinov
Jan-Karl
JK
Burkhardt
Claudia Miranda
CM
Fischer
Ralf Alfons
RA
Kockro
René-Ludwig
RL
Bernays
Helmut
H
Bertalanffy
D006801:Humans; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D009873:Operating Rooms / Q000379:methods; D012846:Singapore; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*