title: Three-dimensional ultrasound-guided placement of ventricular catheters.
abstract: OBJECTIVE
  Many studies demonstrate that the accuracy of freehand catheter placement for cerebrospinal fluid drainage is suboptimal. The aim of placement should be a single pass with a free-floating catheter tip in the intended position. The objective of this study was to achieve an accurate and user-friendly system for three-dimensional (3D) ultrasound-navigated catheter placement through a regular burr hole.
  
  
  METHODS
  A new phased-array ultrasound burr hole probe (4-10 MHz, 8 mm×9 mm footprint) was especially developed and optimized for navigated 3D ultrasound with the SonoWand Invite system. A catheter holder for optical tracking was also developed. Head immobilization was achieved with a vacuum cushion. With the described setup, 4 patients underwent surgery.
  
  
  RESULTS
  Ultrasound image quality and visualization of the ventricles was good in all cases. Optimal placement of the catheter was achieved in a single pass in all patients. One of the trajectories was slightly more medial on postoperative computed tomography than anticipated from the neuronavigation system. None of the patients experienced any adverse event related to the procedure.
  
  
  CONCLUSIONS
  3D ultrasound with the described setup is a promising technique for accurate, fast, and user-friendly navigated placement of catheters for cerebrospinal fluid diversion.
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim; National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; MI Lab, Medical Faculty, Norwegian University of Science and Technology, Trondheim; Department of Neuroscience, Medical Faculty, Norwegian University of Science and Technology, Trondheim. Electronic address: asgeir.s.jakola@ntnu.no.
authors: Asgeir S
authors: AS
authors: Jakola
authors: National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; Department of Medical Technology, SINTEF, Trondheim, Norway.
authors: Ingerid
authors: I
authors: Reinertsen
authors: National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; Department of Medical Technology, SINTEF, Trondheim, Norway.
authors: Tormod
authors: T
authors: Selbekk
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim; National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; Department of Neuroscience, Medical Faculty, Norwegian University of Science and Technology, Trondheim.
authors: Ole
authors: O
authors: Solheim
authors: National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; Department of Medical Technology, SINTEF, Trondheim, Norway.
authors: Frank
authors: F
authors: Lindseth
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim.
authors: Sasha
authors: S
authors: Gulati
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim; National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; Department of Neuroscience, Medical Faculty, Norwegian University of Science and Technology, Trondheim.
authors: Geirmund
authors: G
authors: Unsgård
mesh_terms: D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts; D004322:Drainage; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D059906:Neuroimaging / Q000379:methods*; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Cerebrospinal fluid; Hydrocephalus; Image guidance; Intracranial pressure; Neuronavigation; Ultrasound; Ventricular catheter; Ventriculostomy