title: Use of Three-Dimensional Curved-Multiplanar Reconstruction Images for Sylvian Dissection in Microsurgery of Middle Cerebral Artery Aneurysms.
abstract: OBJECTIVE
  The purpose of this study was to introduce a method of using three-dimensional (3D) curved-multiplanar reconstruction (MPR) images for sylvian dissection during microsurgical treatment of middle cerebral artery (MCA) aneurysms.
  
  
  METHODS
  Forty-nine patients who had undergone surgery for MCA aneurysms were enrolled. We obtained the 3D curved-MPR images along the sphenoid ridge using OsiriX MD™ imaging software, compared sylvian dissection time according to several 3D MPR image factors, and investigated the correlations between these images and intraoperative findings.
  
  
  RESULTS
  Utilizing preoperative information of the sylvian fissure (SF) and peri-aneurysmal space on 3D curved-MPR images, we could predict the feasibility of sylvian dissection for a safe surgery. 3D curved-MPR images showed several features: first, perpendicular images to the sylvian surface in the same orientation as the surgeon's view; second, simultaneous visualization of the brain cortex, vessels, and cisternal space; and third, more accurate measurement of various parameters, such as depth of the MCA from the sylvian surface and the location and width of the SFs.
  
  
  CONCLUSIONS
  In addition to conventional image studies, 3D curved-MPR images seem to provide useful information for Sylvian dissection in the microsurgical treatment of MCA aneurysms.
authors.affiliation: Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Taek Kyun
authors.initials: TK
authors.lastname: Nam
authors.affiliation: Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea. cuttage@cau.ac.kr.
authors.forename: Yong Sook
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Jun Soo
authors.initials: JS
authors.lastname: Byun
authors.affiliation: Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Jeong Taik
authors.initials: JT
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D002535:Cerebral Aqueduct / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D042282:Microdissection / Q000379:methods*; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*
keywords: Aneurysm; dissection; image reconstruction; microsurgery; middle cerebral artery