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Ogura R, Fujiwara H, Natsumeda M, Hiraishi T, Sano M, Oishi M. Preoperative interactive virtual simulation applying three-dimensional multifusion images using a haptic device for lumbosacral lipoma. Childs Nerv Syst 2024; 40:1129-1136. [PMID: 37987859 DOI: 10.1007/s00381-023-06234-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/16/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Untethering surgery for lumbosacral lipoma is a preventive procedure, and avoidance of complications and good long-term outcomes are required. We introduced presurgical interactive virtual simulation (IVS) applying three-dimensional multifusion images using a haptic device aimed at improving operative outcomes. METHODS Fourteen patients with newly diagnosed lumbosacral lipoma were recruited and underwent preoperative IVS. The median age at surgery was 8 months. A three-dimensional image analysis system was used to extract and fuse structures necessary for surgery, such as the lipoma, spinal cord and skin, from CT and MRI, and create three-dimensional multifusion images. The created images were individually converted to standard triangulated language format and loaded onto a workstation (Geomagic freeform™) that could be freely transformed, and the laminectomy range and lipoma extraction procedure were examined. Presurgical IVS was performed, and the actual surgery was performed. RESULTS The disease types were dorsal, caudal, lipomyelomeningocele, transitional, and filum in 5, 5, 2, 1, and 1 patients, respectively. The surgical procedure and extent of the laminectomy were as planned for all patients. Resection of the lipomas tended to be less than expected preoperatively because of positive reactions on intraoperative monitoring. No postoperative complications were observed. The median postoperative follow-up period was 29 months, and there were no reoperations during the observation period. CONCLUSIONS Although there are various types of lumbosacral lipoma, surgery can be safely performed by performing presurgical IVS. The short-term course is good; however, long-term follow-up is necessary for the appearance of neurological symptoms associated with growth and re-tethering.
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Affiliation(s)
- Ryosuke Ogura
- Department of Neurosurgery, Brain Research Institute, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan.
| | - Hidemoto Fujiwara
- Department of Neurosurgery, Brain Research Institute, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan
| | - Manabu Natsumeda
- Department of Neurosurgery, Brain Research Institute, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan
| | - Tetsuya Hiraishi
- Department of Neurosurgery, Brain Research Institute, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan
| | - Masakazu Sano
- Department of Neurosurgery, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Makoto Oishi
- Department of Neurosurgery, Brain Research Institute, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan
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Ozaki M, Ichikawa S, Fukunaga M, Yamamoto H. Improving the depiction of small intracranial vessels in head computed tomography angiography: a comparative analysis of deep learning reconstruction and hybrid iterative reconstruction. Radiol Phys Technol 2024; 17:329-336. [PMID: 37897685 DOI: 10.1007/s12194-023-00749-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/30/2023]
Abstract
This study aimed to evaluate the ability of deep learning reconstruction (DLR) compared to that of hybrid iterative reconstruction (IR) to depict small vessels on computed tomography (CT). DLR and two types of hybrid IRs were used for image reconstruction. The target vessels were the basilar artery (BA), superior cerebellar artery (SCA), anterior inferior cerebellar artery (AICA), and posterior inferior cerebellar artery (PICA). The peak value, ΔCT values defined as the difference between the peak value and background, and full width at half maximum (FWHM), were obtained from the profile curves. In all target vessels, the peak and ΔCT values of DLR were significantly higher than those of the two types of hybrid IR (p < 0.001). Compared to that associated with hybrid IR, the FWHM of DLR was significantly lower in the SCA (p < 0.001), AICA (p < 0.001), and PICA (p < 0.001). In conclusion, DLR has the potential to improve visualization of small vessels.
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Affiliation(s)
- Makoto Ozaki
- Department of Radiological Technology, Kurashiki Central Hospital, 1-1-1, Miwa, Kurashiki, Okayama, 710-8602, Japan.
| | - Shota Ichikawa
- Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746 Asahimachi-Dori, Chuo-Ku, Niigata, Niigata, 951-8518, Japan
- Institute for Research Administration, Niigata University, 8050 Ikarashi 2-No-Cho, Nishi-Ku, Niigata, Niigata, 950-2181, Japan
| | - Masaaki Fukunaga
- Department of Radiological Technology, Kurashiki Central Hospital, 1-1-1, Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Hiroyuki Yamamoto
- Department of Radiological Technology, Kurashiki Central Hospital, 1-1-1, Miwa, Kurashiki, Okayama, 710-8602, Japan
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Chen M, Zhang T. Improved stereo perception in coronary angiography using the X-ray tube as the viewpoint and validation with 3D printed models. Int J Cardiovasc Imaging 2023; 39:2041-2050. [PMID: 37453945 PMCID: PMC10589187 DOI: 10.1007/s10554-023-02906-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Coronary angiography (CAG) provides two-dimensional images, but a clinician who is experienced in percutaneous coronary interventions can use information from these images to interpret spatial depth and infer the three-dimensional (3D) locations of vessels. We hypothesized that CAG results were equivalent to the mirror image of a coronary artery perspective projection, and a stereo perception could be easily established when the viewpoint of the angiogram was the X-ray tube instead of the detector. To eliminate the influence of heartbeat and respiration, a 3D-printed a coronary artery model was constructed for analysis. The effects of gantry movements during digital subtraction angiography (DSA) on the image were used to identify factors that affected DSA image transformation. Then, based on these factors, DSA imaging was simulated using UG NX software with three methods: (i) a perspective projection with the detector as the viewpoint; (ii) a parallel projection; and (iii) a mirror image of the perspective projection with the X-ray tube as the viewpoint. Finally, the resulting 3D images were compared with the DSA image. Our mirror image of the coronary artery perspective projection that used the X-ray tube as the viewpoint fused precisely with the CAG results and provided exact simulations of all the effects of DSA gantry movements on the DSA image. CAG results were equivalent to the mirror image of coronary artery perspective projection, and the stereo perception was easily established using the X-ray tube as the viewpoint.
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Affiliation(s)
- Miao Chen
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, No.95 Yongan Road, Xicheng District, Beijing, 100050, China
| | - Tianpeng Zhang
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, No.95 Yongan Road, Xicheng District, Beijing, 100050, China.
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Inoue K, Matsushima T, Ohara S, Masuoka J, Abe T. Study of the Anatomical Features of the Offending Arteries Involved in Glossopharyngeal Neuralgia. Oper Neurosurg (Hagerstown) 2020; 19:E259-E268. [PMID: 31960063 DOI: 10.1093/ons/opz425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 12/01/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The anatomic features of the posterior inferior cerebellar arteries (PICAs) and the anterior inferior cerebellar arteries (AICAs) as offending arteries involved in glossopharyngeal neuralgia (GPN) are important to dictate the best surgical approach. OBJECTIVE To study and classify the anatomic features of the offending arteries. METHODS All clinical data and surgical videos from 18 GPN cases that were surgically treated during the past 10 yr were retrospectively reviewed. RESULTS Among these 18 patients, the offending arteries involved were the PICA in 12 (66.7%), AICA in 4 (22.2%), and both PICA and AICA in 2 (11.1%). The PICA were then classified into the following groups based on their anatomic features: type I: the PICA formed an upward loop at the level of the glossopharyngeal nerve and passed between the glossopharyngeal and vestibulocochlear nerves; type II: the PICA formed an upward loop at the level of the glossopharyngeal nerve and passed between the glossopharyngeal and vagus nerves or between the rootlets of the vagus nerve; and type III: the PICA passed between the glossopharyngeal and vestibulocochlear nerves without forming a loop. The AICA had only one running pattern. CONCLUSION The offending arteries involved in GPN, mainly the PICA and/or AICA, were classified into 4 different types based on their anatomic features.
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Affiliation(s)
- Kohei Inoue
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Toshio Matsushima
- Graduate School, International University of Health and Welfare, Fukuoka, Japan.,Neuroscience Center, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Shinji Ohara
- Graduate School, International University of Health and Welfare, Fukuoka, Japan.,Neuroscience Center, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Jun Masuoka
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Tatsuya Abe
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
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Quantification of Surgical Route Parameters for Exposure of the Jugular Foramen Via a Trans-Mastoidal Approach Exposing Jugular Foramen in Three-Dimensional Visualization Model. J Craniofac Surg 2018; 29:787-791. [PMID: 29381617 DOI: 10.1097/scs.0000000000004234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Surgical operation within the region of the jugular foramen presents a great challenge. The authors characterized the quantitative impact of surgical window parameters on the exposure of the jugular foramen via a trans-mastoidal approach. METHODS Computed tomography and magnetic resonance imaging data were used to establish a 3-dimensional model of the jugular foramen region. The mastoidale, posterior edge of the mastoid, and the superior edge of the bony external acoustic meatus were selected as points a, b, and c. The anterior edge of the tuberculum jugulare was selected as point d. The midpoints of line segments ab, ac, and bc were selected as points e, f, and g. Triangle abc was divided into triangles aef, beg, cfg, and efg. Surgical corridors of the triangular pyramid were outlined by connecting the above triangles to point d. Anatomic exposure was evaluated by measuring the area and volume of various structures within each route. Statistical comparisons were performed via analysis of variance. RESULTS The model allowed for adequate visualization of all structures. The areas of triangles beg and efg were greater than those of triangles aef and cfg (P < 0.05). The volumes of triangular pyramids d-beg and d-cfg were greater than those of triangular pyramids d-aef and d-efg (P = 0.000). Statistically significant differences were also observed for volumes of osseous, venous, and cranial nerve structures in all divided routes (P = 0.000). CONCLUSION Our results indicate that 3-dimensional modeling may aid in the quantification of surgical exposure and that division of the craniotomy window may allow for more precise operation.
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Matsushima T, Kawashima M, Inoue K, Matsushima K, Miki K. Exposure of wide cerebellomedullary cisterns for vascular lesion surgeries in cerebellomedullary cisterns: opening of unilateral cerebellomedullary fissures combined with lateral foramen magnum approach. World Neurosurg 2014; 82:e615-21. [PMID: 24793562 DOI: 10.1016/j.wneu.2014.04.064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 02/27/2014] [Accepted: 04/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To clarify microsurgical anatomic features of the cerebellomedullary fissure (CMF), the natural cleavage plane between the cerebellum and the medulla, and its relationship to the cerebellomedullary cistern (CMC) and to describe a surgical technique that uses the unilateral trans-CMF approach for CMC surgeries. METHODS In the anatomic study, 2 formalin-fixed cadaver heads were used. In the clinical study, 3 patients with vertebral artery-posterior inferior cerebellar artery aneurysms and 3 patients with glossopharyngeal neuralgia were surgically treated through the unilateral trans-CMF approach combined with the transcondylar fossa approach, which is a lateral foramen magnum approach. RESULTS The CMC was present at the lateral end of the CMF. The CMF was closed by arachnoidal adhesion, and the cerebellar hemisphere was superiorly attached to the cerebellar peduncle. After the unilateral CMF was completely opened, the cerebellar hemisphere was easily retracted rostrodorsally. Clinically, almost completely opening the unilateral CMF markedly enabled the retraction of the biventral lobule to obtain a wide surgical field safely for vascular CMC lesions. We present 2 representative cases. CONCLUSION Combined unilateral trans-CMF/lateral foramen magnum approaches provide a wide and close surgical field in the CMC, allowing easy and safe CMC surgery.
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Affiliation(s)
- Toshio Matsushima
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Masatou Kawashima
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan.
| | - Kohei Inoue
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Ken Matsushima
- Department of Surgical Neurology, University of Florida, Gainesville, Florida, USA
| | - Koichi Miki
- Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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