How to make a three-dimensional surgical illustration of cerebral vessels with a personal computer: technical note

[Space reconstruction of the aneurysms of the vertebrobasilary confluence based on conventional angiography--our experience]

Besides current development of the new diagnostic procedures conventional angiography still represents the golden standard in the diagnosing of intracranial aneurysms. Since it gives a two-dimensional image if the presentation of the third dimension is wanted it is necessary to apply appropriate algorithm structures and computers. In this study we show our experience in the application of space reconstruction of blood vessels and aneurysms of the vertebrobasilary confluence in 6 patients operated at the Institute for Neurosurgery, Clinical Center of Serbia. Intraoperative finding in all patients matched the finding that we got by space reconstruction of the blood vessels, which was possible to observe from different angles. Postoperative course in all patients was satisfying. Upon discharge the patients were without rough lateralization of the pyramidal system. Our initial results and their practical agreement with the interoperative finding give us right to recommend this method as the standard for the preoperative diagnostic protocol.

[Computer-assisted spatial reconstruction of cerebral blood vessels and intra cranial aneurysms]

INTRODUCTION

Today, many medical procedures are based on image analysis with the aim of providing accurate diagnosis and optimal treatment. The goal of this report was to present clinical implications of computer-asssisted geometric design of carotid aneurysms.

MATERIAL AND METHODS

In this study, the three-dimensional reconstruction was based on the approximation power of the parametric spline function, which achieves interpolation and surface fitting of the arterial information obtained by conventional angiography. Two views of conventional angiograms (anterioposterior and lateral views) were used with a personal computer and commercial software.

RESULTS

This method of three-dimensional generated images was applied in 45 cases of cerebral aneurysms in carotid bifurcation. 3D reconstructions were made in approximately 20 minutes. They contributed to assessing vascular structures, and it was possible to rotate the three-dimensional image in different angles.

CONCLUSION

Three-dimensional reconstruction of cerebral vessels is very useful for discussing surgical strategies preoperatively. Furthermore, it could also be used in endovascular procedures.

[Significance of the spatial reconstruction based on mathematical modeling in the surgical treatment of giant intracranial aneurysms]

BACKGROUND

The use of computer models for the 3-dimensional reconstruction could be a reliable method to overcome technical imperfections of diagnostic procedures for the microsurgical operation of giant intracranial aneurysms.

CASE REPORT

We presented a case of successfully operated 52-year-old woman with giant intracranial aneurysm, in which the computer 3-dimensional reconstruction of blood vessels and the aneurysmal neck had been decisive for making the diagnosis. The model for 3-dimensional reconstruction of blood vessels was based on the two 2-dimensional projections of the conventional angiography. Standard neuroradiologic diagnostic procedures showed a giant aneurysm on the left middle cerebral artery, but the conventional subtraction and CT angiography did not reveal enough information. By the use of a personal computer, we performed a 3-dimensional spatial reconstruction of the left carotid artery to visualize the neck of aneurysm and its supplying blood vessels.

CONCLUSION

The 3-dimensional spatial reconstruction of the cerebral vessels of a giant aneurysm based on the conventional angiography could be useful for planning the surgical procedure.