[Three-dimensional surface anatomical scanning with 3D-FSPGR: anatomical conformity with surgical findings].

Three-dimensional imaging with MRI is a useful method for neurosurgical simulations. As in our previous study, we have constructed three-dimensional surface anatomical scanning (3D-SAS) from the data of contrast enhanced 3D fast spoiled gradient recalled acquisition in the steady state (3D-FSPGR) sequence. Using this technique, it is possible to generate 3D images from the data of only one acquisition, without using the fusion function. In our previous study, we did not compare the 3D images with the operative views at surgery. In the present study, two radiologists and one neurosurgeon assessed the 3D images in comparison with the operative views. There were problems in some cases, including unclear cortical sulci owing to brain swelling, lack of depiction of the cortical veins owing to meningeal enhancement, inadequate distinction between pial veins and meningeal veins, and so forth. However, in the majority of cases, 3D-SAS with 3D-FSPGR was able to demonstrate good anatomical conformity with the operative views, indicating the clinical usefulness of this technique.

[Usefulness of three-dimensional MR images of brain tumors for surgical simulation].

The purpose of this study was to determine the usefulness of three-dimensional (3D) MR imaging of brain tumors for surgical planning. Sixty-nine patients with various tumors of the brain were included in the present study. Using a volume-rendering (VR) method on an independent workstation, 3D-MR images were obtained with the fast-SPGR sequence after Gd-DTPA administration. VR images could show an exact relationship between the surface of the brain and major vessels. However, in patients with deeply located tumors, VR images did not necessarily provide sufficient information as to the relationship between the tumor and vessels. In combination with a surface-rendering method, 3D-MR imaging could demonstrate the exact relationships among the tumors, major vessels, and surface of the brain. In tumors without contrast enhancement, this method was able to show 3D images of tumors with surrounding structures. For neurosurgeons, 3D-MR images were useful for understanding the surface anatomy and surrounding structures of the tumors prior to surgery. These images were also helpful in explaining the condition of the disease to patients and their families.