RESUMEN
BACKGROUND: The visualization of any morphological volume (i.e. CT, MRI) together with an additional second morphological volume (i.e. CT, MRI) or functional data set, which may come from SPECT or PET, is a new method for treatment planning, verification and follow-up of interstitial irradiation. METHOD: The authors present their experience on interstitial irradiation of brain tumours with stereotactically implanted I-125 seeds supported by image fusion. The image fusion was performed by the BrainLab-Target 1.13 software on Alfa 430 (Digital) workstation before, during, and after interstitial irradiation of brain tumours with Iodine125 seeds. RESULTS AND INTERPRETATION: On the basis of 20 brachytherapeutic image fusion of stereotactic CT (slices with fiducials) with additional stereotactic CT, MRI, PET and SPECT images provides more accurate and precise target volume, more exact localization of catheters and isotope seeds (verification fusion), differentiation between the localization and amount of the necrotic and proliferating parts of the tumours and shows the volume changes in consequence of interstitial irradiation. The image fusion should help to improve the accuracy and minimize the perifocal morbidity of interstitial irradiation.
Asunto(s)
Braquiterapia/métodos , Neoplasias Encefálicas/radioterapia , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Femenino , Humanos , Radioisótopos de Yodo/uso terapéutico , Masculino , Persona de Mediana Edad , Tomografía Computarizada de Emisión , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
The difficulties of differential diagnosis between intra- and suprasellar tumours resp. inflammatory processes are discussed, based on three personal cases. In all three computed tomography (CT) and magnetic resonance imaging (MR) had demonstrated a tumour, but the clinical signs with discrepancies between radiological and clinical findings were pointing to an inflammatory process. The correct diagnosis of an inflammation was achieved by co-operation between neurologist, neurosurgeon, otologist and ophthalmologist. An unnecessary neurosurgical operation was avoided and the patients were cured by otological intervention and antibiotic therapy.
Asunto(s)
Absceso Encefálico/diagnóstico , Neoplasias Encefálicas/diagnóstico , Imagen por Resonancia Magnética , Meningitis/diagnóstico , Neoplasias Hipofisarias/diagnóstico , Sinusitis/diagnóstico , Tomografía Computarizada por Rayos X , Adulto , Absceso Encefálico/patología , Absceso Encefálico/cirugía , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Masculino , Meningitis/patología , Meningitis/cirugía , Quiasma Óptico/patología , Neoplasias Hipofisarias/patología , Neoplasias Hipofisarias/cirugía , Sinusitis/patología , Sinusitis/cirugíaAsunto(s)
Quiste Dermoide/diagnóstico , Metabolismo de los Lípidos , Imagen por Resonancia Magnética , Neoplasias de la Médula Espinal/diagnóstico , Espacio Subaracnoideo/patología , Tomografía Computarizada por Rayos X , Adulto , Quiste Dermoide/cirugía , Femenino , Humanos , Rotura Espontánea , Neoplasias de la Médula Espinal/cirugíaRESUMEN
Post-operative neurosonography - through calvarial defect. 9 patients were examined by post-operative high resolution real-time ultrasound, using an operative calvarial defect. The findings of 2 patients are analysed in details. The authors have found good agreement with computed tomography, with other imaging methods and pathology as well. They suggest sonographic examination as a first step in the follow-up control of the pathological processes in patients with burr holes.