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Neuroscience
내시경 성 상반신 두개골 기본 수술에서 확산 MRI 기관도법의 역할
내시경 성 상반신 두개골 기본 수술에서 확산 MRI 기관도법의 역할
JoVE Journal
Neuroscience
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JoVE Journal Neuroscience
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

내시경 성 상반신 두개골 기본 수술에서 확산 MRI 기관도법의 역할

Full Text
4,347 Views
09:53 min
July 5, 2021

DOI: 10.3791/61724-v

Matteo Zoli*1,2, Lia Talozzi*2, Micaela Mitolo3, Raffaele Lodi2,4, Diego Mazzatenta*1,2, Caterina Tonon*2,3

1IRCCS Istituto delle Scienze Neurologiche di Bologna,Center for the Diagnosis and Treatment of Hypothalamic-Pituitary Diseases - Pituitary Unit, 2Department of Biomedical and NeuroMotor Sciences,University of Bologna, 3IRCCS Istituto delle Scienze Neurologiche di Bologna, Functional and Molecular Neuroimaging Unit, 4IRCCS Istituto delle Scienze Neurologiche di Bologna

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Overview

This study presents a protocol for integrating diffusion MRI tractography in patient evaluations for endoscopic endonasal surgery aimed at skull base tumors. It outlines methods to utilize neuroimaging studies effectively during both pre- and intra-operative phases to enhance surgical safety and patient outcomes.

Key Study Components

Area of Science

  • Neurosurgery
  • Neuroimaging
  • Oncology

Background

  • Diffusion MRI tractography allows visualization of white matter tracts and tumor proximity.
  • This technique has shown versatility in glioma surgery and applications in drug-resistant focal epilepsy.
  • Integration improves surgical safety and quality of life for patients with pituitary and skull base tumors.
  • Collaboration between imaging and surgical specialists is vital for optimal outcomes.

Purpose of Study

  • To establish a framework for the safe resection of tumors using advanced neuroimaging techniques.
  • To correlate neuroimaging data with clinical outcomes in surgical contexts.
  • To provide training tips for integrating these techniques in surgical practice.

Methods Used

  • Utilized multi-modal MRI on high-field scanners to acquire various sequences for tumor localization and tractography.
  • Employed a detailed stepwise approach for segmentation and analysis using ITK-SNAP and FSL tools.
  • Detailed protocols outline MRI parameters, image acquisition specifics, and assessment techniques.
  • Included a comprehensive surgical protocol for endoscopic procedures based on imaging findings.

Main Results

  • Advanced imaging allowed for better visualization of critical structures, enhancing surgical navigation.
  • Successful demonstration of the method has the potential to standardize practices across surgical teams.
  • Encouragement of collaborative discussions among specialists contributes to improved surgical planning.

Conclusions

  • The integration of diffusion MRI tractography enhances the precision of endoscopic surgeries.
  • This study illustrates the importance of specialized training in both imaging and surgical techniques.
  • Findings promote a better understanding of tumor interactions with eloquent brain structures, paving the way for future advancements in surgical oncology.

Frequently Asked Questions

What are the main advantages of using diffusion MRI tractography?
Diffusion MRI tractography provides clear visualizations of white matter structures, improving surgical navigation and decreasing the risk of injury to critical neural pathways during tumor resection.
How is the biological model implemented in this study?
The biological model focuses on patients with skull base tumors, using imaging to tailor surgical approaches based on individual anatomical features and tumor location.
What types of data are obtained through these imaging methods?
Imaging methods yield detailed anatomical maps identifying tumor relationships with brain structures, contributing to safe surgical planning and execution.
How can the methods be adapted for different types of surgeries?
Methods outlined can be customized to fit various surgical approaches by modifying imaging parameters based on the specific tumor type and location.
Are there any key limitations associated with this approach?
While promising, the reliance on advanced imaging techniques necessitates significant training and familiarity with the technology, which may not be uniformly available across all surgical centers.

우리는 두개골 기본 종양에 대한 내시경 적 박상 수술에 환자 작업 업에서 확산 MRI 학법을 통합하는 프로토콜을 제시한다. 수술 전 및 수술 내 단계에서 이러한 신경 이미징 연구를 채택하는 방법이 설명되어 있습니다.

통합 신경 이미징 및 신경 외과 프로토콜을 사용하여, 환자 특정 종양 절제술 수술을 조정하기 위해 시너지 프레임 워크에서 다른 전문 지식을 병합 할 수 있습니다. MRI 학로를 사용하여 백색 물질 기관 탈구 및 종양 거리를 시각화할 수 있습니다. 신경 교종 수술에 그것의 다재 다능함이 확립되고 또한 약 저항하는 초점 간질에서 적용될 수 있습니다.

뇌 하 수 체, diencephalic 및 두개골 기반 종양에 대 한 내시경 건전도 수술에서 고급 신경 이미징 기술의 통합은 외과 안전을 증가, 합병증을 감소, 환자 결과 및 삶의 질을 개선에 효과적. 작업 fMRI와 결합 된 MRI 기관도는 수술 후 뇌 구조적 및 기능적 재구성의 모니터링을 할 수 있습니다. 또한 임상 결과와의 상관 관계는 임상 및 연구 제안에 유용합니다.

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