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Detecting small conflicting drainages with contrast-enhanced magnetic resonance venography for surgical planning: a technical description and quantified analysis

  • Technical Note - Functional Neurosurgery - Epilepsy
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Recent studies have shown the challenges involved in detecting small conflicting vessels (1.0–1.5 mm) on contrast-enhanced (CE) T1 images during stereoelectroencephalography (SEEG) planning. Improving the resolution of non-invasive approaches to identify these vessels is possible and important. We present a superior sagittal sinus mapping–based CE-magnetic resonance venography (CE-MRV) protocol calibrated by craniotomies.

Method

Seven patients with epileptic symptoms who received craniotomy were enrolled. CE-MRV was acquired with a bolus mapping of the superior sagittal sinus. Together with the T1 image, 3D veins and the brain surface were visualized. The resolution of the CE-MRV was quantified by measuring the diameter of superficial drainages after exposure of the brain surface during craniotomy.

Results

A total of 37 superficial drainages were exposed in the bone windows. CE-MRV visualized all these drainages. On average, one superficial drainage could be found in every 13.2 mm diameter of the bone window. The boundary resolution of the CE-MRV was 0.58–0.8 mm in vessel diameter, while drainages larger than 0.8 mm were visualized consistently.

Conclusions

The resolution of the CE-MRV in the present study met the requirement for detection of small conflicting vessels during SEEG planning. The visualized venous landmarks could be used for visual guidance to the surgical zone. As a non-invasive approach, CE-MRV is practical to use in the clinical setting.

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Abbreviations

CE:

Contrast-enhanced

SEEG:

Stereoelectroencephalography

CE-MRV:

CE-magnetic resonance venography

DSA:

Digital subtraction angiography

MRI:

Magnetic resonance imaging

SSS:

Superior sagittal sinus

BRAVO:

Brain volume imaging

SPM:

Statistical Parametric Mapping toolkits

TPM:

Tissue probability maps

CSF:

Cerebrospinal fluid

FMRIB:

Functional magnetic resonance imaging of the brain

FSL:

FMRIB Software Library

CSF:

Cerebrospinal fluid

SCV:

Superior cerebral veins

SMCF:

Superficial middle cerebral vein

ICV:

Inferior cerebral veins

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Funding

This study was supported by the National Natural Science Foundation of China (Grant Nos. 81801288 and 81871009). The sponsor had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xuanwu District, Beijing, 100053, China

    Peng-Hu Wei, Zi-Yue Yu, Xiao-Tong Fan, Yang An, Yong-Zhi Shan & Guo-Guang Zhao

  2. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Cheng Zhao & Jie Lu

Authors
  1. Peng-Hu Wei
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  2. Zi-Yue Yu
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  3. Cheng Zhao
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  4. Xiao-Tong Fan
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  5. Yang An
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  6. Jie Lu
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  7. Yong-Zhi Shan
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  8. Guo-Guang Zhao
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Correspondence to Yong-Zhi Shan or Guo-Guang Zhao.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical committee of Xuanwu Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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This article is part of the Topical Collection on Functional Neurosurgery - Epilepsy

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Wei, PH., Yu, ZY., Zhao, C. et al. Detecting small conflicting drainages with contrast-enhanced magnetic resonance venography for surgical planning: a technical description and quantified analysis. Acta Neurochir 162, 2519–2526 (2020). https://doi.org/10.1007/s00701-020-04345-2

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  • DOI: https://doi.org/10.1007/s00701-020-04345-2

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