Research Of Multiple Mode Angiographic Images Neuronavigation Assisting In Operations Of Arteriovenous Malformations

PART I Experimental research of Eastimage Angle-Plan CAS1000^? Neuronavigation systemObjective: To test the precision and feasibility of Eastimage Angle-Plan CAS1000^? Neuronavigation system. Materials and Methods: By using Peg-Board Phantom , cadaveric head and skull, calculate the de of the definite points which means the distance of the point in CT or MR and the actual location that the navigation system shows. And analyze the facts that influence the navigation system. Results: Procedures based on CT proved to be more accurate than that on MRI. In navigational tests, the Angle-Plan CAS 1000^? Neuronavigation system showed accuracy and stability. This navigation system can satisfy clinical requirements. Conclusions: Angle-Plan CAS1000^? Neuronavigation system is a China-made neuronavigation system with accuracy and stability. And it can be used in the neurosurgicalnavigation operations. PART II DSA—Rotation data research based on neuronavigational phantomObjective: By measuring the distortion of the stratified DSA-Rotation images and comparing the distortion of MRI images with that of DSA, the phantom test verify that DSA-Rotation data can be used as the source of neuronavigation system. Materials and Methods: The stratified DSA-Rotation image distortion of Peg-Board Phantom, which has been stratified, is measured by Rapidia 2.8 under the windows 2000. Bying analysing the characteristic of DSA image distortion and comparing image distortion of DSA with that of MRI,in order to testify the feasibility of using DSA-Rotation data as neuronavigation source data. Results: The stratified DSA-Rotation image distortion isacceptable by neuronavigation and has insignificant difference with that of MRI.Conclusions: The stratified DSA-Rotation image can be used in the neuronavigationsystem.part IIIResearch of merge—distortion of DSA\CTA and DSA\MRA and image effectsObjective: By measuring the merge—distortion of DSA\CTA and DSA\MRA based on the modified phantom test, verify that DSA\CTA or DSA\MRA merge can be used in neuronavigation system. Materials and Methods: The DSA, CTA and MRA images of modified peg—board phantom was merged to analyse merge—distortion, based on its channel images.By using Photogram, DSA, CTA and MRA images was analysed to show their clearence. Results: The merge—distortion of DSA\CTA is 0.02-0.94mm, and that of MRA 和 DSA is 0.01-1.29mm. The merge-distortion of DSA\CTA comparing with that of DSA\MRA, has no significant difference. Conclusions: Based on phantom research, the merge — distortion of DSA\CTA comparing with that of DSA\MRA has no significant difference. The merge — distortion of DSA\CTA and DSA\MRA can be acceptable in neuronavigation. PART IVOperation of arteriovenous malformations assisted by MRA or CTA images guidedneuronavigationObjective: MRA or CTA images guided neuronavigation assisted to locate the feeders and nidus. Angiographic image neuronavigation in operations of AVM resections is an effective tool. Materials and Methods: 24 hours before surgery, 18 cases of frontal avms,12 cases of temperal avms, 8 cases occipital avms and 5 caes cerebellum avms had CTA or MRA scan for intraoperational neuronavigation. Intraoperational registration with fiducial marks, all 43 cases had AVMs resection assisted by CTA or MRA neuronavigation. MRA and DSA image—merge navigation assisted surgeons to successfully find the feeders and nidus. MRA or DSA navigation help to locate feeders and nidus effectively, sparing more brain injury. All 43 cases have no death and severe function loss. Conclusion: could assist operation of AVM resection. CTA or MRA neuronavigation can locate feeders and nidus acurately in the operations, sparing brain injury. Result: Angiographic image CTA or MRA neuronavigation is helpful in resection of AVMs, because of its clear display and acurate locating construction of AVMs. PART VOperation of arteriovenous malformations assisted by MRA or CTA images merged with fMRI images guiding neuronavigationObjective: MRA or CTA merged with fMRI images guided neuronavigation assisted to locate the feeders, nidus and function areas. Neuronavigation in operations of AVM resections can minimize injuries of brain and locate AVM accurately. Materials and Methods: Before surgery, 10 cases avms had MRA and fMRI scan for intraoperational neuronavigation. Intraoperational registration with fiducial marks, all 10 cases had AVMs resection assisted by MRA neuronavigation. MRA and fMRI image—merged navigation assisted surgeons to successfully find the feeders and nidus, pretect function areas, sparing unnecessary brain injury. All 10 cases have no death and severe function loss. Results: AVM resection assisted by neuronavigation can locate feeders and nidus acurately in the operations, sparing brain injury. 10 cases had no death and severe function loss postoperationally. Only 1 case suffered from epilepsy. After resection of AVMs, CDFIconfirm the total removement of AVMs intraoperationally. Conclusions: MRA merged with fMRI image guided neuronavigation is helpful in resection of AVMs, because of its clear display and acurate locating construction of AVMs and function areas. PART VIOperation of arteriovenous malformations assisted by MRA or CTA images guidedneuronavigations Objective : Angiographic MRA and DSA image — merge guided neuronavigation assisted to locate the feeders and nidus of AVM and successfully removed the AVM, sparing the normal area and function. Materials and Methods: 1 case, 23 year old, male patient had MRA and DSA before opearation. Intraoperationally, MRA and DSA image —merge navigation assisted surgeons to successfully find the feeders and nidus. Results: MRA and DSA merge navigation help to locate feeders and nidus effectively, sparing more brain injury. Conclusions: Angiographic image DSA and MRA merge neuronavigation assisted operation of AVM resection. DSA and MRA merge neuronavigation can be a new kind of angiographic image guided neuronavigation.