Abstract
To evaluate the usefulness of virtual endoscopy (VE) in planning neuroendoscopic intraventricular
surgeries, the technique was applied in 20 of 22 consecutive procedures. Thirteen
endoscopic third ventriculostomies (ETV) in 12 patients, 3 endoscopic colloid cyst
removals, 1 third ventricular arachnoidal cyst fenestration, 1 endoscopic ventricul-cysto-cisternostomy
(suprasellar arachnoidal cyst), 1 endoscopic tumor biopsy, one third ventricular gross
total tumor removal and 2 septostomies at the foramen of Monro due the septal occlusion
were performed. Contrast medium-enhanced MR images (3DMPRAGE, Siemens, Germany) were
semi-automatically segmented with a surface-rendering technique (“Navigator” software,
General Electric Medical, Buc, France) to produce the virtual endoluminal views. Surgery
was performed with cerebral ventriculoscopes by Wolf (Richard Wolf, Knittlingen, Germany).
VE was feasible in all patients and the virtual endoscopic images were comparable
with the real intraventricular views obtained by standard rod lens systems. After
contrast medium administration intra- and paraventricular vessels such as the thalamocaudate
vein, the septal veins, the basilar artery and its branches (distal BA complex) and
the choroid plexus were identified on the virtual endoscopic images. In 8 patients,
the additional anatomic information provided by VE profoundly influenced surgical
planning. VE provides the neurosurgeon with additional morphological information supporting
the planning process of neuroendoscopic intraventricular surgeries, contributing to
the safety of the procedures.
Key words
Virtual Endoscopy - Endoscopy - Neuroendoscopy - Endoscopic Neurosurgery
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J. BurtscherM.D.
Department of Neurosurgery · University Hospital Innsbruck
Anichstr. 35
6020 Innsbruck · Austria
Telefon: +43-512-504-2621
Fax: +43-512-504-2641
eMail: johannes.burtscher@uibk.ac.at
