Usefulness of multidetector-row computerized tomographic angiography for the surgical planning in stereoelectroencephalography

• Published in: Diagnostic and interventional imaging Vol. 97; no. 3; pp. 333 - 337
• Main Authors: Gilard, V, Proust, F, Gerardin, E, Lebas, A, Chastan, N, Fréger, P, Parain, D, Derrey, S
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.03.2016; Elsevier
• Subjects: Adolescent; Adult; Child; Cognitive science; Computed Tomography Angiography - methods; Electrodes, Implanted; Electroencephalography; Epilepsy; Epilepsy - surgery; Female; Humanities and Social Sciences; Humans; Life Sciences; Magnetic Resonance Angiography; Male; Multidetector Computed Tomography; Multidetector-row computerized tomographic angiography; Neuroscience; Patient Care Planning; Prosthesis Implantation - methods; Psychology; Radiology; Stereoelectroencephalography; Surgery, Computer-Assisted; Surgical planning; Young Adult; Multidetector-row computerized tomographic angiography; Stereoelectroencephalography; Surgical planning; Epilepsy
• ISSN: 2211-5684; 2211-5684
• DOI: 10.1016/j.diii.2015.10.001

Abstract Purpose Surgical planning of depth electrode implantation in stereo-electro-encephalography (SEEG) routinely uses magnetic resonance imaging (MRI) alone. Accurate visualization of arteries and veins in the vicinity of the electrode is essential to plan a safe trajectory to presumably reduce the risk of intracranial bleeding. The goal of this study was to compare multidetector row computerized tomographic angiography (MDCTA) with MRI for the visualization of vessels along each planned trajectory in patients who undergo SEEG. Materials and methods Ten consecutive patients who were scheduled to undergo SEEG procedure were included. T1-weighted gadolinium-chelate enhanced MR sequence, stereotactic MDCT and MDCTA were performed after fixation of Leksell's frame. For each of the 106 planned stereotactic trajectories, the number of vessels in a 4.0 mm diameter circle around the trajectory from the dura mater to the target that were visible on MDCTA were compared to that of visible vessels in the same areas on MRI. Results Ten vessels (10/106; 9.4%) were seen on MRI and 66 (66/106; 62.3%) on MDCTA ( P < 0.0001). All vessels visible on MRI were visible on MDCTA. The difference in number of visible vessels between the two techniques remained significant for the different lobes (i.e., frontal lobe, temporal lobe and parieto-occipital lobe). Conclusion MDCTA enabled visualization of more vessels than MRI based SEEG. MDCTA may help neurosurgeons better define the trajectory of the electrode and reduce the risk of intracranial bleeding.