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MR-Directed Stereotactic Resections and Per-Operative Screening using Low-Field MRI

  • D. G. T. Thomas
  • G. P. Kratimenos
Part of the NATO ASI Series book series (NSSA, volume 264)

Abstract

Precision resection of stereotactically defined volume presents one of the current applications of “volumetric stereotaxis”. Computer-assisted reconstruction of serial outlines of the volume for resection obtained with modern computerised neuroimaging methods defines the spatial coordinates of that volume and allows its interpolation in a three-dimensional matrix (Kelly et al., 1984). Information derived from stereotactically performed computerised imaging allows the suspension of the given volume into a stereotactic three-dimensional space and its precise resection using a stereotactic technique. Experience with CT-directed volumetric resections indicates that the method is satisfactory. The ability of magnetic resonance imaging (MRI) to define the boundaries of most intracranial structures more accurately and its superior diagnostic image sensitivity make its use in stereotactic volumetric resections highly desirable. The use of MRI, however, in computerised volumetric stereotactic surgery presents considerable difficulties. Problems concerning the construction of stereotactic hardware materials such as fiducials, frame and stabilising devises have now been successfully addressed. Computer software compatible with current imaging and stereotactic hardware has also been developed and used in clinical practice and although the problem of linear distortion still remains, especially in the periphery of the image, it is now possible to use MRI-derived information in volumetric stereotactic resections either indirectly by registration of the stereotactic coordinates or directly through specially developed software (Kelly et al, 1987).

Keywords

Temporal Lobe Epilepsy Seizure Frequency Magnetic Resonance Imaging Screening Operative Magnetic Resonance Imaging Field Magnetic Resonance Imaging 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Kelly, P. J., Kall, B. A., and Goerss, S. J., 1984, Transposition of volumetric information derived from computed tomographic scanning into stereotactic space, Surgi Neurol. 21: 465–471.CrossRefGoogle Scholar
  2. Kelly, P. J., Sharbrough, F. W., Kall, B. A., et al., 1987, Magnetic resonance imaging-based computer assisted stereotactic resection of the hippocampus and amygdala in patients with temporal lobe epilepsy, May Clin Proc. 62: 103–108.CrossRefGoogle Scholar
  3. Kratimenos, G. P., Pell, M. F., Thomas, D. G. T., Shorvon, S. D., Fish, D. R., and Smith, S. J. N., 1992, Open stereotactic selective amygdalo-hippocampectomy for drug resistant epilepsy, Acta Neurochirurg (Wien). 116: 150–154.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • D. G. T. Thomas
    • 1
  • G. P. Kratimenos
    • 1
  1. 1.National Hospital for Neurology and NeurosurgeryLondonUK

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