Authors: M Awaji K Okamoto K Nishiyama
Publish Date: 2007/06/09
Volume: 49, Issue: 9, Pages: 721-726
Abstract
With a high likelihood of clinical improvement and low rates of complications minimally invasive neuroendoscopic surgery is becoming the treatment of choice for symptomatic or growing arachnoid cysts In neuroendoscopic surgery visualization of anatomical landmarks is essential in achieving successful fenestration without complications Because of the restricted visual field in neuroendoscopic surgery preoperative anatomical assessment is very helpful Magnetic resonance cisternography MRC with high spatial resolution and contrast using for example 3D Fourier transformation constructive interference in steady state CISS or fast imaging employing steadystate acquisition FIESTA sequences is able to detect the arachnoid cyst wall and neighboring anatomical structures as the anatomical landmarks We retrospectively reviewed T2weighted T2W fast spinecho images and the MRC and intraoperative findingsAxial and coronal T2W images 6 and 3 mm thickness respectively and axial and coronal 08 mm thick MRC images with CISS or FIESTA were obtained from four patients with arachnoid cysts treated by neuroendoscopic surgery Intraoperative findings were reviewed on videotape recorded during the proceduresAt the brain surface the arachnoid cyst wall could be detected clearly in any of the four patients on MRC images and was only partly seen in the fourth patient T2W images Adjacent important anatomical structures including vessels and cranial nerves and an enough space for cystocisternostomy were identified on MRC images and the findings were consistent with the findings during neuroendoscopic surgery
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