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The use of 3D computer graphics in the diagnosis and treatment of spinal vascular malformations.
J Neurosurg Spine. 2011 Dec; 15(6):654-9.JN

Abstract

OBJECT

Digital subtraction (DS) angiography is the gold standard for diagnosing spinal vascular malformations. Recently, multidetectorrow spiral CT and contrast-enhanced MR angiography have been introduced as screening examinations before DS angiography. These methods, however, do not always determine the accurate location of an arteriovenous shunt because the resulting images lack information about the spinal cord or the dura mater.

METHODS

Between April 2009 and December 2010, 13 patients underwent imaging evaluations for spinal vascular malformations at the authors' university hospital. This group included 8 patients with spinal dural arteriovenous fistulas (AVFs), 3 with perimedullary AVFs, and 2 with intramedullary arteriovenous malformations. Using data from these patients, the authors attempted to develop 3D computer graphics (CG) based upon the fusion of 3D rotational angiography and postmyelographic CT. They subsequently verified the accuracy of this imaging method. Ten of these 13 patients underwent surgical treatment for their lesions (11 AVFs), and for these 11 lesions the authors compared the diagnoses obtained using 3D CG with those obtained using conventional DS angiography.

RESULTS

In all 13 cases, 3D CG images of the spinal lesions were successfully developed using the patients' actual data. Four (36%) of 11 AVFs were correctly identified using DS angiography, whereas 10 (91%) were correctly identified using 3D CG. Results from 3D CG of spinal AVFs corresponded well with operative findings, and 3D CG was significantly better than conventional DS angiography at predicting AVF location (p = 0.024, Fisher exact test).

CONCLUSIONS

To the authors' knowledge, this is the first reported case series in which 3D CG of spinal vascular malformations was used to provide simultaneous, stereoscopic visualization of the spinal vascular system, spinal cord, dura mater, and bone. The 3D CG method provides precise visual images for the diagnosis and treatment of these lesions.

Authors+Show Affiliations

Department of Neurosurgery, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21905772

Citation

Takai, Keisuke, et al. "The Use of 3D Computer Graphics in the Diagnosis and Treatment of Spinal Vascular Malformations." Journal of Neurosurgery. Spine, vol. 15, no. 6, 2011, pp. 654-9.
Takai K, Kin T, Oyama H, et al. The use of 3D computer graphics in the diagnosis and treatment of spinal vascular malformations. J Neurosurg Spine. 2011;15(6):654-9.
Takai, K., Kin, T., Oyama, H., Iijima, A., Shojima, M., Nishido, H., & Saito, N. (2011). The use of 3D computer graphics in the diagnosis and treatment of spinal vascular malformations. Journal of Neurosurgery. Spine, 15(6), 654-9. https://doi.org/10.3171/2011.8.SPINE11155
Takai K, et al. The Use of 3D Computer Graphics in the Diagnosis and Treatment of Spinal Vascular Malformations. J Neurosurg Spine. 2011;15(6):654-9. PubMed PMID: 21905772.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of 3D computer graphics in the diagnosis and treatment of spinal vascular malformations. AU - Takai,Keisuke, AU - Kin,Taichi, AU - Oyama,Hiroshi, AU - Iijima,Akira, AU - Shojima,Masaaki, AU - Nishido,Hajime, AU - Saito,Nobuhito, Y1 - 2011/09/09/ PY - 2011/9/13/entrez PY - 2011/9/13/pubmed PY - 2012/1/26/medline SP - 654 EP - 9 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 15 IS - 6 N2 - OBJECT: Digital subtraction (DS) angiography is the gold standard for diagnosing spinal vascular malformations. Recently, multidetectorrow spiral CT and contrast-enhanced MR angiography have been introduced as screening examinations before DS angiography. These methods, however, do not always determine the accurate location of an arteriovenous shunt because the resulting images lack information about the spinal cord or the dura mater. METHODS: Between April 2009 and December 2010, 13 patients underwent imaging evaluations for spinal vascular malformations at the authors' university hospital. This group included 8 patients with spinal dural arteriovenous fistulas (AVFs), 3 with perimedullary AVFs, and 2 with intramedullary arteriovenous malformations. Using data from these patients, the authors attempted to develop 3D computer graphics (CG) based upon the fusion of 3D rotational angiography and postmyelographic CT. They subsequently verified the accuracy of this imaging method. Ten of these 13 patients underwent surgical treatment for their lesions (11 AVFs), and for these 11 lesions the authors compared the diagnoses obtained using 3D CG with those obtained using conventional DS angiography. RESULTS: In all 13 cases, 3D CG images of the spinal lesions were successfully developed using the patients' actual data. Four (36%) of 11 AVFs were correctly identified using DS angiography, whereas 10 (91%) were correctly identified using 3D CG. Results from 3D CG of spinal AVFs corresponded well with operative findings, and 3D CG was significantly better than conventional DS angiography at predicting AVF location (p = 0.024, Fisher exact test). CONCLUSIONS: To the authors' knowledge, this is the first reported case series in which 3D CG of spinal vascular malformations was used to provide simultaneous, stereoscopic visualization of the spinal vascular system, spinal cord, dura mater, and bone. The 3D CG method provides precise visual images for the diagnosis and treatment of these lesions. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/21905772/The_use_of_3D_computer_graphics_in_the_diagnosis_and_treatment_of_spinal_vascular_malformations_ L2 - https://thejns.org/doi/10.3171/2011.8.SPINE11155 DB - PRIME DP - Unbound Medicine ER -