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Intraoperative Magnetic Resonance Imaging and Computed Tomography

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Stereotactic and Functional Neurosurgery

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Abstract

The availability of intraoperative computed tomography (CT) and magnetic resonance imaging (MRI) in neurosurgery has steadily grown over the past 15 years. CT scanners are used routinely for the placement of spinal instrumentation, while intraoperative MRI is used in brain tumor surgery to assess degree of resection. These imaging platforms are increasingly being incorporated into deep brain stimulation (DBS) surgery. Common data points for determining final lead placement in DBS surgery are test stimulation of the lead—to determine clinical benefit and side effects—and microelectrode recording (MER). Intraoperative three-dimensional imaging allows the surgeon to quantify stereotactic accuracy at the time of surgery. While intraoperative CT and MRI can be used in conjunction with test stimulation and MER, there has been a growing interest in using stereotactic accuracy alone in determining target engagement. As this approach to DBS surgery evolves, the role of intraoperative CT and MRI in DBS surgery will become increasingly fundamental.

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Abbreviations

ANT:

Anterior nucleus of the thalamus

CT:

Computed tomography

DBS:

Deep brain stimulation

FGATIR:

Fast gray matter acquisition T1 inversion recovery

GPe:

Globus pallidus externa

GPi:

Globus pallidus interna

MER:

Microelectrode recording

MRI:

Magnetic resonance imaging

MTT:

Mammillothalamic tract

STN:

Subthalamic nucleus

UPDRS:

Unified Parkinson’s Disease Rating Scale

VIM:

Ventral intermediate nucleus

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Acknowledgments

The authors thank the staff of Neuroscience Publications at Barrow Neurological Institute for assistance with manuscript preparation.

Disclosures

FAP is a consultant for Medtronic and Boston Scientific.

Financial Support

Barrow Center for Neuromodulation

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Authors and Affiliations

  1. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA

    Francisco A. Ponce

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  1. Francisco A. Ponce
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Correspondence to Francisco A. Ponce .

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Editors and Affiliations

  1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Nader Pouratian

  2. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA

    Sameer A. Sheth

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Ponce, F.A. (2020). Intraoperative Magnetic Resonance Imaging and Computed Tomography. In: Pouratian, N., Sheth, S. (eds) Stereotactic and Functional Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-34906-6_3

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  • DOI: https://doi.org/10.1007/978-3-030-34906-6_3

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