CLINICAL USEFULNESS OF 3-D CT ENDOSCOPIC IMAGING OF CEREBRAL ANEURYSMS

Usefulness of endoscopic imaging of cerebral aneurysms is presented. 3 -D luminal images were obtained using a new processing technique which extracts CT numbers in the boundary region between the vessel wall an d contrast media filled in the vascular lumen. Clinical application of this technique to complicated large cerebral aneurysms showed that, w ith this 3-D CT endoscopic imaging, anatomical details of cerebral ane urysms such as the orifice of the aneurysm, intraluminal thrombus, and calcification of the wall could be clearly demonstrated. Using a 3-D imaging method by Helical CT, virtual views of various surgical approa ches were compared preoperatively. With this technique, not only virtu al surgical views of aneurysms and related vasculature, but also surgi cal views after virtual resection of skull base bone to a desirable ex tent are freely available. We operated on two large, complicated aneur ysms and one broad-based aneurysm after obtaining 3-D CT endoscopic im ages of the aneurysms. Such information was found to be very useful fo r determining difficult and complicated cerebral aneurysms and broad-b ased aneurysms for coil embolization or direct open surgery.