Neuropediatrics 2006; 37 - THP15
DOI: 10.1055/s-2006-945838

BRAIN MRI 3 D/CT FUSION FOR SUBDURAL AND DEPTH ELECTRODES PLACEMENT IN EPILEPSY SURGERY

W Silva 1, C Ciraolo 2, O Endara 3, S Ferraro 1, C Maxit 1, E Vaucheret 1, M Eleta 3, M Pietrani 3, G Agosta 1
  • 1Pediatric Neurology Departament
  • 2Pediatric Neurosurgery
  • 3Images Diagnostic Departament, Hospital Italiano de Buenos Aires, Argentina

Introduction: The correct placement of the subdural strips and grids and depth electrodes is critical to plan the surgical area.

Objective: To analyse the information that the MRI 3D /TAC fusion gives in a patient with refractory partial epilepsy and in who depth electrode and subdural grids were implanted.

Method: A depth temporal electrode in the limbic structures (amygdale, hippocampus), a fronto temporal grid and an orbital strip were implanted. After surgery Rx skull, brain volumetric CT with 2mm slices (Pich 1 and 1mm between slices) and MRI (3D, with T1 and 1mm slices, index: 0, angulation 0, TR: 11.4, TE: 4.4, FA: 8, matrix 256×256) were performed. A volumetric construction on CT and MRI images was done and 3D images were obtained. The placement of the electrodes in the Rx was compared with the CT, the MRI and the visual field in the surgery.

Results: The concordance of each method was compared with visual inspection during surgery. Rx skull had a concordance of less 75% with Jacob's parameters. Fusion Brain MRI 3D/CT obtained a concordance of 95%.

Conclusion: Brain MRI 3D/Ct can be a good method to control the real place of grids, strips and depth electrodes and to obtain a better surgical resection plane.