Intraoperative cone-beam computed tomography for catheter placement verification in pediatric hydrocephalus: technical note.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Child's Nervous System Pub Date : 2024-11-01 Epub Date: 2024-09-04 DOI:10.1007/s00381-024-06592-5
Matthias Krause, Jasmina Lagumdzija, Simon Enzinger, Jörn Wittig, Alexander Gaggl, Roman P Metzger, Christoph J Griessenauer
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引用次数: 0

Abstract

Ventriculoperitoneal (VP) shunt placement, essential for managing hydrocephalus, often risks catheter malpositioning, especially in patients with small ventricles. We present a novel technique combining neuronavigation with intraoperative cone-beam computed tomography using the BrainLab system and Loop-X mobile imaging unit. This approach enables real-time verification of catheter placement by integrating preoperative MRI data with intraoperative CT imaging. In a 12-year-old boy with therapy-refractory idiopathic intracranial hypertension, neuronavigation was guided by the BrainLab Skull Fix and Cushing canula, ensuring precise catheter insertion into the right frontal horn. Post-placement, Loop-X facilitated immediate verification of the catheter's trajectory and positioning, corroborated by postoperative MRI. This technique demonstrated high precision and minimized radiation exposure, emphasizing its utility in reducing revision rates due to suboptimal catheter placement.

Abstract Image

用于验证小儿脑积水导管位置的术中锥形束计算机断层扫描:技术说明。
脑室腹腔(VP)分流术是治疗脑积水的关键,但经常存在导管定位错误的风险,尤其是对于脑室较小的患者。我们利用 BrainLab 系统和 Loop-X 移动成像装置,提出了一种将神经导航与术中锥形束计算机断层扫描相结合的新技术。这种方法通过整合术前核磁共振成像数据和术中 CT 成像,实现了导管放置的实时验证。在一名患有治疗难治性特发性颅内高压的 12 岁男孩身上,BrainLab 颅骨固定器和库欣管引导神经导航,确保导管精确插入右额角。置入后,Loop-X 可立即验证导管的轨迹和定位,术后核磁共振成像也证实了这一点。这项技术显示出高度的精确性,并最大限度地减少了辐射暴露,强调了其在降低因导管置入不理想而导致的翻修率方面的实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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