マツオカ　アヤコ   MATSUOKA Ayako   松岡　綾子    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Usefulness of the advanced neuroimaging protocol based on plain and gadolinium-enhanced constructive interference in steady state images for gamma knife radiosurgery and planning microsurgical procedures for skull base tumors.
掲載誌名	正式名：Acta neurochirurgica. Supplement 略　 称：Acta Neurochir Suppl ISSNコード：00651419/00651419
掲載区分	国外
巻・号・頁	116,pp.167-78
著者・共著者	Motohiro Hayashi, Mikhail F Chernov, Noriko Tamura, Shoji Yomo, Manabu Tamura, Ayako Horiba, Masahiro Izawa, Yoshihiro Muragaki, Hiroshi Iseki, Yoshikazu Okada, Pavel Ivanov, Jean Régis, Kintomo Takakura
発行年月	2013
概要	BACKGROUND:Gamma Knife radiosurgery (GKS) is currently performed with 0.1 mm preciseness, which can be designated microradiosurgery. It requires advanced methods for visualizing the target, which can be effectively attained by a neuroimaging protocol based on plain and gadolinium-enhanced constructive interference in steady state (CISS) images.METHODS:Since 2003, the following thin-sliced images are routinely obtained before GKS of skull base lesions in our practice: axial CISS, gadolinium-enhanced axial CISS, gadolinium-enhanced axial modified time-of-flight (TOF), and axial computed tomography (CT). Fusion of "bone window" CT and magnetic resonance imaging (MRI), and detailed three-dimensional (3D) delineation of the anatomical structures are performed with the Leksell GammaPlan (Elekta Instruments AB). Recently, a similar technique has been also applied to evaluate neuroanatomy before open microsurgical procedures.RESULTS:Plain CISS images permit clear visualization of the cranial nerves in the subarachnoid space. Gadolinium-enhanced CISS images make the tumor "lucid" but do not affect the signal intensity of the cranial nerves, so they can be clearly delineated in the vicinity to the lesion. Gadolinium-enhanced TOF images are useful for 3D evaluation of the interrelations between the neoplasm and adjacent vessels. Fusion of "bone window" CT and MRI scans permits simultaneous assessment of both soft tissue and bone structures and allows 3D estimation and correction of MRI distortion artifacts.CONCLUSION:Detailed understanding of the neuroanatomy based on application of the advanced neuroimaging protocol permits performance of highly conformal and selective radiosurgical treatment. It also allows precise planning of the microsurgical procedures for skull base tumors.
DOI	10.1007/978-3-7091-1376-9_26
PMID	23417476