Visualization of Surgical Image of Endoscopic Transsphenoidal Surgery Using CT/MR Fusion Technique

Visualization of intimate anatomical relationships prior to surgery provides useful and helpful information for surgeons. Fusion images of multidetector-row computed tomography (MDCT) and magnetic resonance (MR) imaging have begun to shed light on presuming three-dimensional (3D) anatomies. In an endoscopic endonasal transsphenoidal surgery (ETSS), anatomical correlation of tumor, the internal carotid artery, the optic nerve, and bony structures should be obtained for performing safe surgery. The CT/MR fusion images of parasellar lesions have been created to obtain 3D surgical images for ETSS.

Both MDCT and 3 tesla-MR data were transferred to a standalone workstation. Three orthogonal multiplanar reconstruction images and volume rendering were created using the workstation (Zio Station, AMIN, Inc., Tokyo, Japan).

The CT/MR fusion technique revealed visualization of precise anatomical relationship between the tumor and adjacent structures such as the optic nerve, the internal carotid artery, and bony structures. The images obtained by the fusion technique made it easy for surgeons to imagine the actual surgical field.