Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: Technical note

F. Prada, M. Del Bene, G. Mauri, M. Lamperti, D. Vailati, C. Richetta, M. Saini, D. Santuari, M. Yashar S. Kalani, F. DiMeco

Research output: Contribution to journalArticle

Abstract

The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins. Intraoperative ultrasound (ioUS) permits the real-time study of venous compartments using different modalities, thus allowing complete characterization of their anatomical and functional features. The B-mode (brightness mode) offers a high-resolution anatomical representation of veins and their relationships with lesions. Doppler modalities (color, power, spectral) allow the study of blood flow and identification of vessels to distinguish their functional characteristics. Contrast-enhanced US allows one to perform real-time angiosonography showing both the functional and the anatomical aspects of vessels. In this technical report, the authors demonstrate the different applications of multimodal ioUS in neurosurgery for identifying the anatomical and functional characteristics of the venous compartment. They discuss the general principles and technical nuances of ioUS and analyze their potential implications for the study of various venous districts during neurosurgical procedures. © AANS 2018.
Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalNeurosurgical Focus
Volume45
Issue number1
DOIs
Publication statusPublished - 2018

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Neurosurgery
Neurosurgical Procedures
Veins
Anatomy
Time and Motion Studies
Decision Making
Color

Keywords

  • Cerebral veins
  • Contrast-enhanced ultrasound
  • Dural sinuses
  • Extracranial veins
  • Intraoperative imaging
  • Intraoperative ultrasound

Cite this

Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: Technical note. / Prada, F.; Del Bene, M.; Mauri, G.; Lamperti, M.; Vailati, D.; Richetta, C.; Saini, M.; Santuari, D.; Yashar S. Kalani, M.; DiMeco, F.

In: Neurosurgical Focus, Vol. 45, No. 1, 2018, p. 1-9.

Research output: Contribution to journalArticle

Prada, F. ; Del Bene, M. ; Mauri, G. ; Lamperti, M. ; Vailati, D. ; Richetta, C. ; Saini, M. ; Santuari, D. ; Yashar S. Kalani, M. ; DiMeco, F. / Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: Technical note. In: Neurosurgical Focus. 2018 ; Vol. 45, No. 1. pp. 1-9.
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abstract = "The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins. Intraoperative ultrasound (ioUS) permits the real-time study of venous compartments using different modalities, thus allowing complete characterization of their anatomical and functional features. The B-mode (brightness mode) offers a high-resolution anatomical representation of veins and their relationships with lesions. Doppler modalities (color, power, spectral) allow the study of blood flow and identification of vessels to distinguish their functional characteristics. Contrast-enhanced US allows one to perform real-time angiosonography showing both the functional and the anatomical aspects of vessels. In this technical report, the authors demonstrate the different applications of multimodal ioUS in neurosurgery for identifying the anatomical and functional characteristics of the venous compartment. They discuss the general principles and technical nuances of ioUS and analyze their potential implications for the study of various venous districts during neurosurgical procedures. {\circledC} AANS 2018.",
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author = "F. Prada and {Del Bene}, M. and G. Mauri and M. Lamperti and D. Vailati and C. Richetta and M. Saini and D. Santuari and {Yashar S. Kalani}, M. and F. DiMeco",
note = "Export Date: 5 February 2019 Correspondence Address: Prada, F.; Fondazione IRCCS Istituto Neurologico C. BestaItaly; email: francesco.prada@istituto-besta.it References: Ayanzen, R.H., Bird, C.R., Keller, P.J., McCully, F.J., Theobald, M.R., Heiserman, J.E., Cerebral MR venography: normal anatomy and potential diagnostic pitfalls (2000) AJNR Am J Neuroradiol, 21, pp. 74-78; Bozzao, A., Finocchi, V., Romano, A., Ferrante, M., Fasoli, F., Trill{\`o}, G., Role of contrast-enhanced MR venography in the preoperative evaluation of parasagittal meningiomas (2005) Eur Radiol, 15, pp. 1790-1796; Brockmann, C., Kunze, S.C., Schmiedek, P., Groden, C., Scharf, J., Variations of the superior sagittal sinus and bridging veins in human dissections and computed tomography venography (2012) Clin Imaging, 36, pp. 85-89; Debernardi, A., Quilici, L., La Camera, A., Boccardi, E., Cenzato, M., Torcular meningioma with multi-venous sinus invasion: compensatory drainage veins and surgical strategy (2018) World Neurosurg, 109, pp. 451-454; Ferroli, P., Acerbi, F., Tringali, G., Albanese, E., Broggi, M., Franzini, A., Venous sacrifice in neurosurgery: new insights from venous indocyanine green videoangiography (2011) J Neurosurg, 115, pp. 18-23; Gisolf, J., van Lieshout, J.J., van Heusden, K., Pott, F., Stok, W.J., Karemaker, J.M., Human cerebral venous outflow pathway depends on posture and central venous pressure (2004) J Physiol, 560, pp. 317-327; Han, H., Deng, X., Fong, A.H., Zhang, M., Dural entrance of the bridging vein in the middle cranial fossa: a novel classification of the cerebral veins for preoperative planning (2010) Neurosurgery, 67 (3), pp. ons.9-ons.15; Kugler, N., Patel, P.J., Lee, C.J., Chronic cerebrospinal venous insufficiency in multiple sclerosis: a failed concept (2015) Vasc Spec Int, 31, pp. 11-14; Mathiesen, T., Pettersson-Segerlind, J., Kihlstr{\"o}m, L., Ulfarsson, E., Meningiomas engaging major venous sinuses (2014) World Neurosurg, 81, pp. 116-124; Mavrocordatos, P., Bissonnette, B., Ravussin, P., Effects of neck position and head elevation on intracranial pressure in anaesthetized neurosurgical patients: preliminary results (2000) J Neurosurg Anesthesiol, 12, pp. 10-14; Nedelmann, M., Kaps, M., Mueller-Forell, W., Venous obstruction and jugular valve insufficiency in idiopathic intracranial hypertension (2009) J Neurol, 256, pp. 964-969; Perin, A., Prada, F.U., Moraldo, M., Schiappacasse, A., Galbiati, T.F., Gambatesa, E., USim: A new device and app for case-specific, intraoperative ultrasound simulation and rehearsal in neurosurgery. A preliminary study (2018) Oper Neurosurg (Hagerstown), 14, pp. 572-578; Prada, F., Del Bene, M., Casali, C., Saladino, A., Legnani, F.G., Perin, A., Intraoperative navigated angiosonography for skull base tumor surgery (2015) World Neurosurg, 84, pp. 1699-1707; Prada, F., Del Bene, M., Farag{\`o}, G., DiMeco, F., Spinal dural arteriovenous fistula: is there a role for intraoperative contrastenhanced ultrasound? (2017) World Neurosurg, 100, pp. 712.e15-712.e18; Prada, F., Del Bene, M., Moiraghi, A., Casali, C., Legnani, F.G., Saladino, A., From grey scale B-mode to elastosonog-raphy: multimodal ultrasound imaging in meningioma surgery-pictorial essay and literature review (2015) BioMed Res Int, 2015; Prada, F., Del Bene, M., Saini, M., Ferroli, P., DiMeco, F., Intraoperative cerebral angiosonography with ultrasound contrast agents: how I do it (2015) Acta Neurochir (Wien), 157, pp. 1025-1029; Prada, F., Perin, A., Martegani, A., Aiani, L., Solbiati, L., Lamperti, M., Intraoperative contrast-enhanced ultrasound for brain tumor surgery (2014) Neurosurgery, 74, pp. 542-552; Prada, F., Solbiati, L., Martegani, A., DiMeco, F., (2016) Intraoperative Ultrasound (IOUS) in Neurosurgery: from Standard B-mode to Elastosonography, , Cham, Switzerland: Springer; Prada, F., Vitale, V., Del Bene, M., Boffano, C., Sconfienza, L.M., Pinzi, V., Contrast-enhanced MR imaging versus contrast-enhanced US: a comparison in glioblastoma surgery by using intraoperative fusion imaging (2017) Radiology, 285, pp. 242-249; Sidhu, P.S., Cantisani, V., Dietrich, C.F., Gilja, O.H., Saftoiu, A., Bartels, E., The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (long version) (2018) Ultraschall Med, 39, pp. e2-e44; Silva, M.A., Deen, K.I., Fernando, D.J., Sheriffdeen, A.H., The internal jugular vein valve may have a significant role in the prevention of venous reflux: evidence from live and cadaveric human subjects (2002) Clin Physiol Funct Imaging, 22, pp. 202-205; Sindou, M., Meningiomas involving major dural sinuses: should we attempt at radical removal and venous repair? (2014) World Neurosurg, 81, pp. 46-47; Sindou, M., Auque, J., Jouanneau, E., Neurosurgery and the intracranial venous system (2005) Acta Neurochir Suppl, 94, pp. 167-175; Sindou, M., Hallacq, P., Venous reconstruction in surgery of meningiomas invading the sagittal and transverse sinuses (1998) Skull Base Surg, 8, pp. 57-64; Sindou, M.P., Alvernia, J.E., Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses (2006) J Neurosurg, 105, pp. 514-525; Valdueza, J.M., von M{\"u}nster, T., Hoffman, O., Schreiber, S., Einh{\"a}upl, K.M., Postural dependency of the cerebral venous outflow (2000) Lancet, 355, pp. 200-201; Wetzel, S.G., Kirsch, E., Stock, K.W., Kolbe, M., Kaim, A., Radue, E.W., Cerebral veins: comparative study of CT venography with intraarterial digital subtraction angiography (1999) AJNR Am J Neuroradiol, 20, pp. 249-255; Wilson, M.H., Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological components of intracranial pressure (2016) J Cereb Blood Flow Metab, 36, pp. 1338-1350",
year = "2018",
doi = "10.3171/2018.4.FOCUS18101",
language = "English",
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journal = "Neurosurgical Focus",
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}

TY - JOUR

T1 - Dynamic assessment of venous anatomy and function in neurosurgery with real-time intraoperative multimodal ultrasound: Technical note

AU - Prada, F.

AU - Del Bene, M.

AU - Mauri, G.

AU - Lamperti, M.

AU - Vailati, D.

AU - Richetta, C.

AU - Saini, M.

AU - Santuari, D.

AU - Yashar S. Kalani, M.

AU - DiMeco, F.

N1 - Export Date: 5 February 2019 Correspondence Address: Prada, F.; Fondazione IRCCS Istituto Neurologico C. BestaItaly; email: francesco.prada@istituto-besta.it References: Ayanzen, R.H., Bird, C.R., Keller, P.J., McCully, F.J., Theobald, M.R., Heiserman, J.E., Cerebral MR venography: normal anatomy and potential diagnostic pitfalls (2000) AJNR Am J Neuroradiol, 21, pp. 74-78; Bozzao, A., Finocchi, V., Romano, A., Ferrante, M., Fasoli, F., Trillò, G., Role of contrast-enhanced MR venography in the preoperative evaluation of parasagittal meningiomas (2005) Eur Radiol, 15, pp. 1790-1796; Brockmann, C., Kunze, S.C., Schmiedek, P., Groden, C., Scharf, J., Variations of the superior sagittal sinus and bridging veins in human dissections and computed tomography venography (2012) Clin Imaging, 36, pp. 85-89; Debernardi, A., Quilici, L., La Camera, A., Boccardi, E., Cenzato, M., Torcular meningioma with multi-venous sinus invasion: compensatory drainage veins and surgical strategy (2018) World Neurosurg, 109, pp. 451-454; Ferroli, P., Acerbi, F., Tringali, G., Albanese, E., Broggi, M., Franzini, A., Venous sacrifice in neurosurgery: new insights from venous indocyanine green videoangiography (2011) J Neurosurg, 115, pp. 18-23; Gisolf, J., van Lieshout, J.J., van Heusden, K., Pott, F., Stok, W.J., Karemaker, J.M., Human cerebral venous outflow pathway depends on posture and central venous pressure (2004) J Physiol, 560, pp. 317-327; Han, H., Deng, X., Fong, A.H., Zhang, M., Dural entrance of the bridging vein in the middle cranial fossa: a novel classification of the cerebral veins for preoperative planning (2010) Neurosurgery, 67 (3), pp. ons.9-ons.15; Kugler, N., Patel, P.J., Lee, C.J., Chronic cerebrospinal venous insufficiency in multiple sclerosis: a failed concept (2015) Vasc Spec Int, 31, pp. 11-14; Mathiesen, T., Pettersson-Segerlind, J., Kihlström, L., Ulfarsson, E., Meningiomas engaging major venous sinuses (2014) World Neurosurg, 81, pp. 116-124; Mavrocordatos, P., Bissonnette, B., Ravussin, P., Effects of neck position and head elevation on intracranial pressure in anaesthetized neurosurgical patients: preliminary results (2000) J Neurosurg Anesthesiol, 12, pp. 10-14; Nedelmann, M., Kaps, M., Mueller-Forell, W., Venous obstruction and jugular valve insufficiency in idiopathic intracranial hypertension (2009) J Neurol, 256, pp. 964-969; Perin, A., Prada, F.U., Moraldo, M., Schiappacasse, A., Galbiati, T.F., Gambatesa, E., USim: A new device and app for case-specific, intraoperative ultrasound simulation and rehearsal in neurosurgery. A preliminary study (2018) Oper Neurosurg (Hagerstown), 14, pp. 572-578; Prada, F., Del Bene, M., Casali, C., Saladino, A., Legnani, F.G., Perin, A., Intraoperative navigated angiosonography for skull base tumor surgery (2015) World Neurosurg, 84, pp. 1699-1707; Prada, F., Del Bene, M., Faragò, G., DiMeco, F., Spinal dural arteriovenous fistula: is there a role for intraoperative contrastenhanced ultrasound? (2017) World Neurosurg, 100, pp. 712.e15-712.e18; Prada, F., Del Bene, M., Moiraghi, A., Casali, C., Legnani, F.G., Saladino, A., From grey scale B-mode to elastosonog-raphy: multimodal ultrasound imaging in meningioma surgery-pictorial essay and literature review (2015) BioMed Res Int, 2015; Prada, F., Del Bene, M., Saini, M., Ferroli, P., DiMeco, F., Intraoperative cerebral angiosonography with ultrasound contrast agents: how I do it (2015) Acta Neurochir (Wien), 157, pp. 1025-1029; Prada, F., Perin, A., Martegani, A., Aiani, L., Solbiati, L., Lamperti, M., Intraoperative contrast-enhanced ultrasound for brain tumor surgery (2014) Neurosurgery, 74, pp. 542-552; Prada, F., Solbiati, L., Martegani, A., DiMeco, F., (2016) Intraoperative Ultrasound (IOUS) in Neurosurgery: from Standard B-mode to Elastosonography, , Cham, Switzerland: Springer; Prada, F., Vitale, V., Del Bene, M., Boffano, C., Sconfienza, L.M., Pinzi, V., Contrast-enhanced MR imaging versus contrast-enhanced US: a comparison in glioblastoma surgery by using intraoperative fusion imaging (2017) Radiology, 285, pp. 242-249; Sidhu, P.S., Cantisani, V., Dietrich, C.F., Gilja, O.H., Saftoiu, A., Bartels, E., The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (long version) (2018) Ultraschall Med, 39, pp. e2-e44; Silva, M.A., Deen, K.I., Fernando, D.J., Sheriffdeen, A.H., The internal jugular vein valve may have a significant role in the prevention of venous reflux: evidence from live and cadaveric human subjects (2002) Clin Physiol Funct Imaging, 22, pp. 202-205; Sindou, M., Meningiomas involving major dural sinuses: should we attempt at radical removal and venous repair? (2014) World Neurosurg, 81, pp. 46-47; Sindou, M., Auque, J., Jouanneau, E., Neurosurgery and the intracranial venous system (2005) Acta Neurochir Suppl, 94, pp. 167-175; Sindou, M., Hallacq, P., Venous reconstruction in surgery of meningiomas invading the sagittal and transverse sinuses (1998) Skull Base Surg, 8, pp. 57-64; Sindou, M.P., Alvernia, J.E., Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses (2006) J Neurosurg, 105, pp. 514-525; Valdueza, J.M., von Münster, T., Hoffman, O., Schreiber, S., Einhäupl, K.M., Postural dependency of the cerebral venous outflow (2000) Lancet, 355, pp. 200-201; Wetzel, S.G., Kirsch, E., Stock, K.W., Kolbe, M., Kaim, A., Radue, E.W., Cerebral veins: comparative study of CT venography with intraarterial digital subtraction angiography (1999) AJNR Am J Neuroradiol, 20, pp. 249-255; Wilson, M.H., Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological components of intracranial pressure (2016) J Cereb Blood Flow Metab, 36, pp. 1338-1350

PY - 2018

Y1 - 2018

N2 - The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins. Intraoperative ultrasound (ioUS) permits the real-time study of venous compartments using different modalities, thus allowing complete characterization of their anatomical and functional features. The B-mode (brightness mode) offers a high-resolution anatomical representation of veins and their relationships with lesions. Doppler modalities (color, power, spectral) allow the study of blood flow and identification of vessels to distinguish their functional characteristics. Contrast-enhanced US allows one to perform real-time angiosonography showing both the functional and the anatomical aspects of vessels. In this technical report, the authors demonstrate the different applications of multimodal ioUS in neurosurgery for identifying the anatomical and functional characteristics of the venous compartment. They discuss the general principles and technical nuances of ioUS and analyze their potential implications for the study of various venous districts during neurosurgical procedures. © AANS 2018.

AB - The relevance of the cerebral venous system is often underestimated during neurosurgical procedures. Damage to this draining system can have catastrophic implications for the patient. Surgical decision-making and planning must consider each component of the venous compartment, from the medullary draining vein to the dural sinuses and extracranial veins. Intraoperative ultrasound (ioUS) permits the real-time study of venous compartments using different modalities, thus allowing complete characterization of their anatomical and functional features. The B-mode (brightness mode) offers a high-resolution anatomical representation of veins and their relationships with lesions. Doppler modalities (color, power, spectral) allow the study of blood flow and identification of vessels to distinguish their functional characteristics. Contrast-enhanced US allows one to perform real-time angiosonography showing both the functional and the anatomical aspects of vessels. In this technical report, the authors demonstrate the different applications of multimodal ioUS in neurosurgery for identifying the anatomical and functional characteristics of the venous compartment. They discuss the general principles and technical nuances of ioUS and analyze their potential implications for the study of various venous districts during neurosurgical procedures. © AANS 2018.

KW - Cerebral veins

KW - Contrast-enhanced ultrasound

KW - Dural sinuses

KW - Extracranial veins

KW - Intraoperative imaging

KW - Intraoperative ultrasound

U2 - 10.3171/2018.4.FOCUS18101

DO - 10.3171/2018.4.FOCUS18101

M3 - Article

VL - 45

SP - 1

EP - 9

JO - Neurosurgical Focus

JF - Neurosurgical Focus

SN - 1092-0684

IS - 1

ER -