September 1, 2007 — Neurosurgeons' jobs are made easier by a 3-D CT scan produced by an advanced imaging system. It produces a computerized image of blood vessels and surrounding soft tissue, which can be rotated for viewing from any angle. Brain surgeries can be performed more smoothly because this real-time representation makes visualization of aneurysms and stents simpler.
Surgery is getting better and better and the tools used are getting smaller and smaller. What used to require large incisions and months of recovery is now done with tiny instruments. The latest 3-D technology makes brain surgery better and safer for patients suffering from a stroke or aneurysm.
"It's a funny feeling to wake up, and all of a sudden in a hospital, and you've got things stuck in you everywhere, and you're thinking, 'What the hell happened?!' It's like a horror movie," Arlene Mikol said.
Mikol had a bleeding brain aneurysm -- something people survive only half the time. She credits being alive to neurosurgons who used a new brain imaging technology. During surgery, doctors threaded tiny instruments through the leg artery up to brain vessels. The imaging system produces 3-D CT scan images in real time.
"Think about this; if you're working on the roof of your house, without a flashlight, for example. You know, how can you really repair something if you're not seeing it very well?" asks Demetrius Lopes, a neurosurgeon from Rush University Medical Center.
With the standard angiogram, you need to take 50 different images. Now, the 3-D scan can be rotated to look from any angle and see 500 pictures from just one image. "That has an impact on how fast a procedure is and how safe that procedure is going to be done."
Arlene knows how lucky she is and has a new perspective. She said she wants to live till 90 to see her grandchildren grow up.
"So I'm fighting it as long as I can. I'm going to fight it!" Mikol exclaims.
The system is also used for stroke patients. Other advantages to it: surgeons are able to see fine details like the shape of an aneurysm and the exact placement of a stent. Also, patients are exposed to less radiation and need less contrast dye, which can affect the kidneys.
BACKGROUND: For victims of stroke, every second counts. New technology at Rush University Medical Center helps surgeons treat the blood vessels in the brain faster and with less risk. The new neuroendovascular suite is equipped with the latest in advanced, 3D imaging and interoperative software, allowing surgeons to see the blood vessels and surrounding brain tissue in ways they could not before.
HOW IT WORKS: Neuroendovascular surgeons use a catheter and an image-guidance system to thread tiny instruments through the femoral artery in the leg up to the brain vessels. The new imaging system at Rush produces 3D CT scans rendered in real time. As the surgeon snakes the catheter through the twists and turns of the blood vessels, a computerized 3D image of the blood vessel and surrounding soft tissue can be rotated to view from any angle. The image is translucent allowing the surgeon to see exactly where the catheter is in the tiny blood vessels. It's similar to having a GPS system guiding you to your destination, compared to trying to navigate by the stars.
BENEFITS: While the procedure is taking place, the surgeon can visualize fine details such as the shape of the aneurysm or the exact placement of a stent. With the ability to take CT images, the impact on other structures in the brain can be immediately detected and evaluated, such as complications like intracranial bleeding. In addition to visualizing the brain, it is crucial for surgeons to know how well the brain is functioning during the procedure. The new suite offers a unique neurophysiologic monitoring system. During surgery, the specialists can monitor the patientýs vision, sensation, and movement even while the patient is under general anesthesia.
ABOUT CAT SCANS: CAT (Computerized Axial Tomography) scans are similar to conventional X-ray imaging, but instead of imaging the outline of bones and organs, a CAT scan machine forms a full three-dimensional computer model of the inside of a patient's body. Doctors can even examine the body one narrow slice at a time. The X-ray beam moves all around the patient, scanning from hundreds of different angles, and the computer takes all that information to compile a 3D image of the body.
Note: This story and accompanying video were originally produced for the American Institute of Physics series Discoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law. All rights reserved.
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