Three-dimensional Intraoperative Ultrasound

A dedicated commercial system for navigated Three-dimensional Intraoperative Ultrasound allowing to acquire 3D ultrasound (US) volumes by combining a stack of 2D US scans with known spatial positions was first presented in 2000 by Gronningsaeter et al., 1) and applied to different cranial pathologies 2) 3)

Intraoperative coregistration of 3D intraoperative ultrasound data with preoperative 3D Rotational Angiography is possible with high accuracy. It allows the immediate visualization of vessels beyond the microscopic field, as well as parallel assessment of blood velocity, aneurysm and vascular tree configuration. Although spatial resolution is lower than for standard angiography, the method provides an excellent vascular overview, advantageous interpretation of 3D-ioUS and immediate intraoperative feedback of the vascular status. A prerequisite for understanding vascular intraoperative ultrasound is image quality and a successful match with preoperative rotational digital subtraction angiography 4).


1)
Gronningsaeter A, Kleven A, Ommedal S, et al. SonoWand, an ultrasound-based neuronavigation system. Neurosurgery. 2000;47:1373-1379 [discussion: 1379-1380].
2)
Unsgaard G, Ommedal S, Rygh OM, Lindseth F. Operation of arteriovenous malformations assisted by stereoscopic navigation-controlled display of preoperative magnetic resonance angiography and intraoperative ultrasound angiography. Oper Neurosurg. 2005;56:281-290.
3)
Unsgaard G, Selbekk T, Brostrup Muller T, et al. Ability of navigated 3D ultrasound to delineate gliomas and metastases–comparison of image interpretations with histopathology. Acta Neurochir (Wien). 2005;147:1259-1269 [discussion: 1269].
4)
Podlesek D, Meyer T, Morgenstern U, Schackert G, Kirsch M. Improved Visualization of Intracranial Vessels with Intraoperative Coregistration of Rotational Digital Subtraction Angiography and Intraoperative 3D Ultrasound. PLoS One. 2015 Mar 24;10(3):e0121345. doi: 10.1371/journal.pone.0121345. eCollection 2015. PubMed PMID: 25803318.
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