STMO-02 PREOPERATIVE FENCE-POST METHOD PLANNING WITH 3D-FUSION IMAGING

The fence-post method has been used for removal of intra-axial tumors. Preoperative detailed planning with only navigation work system is sometimes difficult to identify actual brain surface, small feeding artery and passing artery. Recently, 3-dementional imaging is well developed to integrate various anatomical findings. The purpose of this study is pursuit of perfect preoperative planning for removal intra-axial tumors with 3D-fusion imaging. From May 2017 to June 2019, 21 patients with intra-axial tumor were included. The software “AZE” was used to create 3D-fusion imaging. The brain tumor, brain surface and tractography were built from MRI, artery from digital angiography and vein from subtraction enhanced computed tomography. Then detailed preoperative planning was planned including how many fence-posts, procedure of cutting feeder, making sulcotomy or corticotomy, and finally cutting drainer. The average bleeding volume was 101±129cc, and there were no patients who had transfusion. All patients did not show additional neurological impairment after surgery. Detailed and perfect preoperative planning with 3D-sufion imaging should be effective for secure neurosurgery.