The Usefulness of Dual-Volume Visualization (Three-Dimensional Digital Subtraction Angiography and Cross-Sectional Imaging) for Surgical Planning in Treating Intracranial Meningiomas: A Case Series and Technical Report.

Abstract

In presurgical planning for intracranial meningiomas, the relationship between tumors and adjacent vasculature must be identified. The purpose of this study was to evaluate the usefulness of 3-dimensional digital subtraction angiography (3D-DSA) with dual-volume visualization (DVV). Between February 2013 and April 2016, 26 patients with intracranial meningiomas enrolled in this study. Two or 3 days before surgery, 3D-DSA with DVV was performed for presurgical planning. If necessary, the tumor was simultaneously embolized. Vascular supply and disfiguration observed by preoperative 3D-DSA with DVV closely resembled those actually observed during surgery. All but 2 patients had total tumor resection (Simpson grade 1 or 2). Three of 26 patients had new neurologic deficits. 3D-DSA with DVV may be useful for preoperative planning by allowing the surgeon to identify the relationship between a tumor and peritumoral vasculature before meningioma surgery. Young neurosurgeons with little experience may benefit most from this technique.