Vol 68, No 3 (2009)
Original article
Published online: 2009-05-13
Image-guided dissection of human white matter tracts as a new method of modern neuroanatomical training
Folia Morphol 2009;68(3):135-139.
Abstract
Neuronavigation is a kind of image-guided surgery used during neurosurgical
procedures. Based on specific equipment which is compatible with the software
calculating and processing the patient’s data; this method allows the determination
of the location of anatomical structures and visualisation of surgical instruments
in the operative field. Although standard brain dissection is still the best
method of neuroanatomical training, some limitations occur. The most important
of these is the inability of conversion from three-dimensional (3D) view to
flat pictures of the brain structures, as viewed on computed tomography (CT)
and magnetic resonance imaging (MRI), being essential in neuroanatomical training
nowadays. The aim of the study was the implementation of a neuronavigating
system for brain anatomy training purposes. The study was performed on
10 human brain hemispheres, dissected due to classical methods (standard brain
anatomical sections, stepwise ventricular system opening and partial dissection
of white matter tracts using Klingler’s dissection technique). The material was
scanned in a 1.5 T magnetic resonance scanner using a modified neuronavigation
protocol. The brains were prepared before dissection as proposed by Klingler.
The subsequent steps of the dissection were documented with a digital
camera. The progress of the dissection was visualised using the neuronavigation
system (Medtronic Stealth Station Treon) with cranial application software. In
the course of the study, numerous 3D and 2D images were obtained. The images
were related to each other and linked anatomical structures in the specimen
with their appearance on CT and MRI scans. The implementation of a neuronavigation
system for brain structures dissection facilitates visualization and understanding
of their proper location. This new method offers a constant and precise
orientation and simplifies understanding of the relation of the 3D view of a specimen
to that of the 2D image.
Keywords: neuronavigationwhite matter tracts dissection