Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2015;11(1):17-20.
Published online June 30, 2015.
A Method for the Application of the Leksell Stereotactic Frame Using the Hard Palate in Stereotactic and Functional Neurosurgery : Clinical Analysis of Efficacy
Woo Jae Kim, Myung Ki Lee, Gun Sang Lee, Ho Sang Kim, Jeong Ho Kim, Yun-Suk Kim
Department of Neurosurgery, Maryknoll General Hospital, Busan, Korea
Abstract
Objective
We introduce a method for the application of the Leksell stereotactic frame running parallel to the anterior commissure-posterior commissure (AC-PC) line through CT and MRI scans using the hard palate.
Methods
Twenty-two patients who underwent stereotactic surgery for movement disorders were analyzed retrospectively. We measured an angle between the AC-PC line and the superior cortical surface of the hard palate on sagittal MRI. CT was then examined for the predetermined gantry angle relative to the hard plate on the lateral scout film. A cutaneous external landmark using the laser guide light of the CT was displayed along the AC-PC plane. The frame was applied using the cutaneous landmark. We compared the MRI scans with the frame-based CT scans regarding the AC-PC length.
Results
The AC-PC line was angled at 9.2°±4.0° from the hard palate, and the AC-PC length was measured as 23.5±1.3mm on the MRI. After the application of the frame, the AC-PC length was measured as 24.2±0.6mm on the CT. The AC and PC were visible in the same axial image in 18cases (81.8%). The remaining 4cases (18.2%) were visible on the adjacent slices. There was no significant difference in the length of the AC-PC line before and after the frame application.
Conclusions
The MR and CT images using the hard palate offer a useful method for the application of the Leksell frame running parallel to the AC-PC line in stereotactic neurosurgery
Key Words: Stereotactic technique, Hard palate, Computed tomography, Magnetic resonance imaging.
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