Cerebellar anatomy as applied to cerebellar microsurgical resections / Anatomia cerebelar aplicada à microcirurgia cerebelar ablativa

OBJECTIVE: To define the anatomy of dentate nucleus and cerebellar peduncles, demonstrating the surgical application of anatomic landmarks in cerebellar resections. METHODS: Twenty cerebellar hemispheres were studied. RESULTS: The majority of dentate nucleus and cerebellar peduncles had demonstrated constant relationship to other cerebellar structures, which provided landmarks for surgical approaching. The lateral border is separated from the midline by 19.5 mm in both hemispheres. The posterior border of the cortex is separated 23.3 mm from the posterior segment of the dentate nucleus; the lateral one is separated 26 mm from the lateral border of the nucleus; and the posterior segment of the dentate nucleus is separated 25.4 mm from the posterolateral angle formed by the junction of lateral and posterior borders of cerebellar hemisphere. CONCLUSIONS: Microsurgical anatomy has provided important landmarks that could be applied to cerebellar surgical resections.

OBJETIVO: Definir a anatomia do núcleo denteado e dos pedúnculos cerebelares, demonstrando a aplicação dos marcos anatômicos em cirurgias cerebelares. MÉTODOS: Foram estudados 20 hemisférios cerebelares. RESULTADOS: A maioria dos núcleos denteados e pedúnculos cerebelares demonstraram relação anatômica constante com outras estruturas cerebelares, fato que proporcionou o estabelecimento de marcos anatômicos específicos a serem utilizados em acessos cirúrgicos. O bordo lateral do núcleo denteado é separado da linha média em 19,5 mm em ambos os hemisférios cerebelares. O bordo posterior do córtex é separado do segmento posterior do núcleo denteado por 23,3 mm. O bordo lateral do córtex é separado do bordo lateral do núcleo por 26 mm e o segmento posterior do núcleo denteado é separado por 25,4 mm do ângulo posterolateral, que é formado pela junção dos bordos lateral e posterior do hemisfério cerebelar. CONCLUSÕES: O estudo da anatomia microcirúrgica proporcionou o estabelecimento de marcos anatômicos importantes que podem ser utilizados durante cirurgias cerebelares ablativas.

Fluid Attenuated Inversion Recovery (FLAIR) Imaging of the Normal Brain: Comparisons between Under the Conditions of 3.0 Tesla and 1.5 Tesla

OBJECTIVE: The aim of this study was to evaluate the differences in normal brain MRI findings between under 3.0 Tesla (T) and 1.5T MRI conditions with the use of the fluid attenuated inversion recovery (FLAIR) sequences. MATERIALS AND METHODS: Eleven normal adults underwent imaging with the use of the FLAIR sequences on both 1.5T and 3.0T scanners. Two neuroradiologists compared the signal intensity (SI) of the centrum semiovale (CS), pulvinar thalami (PT) and normal iron deposit structures (IDSs) on the 3.0T and 1.5T FLAIR images, and they evaluated three MRI findings qualitatively: high SI of CS; low SI of PT; low SI of IDS. We also evaluated signal-to-noise ratios (SNRs) for the CS, PT, red nucleus and cerebellar dentate nucleus on the FLAIR images. RESULTS: Based on qualitative analyses, the 3.0T FLAIR images showed all three MRI findings for all cases. Low SI for the PT in seven cases (64%), high SI of the CS in one case (9%) and low SI of the cerebellar dentate nucleus in one case (9%) were visualized only on 3.0T FLAIR images. The mean SNRs of the PT, red nucleus and dentate nucleus in patients where 3.0T FLAIR imaging was performed were significantly lower as compared with the SNRs on 1.5T FLAIR images. The SNR of the CS was not significantly different between under the two magnetic field strengths (p > 0.05). CONCLUSION: We have demonstrated that normal, high and low SIs of the CS, PT and IDS on 3.0T FLAIR images were depicted more frequently and more prominently as compared with those on 1.5T FLAIR images in normal adult brains.