DrMANZO NORBERT-CHEF DE SERVICE DE NEUROCHIRURGIE.CHU FORT DE FRANCE.

Norbert Lucio

Description

Angiomes vertébraux multiples
Dr N.MANZO. CHU .Fort de France. Neurochirurgie.
Les hémangiomes vertébraux sont des lésions bénignes particulièrement fréquentes. Leur découverte est le plus
Souvent fortuite lors d’examens d’imagerie réalisés pour d’autres raisons. La majorité n’a aucune traduction
Clinique et ne requière aucun traitement. Dans moins d’un pourcent des cas, les hémangiomes ont un
Développement extensif à l’origine d’une symptomatologie neurologique. Dans un quart des cas, l’atteinte
Vertébrale est multiple et la présentation clinico-radiologique peut alors faire évoquer une atteinte métastatique
Du rachis.
Une fois le diagnostic d’angiome vertébral agressif posé, la stratégie thérapeutique doit être adaptée au type
D’atteinte et à l’importance du tableau neurologique. Même si les moyens thérapeutiques sont multiples, la prise
En charge de ces lésions reste encore controversée.
A l’occasion de la prise en charge de deux cas d’hémangiomes agressifs multiples dans notre service, et après
Analyse de la littérature, nous réévaluons l’intérêt des différentes options thérapeutiques et synthétisons une
Stratégie de traitement basée sur la topographie de l’envahissement vertébral.

Informations

• Publié par: pijudo
• Publié le: 19 avril 2011
• Nombre de lectures: 290
• Langue: English
• Poids de l'ouvrage: 5 Mo

Extrait

FLOW 800 A New Dimension in Fluorescence

FLOW 800 – f l u o r e s c e n c eo fi n t r a o p e r a t i v et h ef u t u r eE x p e r i e n c e

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FLOW 800 Analyzing blood flow in every detail

TM Direction, intensity and sequence: FLOW800 enables visual analysis of vascular blood flow dynamics.

1 All the information from INFRARED 800 video sequences is compiled into visual maps– clearly presented

at a glance. The blood flow in various vessels can be further analyzed by using the diagram function

summarizing the variation of blood flow over time. The side-by-side comparison allows direct evaluation

of data at different procedure sequences intraoperatively. FLOW 800 supports an in-depth interpretation

of fluorescence videos by creating an objective evaluation of results visually and in color.

Pinpoint analysis Blood flow evaluation of specific anatomical regions of interest.

Blood flow mapping Instant visual capture of blood flow dynamics.

Side by side comparison Direct side-by side illustration of selected flow sequences.

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Insights into blood flow dynamics

What are the patient‘s blood flow dynamics and how have they changed during the procedure? FLOW 800 can instantly provide the answer, thereby optimizing analysis time of the patient’s blood flow dynamics. Complex associations and visual connections can be quickly mapped and analyzed. Fluorescence signals take on a whole new dimension and provide the basis for clear-headed decisions.

Temporal Fluorescence Projection This map employs colors to instantly identify the direction and sequence of 3 blood flow.This function is beneficial for visualizing feeder arterial vessels and draining veins when treating Arte- riovenous Malformations. To enable an accurate identification of vessel blood flow, a continuous color scale is used. Red represents the initial blood inflow, followed by a gradient color scale for subsequent blood flow sequences.

Peak Fluorescence Values This visual map features an overview of blood flow dynamics, right down to the smallest blood vessels. The image was created by compiling all the information from the entire fluorescence video sequence. Peak fluorescence values are displayed in the 1, 2 form of different shades of gray.

Side-by-Side Comparison The comparison function in FLOW 800 enables direct comparison of fluorescence imaging sequences intraoperatively to visualize blood flow changes. No more tedious advancing and rewinding of video sequences is needed to filter out changes! The surgeon is able to easily compare blood flow before and after clipping in cerebral aneurysm surgery.

Running the Curves The intensity diagram function helps to visualize the variation in blood flow over time. The user can freely define which regions are to be evaluated by using either a rectangular shape or a variable shape that automatically 4 adapts to the structure of the vessel .

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Visualization simplified

FLOW 800 presents an effortless and intuitive user interface platform. The visual data and information are available at the touch of a button.

Easy to use Operation of FLOW 800 is seamlessly integrated within the intuitive INFRARED 800 workflow. FLOW 800 functions can be controlled using the handgrip or ® ® touchscreen on the OPMI Pentero system.The clear and intuitive interface enables the user to perform tasks effortlessly.

Automatically on target During the INFRARED 800 video playback phase, FLOW 800 starts processing all the fluorescence video data and generates numerous flow dynamics visual maps and rate charts. Compensating for slight movements of the surgical microscope, the system also makes corrections for the reduced light intensity towards the 5 edge of the image.

The right information in the right place The results generated by FLOW 800 can be instantly displayed on OPMI Pentero’s touchscreen or an external monitor. Data downloads for external blood flow dynamics analysis are a thing of the past! All flow dynamics information is ready when you are. The graphs and diagrams are automatically saved in the patient’s file and can be exported via CD/DVD or the USB port after surgery.

Comparison of video sequence Direct comparison of different phases of an operation

Blood flow preview A preview helps the user select which phases of the operation should be compared

Function selection Switching between the three basic functions is easy

Mode selection Easily select between the different display options

Flow dynamics color gradient – second sequence Color blood flow scale of comparison video

Selectable rate of flow scale Rate of flow scaling can be adjusted to a uniform or independent setting for each image as desired

Video sequence summary A combined overview of the fluorescence video sequence at a glance

Flow dynamics color gradient Color scale indicates rate of blood flow and sequencing enabling a fast and effective assessment

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Greater clarity in complex situations

Accurate information gives surgeons the tools they need to make clear decisions. FLOW 800 is an analytical visualization function for the rapid and reliable interpretation of fluorescence video sequences generated using INFRARED 800.

Just the information you need FLOW 800 provides the surgeon with an effective visualization tool kit. Clearly presented maps make it 1, 3 possible to quickly ascertain blood flow dynamics. Line graphs enable pinpoint analysis of critical regions at even greater levels of accuracy. And the comparison view helps users identify changes in blood flow more quickly. FLOW 800 saves valuable time by making sure that you have all the relevant information available at a glance.

Improved communication FLOW 800 offers the option of extracting data from INFRARED 800 videos. This information is automatically saved in the relevant patient file and can be exported via CD/DVD or the USB port. Whether for lecturing or publishing, this method allows presentation of clinical cases clearly and succinctly.

Improved efficiency FLOW 800 is a logical evolution of INFRARED 800 and acts as its perfect complement. It converts difficult- to-access information from fluorescence videos into user-friendly formats. The integration of FLOW 800 into INFRARED 800 and OPMI Pentero has created a seamless solution that provides a fast and easy means of achieving optimum results.

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Image courtesy of

Page 1/2 Robert F. Spetzler, M.D; Louis Kim, M.D. Barrow Neurological Institute, Phoenix, Arizona, USA

Page 4/5; 7 (below); 8/9 Yasuo Murai, M.D., Ph.D., Department of Neurosurgery, Nihon Medical School, Tokyo, Japan

Page 6/7 Yasushi Takagi, M.D., Ph.D., Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

1 Patent pending No. P17010 2 Patent pending No. P17007 3 Patent pending No. P17009 4 Patent pending No. P17011 5 Patent pending No. P16964P17013

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Not available for sale in the US OPMI and Pentero are registered trademarks of Carl Zeiss. FLOW is a trademark of Carl Zeiss.

Carl Zeiss Surgical GmbH A Carl Zeiss Meditec Company 7446 Oberkochen Germany

Fax: +49(0) 764 / 20-482 Email: [e-mail] www.meditec.zeiss.com/iof www.meditec.zeiss.com/contacts