sechenovSechenov Medical JournalСеченовский вестник2218-73322658-3348Сеченовский Университет10.47093/2218-7332.2022.13.2.12-19sechenov-729Research ArticleNEUROSURGERYНЕЙРОХИРУРГИЯOptimization of intraoperative ultrasound navigation during focal cortical dysplasia surgery: a case reportОптимизация интраоперационной ультразвуковой навигации при оперативном лечении очаговой кортикальной дисплазии: клинический случайhttps://orcid.org/0000-0003-3611-3720СимфуквеК.SimfukweK.

Кейт Симфукве, аспирант по специальности «Нейрохирургия»

ул. Трубецкая, д. 8, стр. 2, г. Москва, 119991

Keith Simfukwe, postgraduate student in neurosurgery

8/2, Trubetskaya str., Moscow, 119991

https://orcid.org/0000-0001-7580-0385СуфиановА. А.SufianovA. A.

Суфианов Альберт Акрамович, д-р мед. наук, профессор, член-корреспондент РАН, главный врач ФГБУ «Федеральный центр нейрохирургии» Минздрава России; зав. кафедрой нейрохирургии ФГАОУ ВО «Первый МГМУ им. И. М. Сеченова» Минздрава России (Сеченовский Университет); профессор ФГАОУ ВО «Российский университет дружбы народов»

ул. Трубецкая, д. 8, стр. 2, г. Москва, 119991

4-й км Червишевского тракта, д. 5, Тюмень, 625032

ул. Миклухо-Маклая, д. 6, г. Москва, 117198

Тел.: +7 (909) 190-24-65

Albert A. Sufianov, Dr. of Sci. (Medicine), Professor, Corresponding Member of RAS, Head of Federal Centre of Neurosurgery; Head of the Department of Neurosurgery, Sechenov First Moscow State Medical University (Sechenov University); Professor, Peoples’ Friendship University of Russia (RUDN University)

8/2, Trubetskaya str., Moscow, 119991

5, 4th km of Chervishevskу tract, Tyumen, 625032

6, Miklukho-Maklay str., Moscow, 117198

Tel.: +7 (909) 190-24-65

sufianov@gmail.comФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет); ФГБУ «Федеральный центр нейрохирургии» Минздрава России; ФГАОУ ВО «Российский университет дружбы народов»РоссияSechenov First Moscow State Medical University (Sechenov University); Federal Centre of Neurosurgery; Peoples’ Friendship University of Russia (RUDN University)Russian Federation2022230920221321219Copyright © Simfukwe K., Sufianov A.A., 20222022Симфукве К., Суфианов А.А.Simfukwe K., Sufianov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sechenovmedj.com/jour/article/view/729

Intraoperative ultrasound (IUS) is known to be an effective method for neuronavigation during surgical treatment of intractable seizures caused by focal cortical dysplasia (FCD). However, the 2-dimensional (2D) IUS has poor image quality and low spatial resolution. We describe via a case report how Ultrasound integrated Brainlab (BL) – Navigation software was used to optimize 2D IUS and thereby reduce these challenges.

Case report

Case report: We present a case report of a 22-year-old female patient with a long-standing history of seizures. The patient was treated with more than two anti-epileptic drugs without any clinical efficacy. In 2022 she was diagnosed with temporal lobe FCD. We performed a temporal lobe lesionectomy using optimized IUS BL-Navigation that provided enhanced 3-dimensional (3D) images.

Discussion

Discussion: The extent of resection of the underlying FCD lesion is a key factor in determining whether a patient achieves meaningful seizure freedom after surgery. While the 2D IUS offers admirable characteristics that have been used as an aid during surgery, it is our view that IUS enhanced 3D BL-Navigation offers better appreciation of FCD lesions and therefore improves the extent of resection.

Интраоперационное ультразвуковое исследование является эффективным методом нейронавигации при хирургическом лечении резистентных к терапии судорог у пациентов с фокальной кортикальной дисплазией (ФКД). Однако двумерное УЗИ имеет низкое качество изображения и пространственное разрешение. Представлен клинический случай оперативного лечения ФКД с применением программного обеспечения Brainlab (BL)-Navigation, интегрированного с ультразвуком.

Описание случая

Описание случая. Представлен клинический случай 22-летней пациентки с длительным анамнезом судорог. Лечение более чем двумя противоэпилептическими препаратами было неэффективным. В 2022 году установлен диагноз ФКД височной доли. Мы выполнили удаление пораженного участка височной доли с использованием оптимизированного УЗИ с BL, позволяющего получить улучшенные трехмерные (3D) изображения.

Обсуждение

Обсуждение. Объем резекции при оперативном лечении ФКД – ключевой фактор эффективности лечения приступов эпилепсии. Несмотря на то что двумерное УЗИ широко используется в практике и обладает приемлемыми характеристиками, на наш взгляд, УЗИ с BL позволяет лучше оценить объем ФКД и, следовательно, точнее определить объем резекции.

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The authors declare that there are no conflicts of interest present.