• World Neurosurg · Dec 2022

    Anatomical and technical preparations of the human brain for white matter fibers dissection with electromagnetic neuronavigation assistance technical nuances for application.

    • Andrey E Bykanov, David Pitskhelauri, Artem I Batalov, Maxim Trube, Gleb Danilov, and Denis Golbin.
    • Department of Neurooncology, N.N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia; Department of Neuroanatomy, N.N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia.
    • World Neurosurg. 2022 Dec 1; 168: 173178173-178.

    BackgroundKlinger's fiber dissection technique is widely used for studying the anatomy of white matter. Herein, we present a technical description of Klinger's proposed fiber dissection algorithm with neuronavigation assistance which allows for a more accurate determination of the projection of association fibers.MethodsAn anatomical study was conducted on 8 hemispheres of the human brain, prepared according to the Klingler fiber dissection technique. In all the cases, a frameless electromagnetic navigation system was used. For each anatomical specimen, an individualized support device was three-dimensional -printed and placed it into the magnetic resonance imaging (MRI) gantry. MRI study of each anatomical specimen was performed using a specific protocol that enabled a subsequent three-dimensional visualization of the anatomical structures as follows: FSPGR (Fast SPoiled Gradient Recalled echo) BRAVO (BRAin VOlume Imaging), T2 CUBE, FLAIR (FLuid Attenuated Inversion Recovery) CUBE, CUBE DIR (double inversion recovery) WHITE MATTER, and CUBE DIR GRAY MATTER.ResultsThe average time required to register an anatomical specimen in the navigation system was 7 minutes 28 seconds. In all of the 8 cases, the anatomical structures were correctly identified using neuronavigation. Moreover, the choice of MRI mode depends on the purpose of the study and the region of interest in the brain.ConclusionsElectromagnetic navigation is an accurate and useful technique. It allows the researcher the ability to virtually project the association fibers and their cortico-cortical terminations to the surface of the brain, even at the final stages of dissection when the superficial structures are removed. To obtain accurate targeting, it is important to use the appropriate neuronavigation protocol.Copyright © 2022 Elsevier Inc. All rights reserved.

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