The usefulness of dual volume visualization (three-dimensional digital subtraction angiography and cross-sectional imaging) for surgical planning in treating intracranial meningiomas: a case series and technical report.

OBJECTIVE: In pre-surgical planning for intracranial meningiomas, the relationship between tumors and adjacent vasculature must be identified. The purpose of this study was to evaluate the usefulness of three-dimensional digital subtraction angiography (3D-DSA) with dual volume visualization (DVV).

METHODS: Between Feb. 2013 and April 2016, 26 patients with intracranial meningioma enrolled in this study. Two or 3 days before surgery, 3D-DSA with DVV was performed for pre-surgical planning. If necessary, the tumor was simultaneously embolized.

RESULTS: Vascular supply and disfiguration observed by preoperative 3D-DSA with DVV closely resembled those actually observed during surgery. All but two patients had total tumor resection (Simpson's grade 1 or 2). Three of 26 patients had new neurologic deficits.

CONCLUSIONS: 3D-DSA with DVV may be useful for preoperative planning by allowing the surgeon to identify the relationship between a tumor and peritumoral vasculature before meningioma surgery. Young neurosurgeons with little experience may benefit most from this technique.