MRI and stereotaxis. Choice of an approach route on an independent console.

The authors report their experience of cerebral stereotaxis for biopsy purposes. Since January 1990, they have been using MRI which provides vascular images and makes it possible to simulate surgical procedures beforehand. The authors have developed a specific program on an independent console. MRI sections are acquired with a 1.5 Tesla Sigma (G.E.) apparatus in 3DFT volume and T1-weighted SPRG sequence, after gadolinium injection. The sections are memorized and reconstructed by a SUN computer. After automatic recognition of the referential of a Leksell G plane, the target and the puncture vector are chosen by a radiologist and a neurosurgeon. The X, Y, Z co-ordinates of the point of puncture and the angles of penetration into the cerebral volume are delivered automatically. Provided the entire measurement chain is constantly tested and corrected if necessary, the precision of the system is of the order of one millimetre.