Three-Dimensional Computer Reconstruction of a Fourth Ventricle Ependymoma

It is very important to establish the surgical strategy for fourth ventricle ependymoma with the aim of total tumor resection because improving the degree of surgical removal is the most promising means of improving outcome. We present our experience in reconstructing a three-dimensional (3-D) image of a fourth ventricle ependymoma perioperation. We used computerassisted 3-D reconstruction to visualize a fourth ventricle ependymoma. Tumor outlines were manually traced out and imported to a 3-D visualization tool for 3-D reconstruction. The patient was operated through a median infratentorial approach. Perioperation by rotating the 3-D image and observing from various angles, we acquired abundant information such as 3-D tumor contour, the relation between the tumor and the wall of the fourth ventricle, the origin and invasion of the tumor, which were very useful to monitor tumor resection, adjust the approach to the ependymoma, and avoid inadvertent injury of important anatomic structures. Computer-assisted 3-D reconstruction may not only provide useful information before and during surgery, but also simplify the surgical procedure. It may be a useful aid to surgery making neurosurgery less invasive and more effective.