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The 3DQ Lab was presented with a request to visualize and create a 3D print of the brain of a patient with the rare diagnosis of Periventricular Nodular Heterotopia (PVNH). PVNH is identifiable in medical images when abnormally growing brain tissue appears inside and around the ventricles, which are normally filled with cerebrospinal fluid. Patients with PVNH can lead normal lives but symptoms such as seizures must be managed to ensure quality of life is as high as possible. Stanford Healthcare’s Neurosurgery team assists with treatment by temporarily implanting electrodes in the brain to track seizure activity and discern their origin.

For 3D visualization and printing, the 3DQ Lab requires an MR exam of the patient’s brain before electrodes are inserted, and a CT of the head with the implanted electrodes. The MRI and CT scans are then processed by a 3DQ Lab technologist to specifically highlight the tissues of interest in the MR scan (Figure C, left), and the electrodes in the CT scan (Figure C, right), with a radiologist guiding the identification of the very subtle pathology. The green structures in Figure A and Figure B represent PVNH abnormal brain growth, and the red structures in Figure A are electrodes intended to help surgeons and epileptologists map regions of the brain causing seizure activity.

The processed MR and CT images were aligned and linked together for optimal visualization of the relationship between the electrodes, PVNH, and brain ventricles. The computer visualization of this, as well as a 3D printed model (Figures D) were sent to the Stanford Healthcare Neurosurgery team for planning purposes.

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