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Asian J Neurosurg. 2019 Jul-Sep;14(3):762-766. doi: 10.4103/ajns.AJNS_63_19.

The Use of Osirix for Surgical Planning Using Cranial Measures and Region of Interest Tools: Technical Note.

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Department of Surgery, Division of Neurosurgery, Santa Casa De São Paulo School of Medical Sciences, São Paulo, Brazil.
Department of Neurosurgery, Londrina State University, Londrina, Brazil.
Department of Neurosurgery, Hospital Sirio Libanes, São Paulo, Brazil.
Department of Neurosurgery, Hospital Albert Einsten, São Paulo, Brazil.
Department of Neurosurgery, Hospital Do Coração, São Paulo, Brazil.
Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul, Turkey.



During the surgery for intrinsic brain lesions, it is important to plan the proper site of the craniotomy and to identify the relations with the gyri and superficial veins. This might be a challenge, especially in small subcortical lesions and when there is a distortion of the cortical anatomy.

Materials and Methods:

Using the free computer software Osirix, we have created a 3-dimensional reconstruction of the head and cerebral showing the gyri and superficial veins. With the aid of some tools, it is possible to create a colored image of the lesion and also to calculate the distance between the areas of interest and some easily identifiable structure, making it easier to plan the site of the craniotomy identify the topography of the lesion.


The reconstructions were compared to the intraoperative view. We found this technique to be useful to help identify the gyri and cortical veins and use them to find the lesions. The use of a region of interest to show better the lesion under the cortical surface and in the three-dimensional reconstruction of the head was also helpful.


This is a low-cost and easy technique that can be quickly learned and performed before every surgery. It helps the surgeon to plan a safe craniotomy and lesionectomy.


Gyrus; medical topography; neuroanatomy; sulcus; surgical procedure

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