Erschienen in:
01.02.2012 | Original Article
Intraoperative 3-Tesla MRI in the management of paediatric cranial tumours—initial experience
verfasst von:
Shivaram Avula, Connor L. Mallucci, Barry Pizer, Deborah Garlick, Daniel Crooks, Laurence J. Abernethy
Erschienen in:
Pediatric Radiology
|
Ausgabe 2/2012
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Abstract
Background
Intraoperative MRI (ioMRI) has been gaining recognition because of its value in the neurosurgical management of cranial tumours. There is limited documentation of its value in children.
Objectives
To review the initial experience of a paediatric 3-Tesla ioMRI unit in the management of cranial tumours.
Materials and methods
Thirty-eight children underwent ioMRI during 40 cranial tumour resections using a 3-Tesla MR scanner co-located with the neurosurgical operating theatre. IoMRI was performed to assess the extent of tumour resection and/or to update neuronavigation. The intraoperative and follow-up scans, and the clinical records were reviewed.
Results
In 27/40 operations, complete resection was intended. IoMRI confirmed complete resection in 15/27 (56%). As a consequence, surgical resection was extended in 5/27 (19%). In 6/27 (22%), ioMRI was equivocal for residual tumour. In 13/40 (33%) operations, the surgical aim was to partially resect the tumour. In 7 of the 13 (54%), surgical resection was extended following ioMRI.
Conclusion
In our initial experience, ioMRI has increased the rate of complete resection, with intraoperative surgical strategy being modified in 30% of procedures. Collaborative analysis of ioMRI by the radiologist and neurosurgeon is vital to avoid errors in interpretation.