Implementation of a mobile 0.15-T intraoperative MR system in pediatric neuro-oncological surgery: feasibility and correlation with early postoperative high-field strength MRI

被引:12
作者
Kubben, P. L. [1 ]
van Santbrink, H. [1 ]
ter Laak-Poort, M. [1 ]
Weber, J. W. [2 ]
Vles, J. S. H. [2 ]
Granzen, B. [3 ]
van Overbeeke, J. J. [1 ]
Cornips, E. M. J. [1 ]
机构
[1] Maastricht Univ Med Ctr, Dept Neurosurg, NL-6202 AZ Maastricht, Netherlands
[2] Maastricht Univ Med Ctr, Dept Child Neurol, NL-6202 AZ Maastricht, Netherlands
[3] Maastricht Univ Med Ctr, Dept Pediat, NL-6202 AZ Maastricht, Netherlands
关键词
Intraoperative MRI; Postoperative MRI; Feasibility; Oncology; Pediatric neurosurgery; RESONANCE-IMAGING SYSTEM; GLIOBLASTOMA-MULTIFORME; TUMOR RESECTION; COMPACT; EXTENT; EXPERIENCE; IMAGER;
D O I
10.1007/s00381-012-1815-8
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We analyze our preliminary experience using the PoleStar N20 mobile intraoperative MR (iMR) system as an adjunct for pediatric brain tumor resection. We analyzed 11 resections in nine children between 1 month and 17 years old. After resection, we acquired iMR scans to detect residual tumor and update neuronavigation. We compared final iMR interpretation by the neurosurgeon with early postoperative MR interpretation by a neuroradiologist. Patient positioning was straightforward, and image quality (T1 7-min 4-mm sequences) sufficient in all cases. In five cases, contrast enhancement suspect for residual tumor was noted on initial postresection iMR images. In one case, a slight discrepancy with postoperative imaging after 3 months was no longer visible after 1 year. No serious perioperative adverse events related to the PoleStar N20 were encountered, except for transient shoulder pain in two. Using the PoleStar N20 iMR system is technically feasible and safe for both supra- and infratentorial tumor resections in children of all ages. Their small head and shoulders favor positioning in the magnet bore and allow the field of view to cover more than the area of primary interest, e.g., the ventricles in an infratentorial case. Standard surgical equipment may be used without significant limitations. In this series, the use of iMR leads to an increased extent of tumor resection in 45 % of cases. Correlation between iMR and early postoperative MR is excellent, provided image quality is optimal and interpretation is carefully done by someone sufficiently familiar with the system.
引用
收藏
页码:1171 / 1180
页数:10
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