Magnetic resonance imaging-guided neurosurgery in the magnetic fringe fields: the next step in neuronavigation.
Magnetic resonance imaging-guided neurosurgery in the magnetic fringe fields: the next step in neuronavigation.
复制标题
磁共振成像引导的磁边缘场神经外科手术：神经导航的下一步。
作者：
G. Rubino;K. Farahani;David McGill;B. Van de Wiele;J. Villablanca;Anna Wang
目的
我们描述了术中磁共振成像（iMR）引导神经外科手术的替代方法的发展，并报告了我们对22例开颅手术和16例脑活检的初步经验。每种方法的优点和缺点进行检查。
方法
iMR套件内装有0.2 T开放式配置系统（Siemens Medical Systems，埃尔兰根，德国），并配备麻醉气体和磁共振成像（MRI）兼容麻醉机和监护仪。在开放式MRI系统周围的边缘磁场中，对标准操作仪器和设备进行了安全性和兼容性测试。然后，我们在iMR套件中进行了脑活检和开颅手术。
结果
标准操作设备在0.5至10 mT区域内正常运行，不受磁铁吸引力的影响。22例开颅术和16例脑活检在介入手术室进行，使用连续术中MRI引导，没有对患者或手术室工作人员造成伤害。
结论
可以使用标准手术室设备在MRI系统周围的弱边缘场中进行完整的神经外科手术。这种iMR引导神经外科手术的方法比用“MRI兼容”手术设备改造整个手术室具有显著的成本优势。外科医生对标准设备的熟悉和设备的可靠性是额外的优势。边缘领域的神经外科手术允许神经外科医生使用系列MRI，最大限度地减少不便、中断和对标准神经外科手术的改变。连续术中成像可视化与神经外科干预相关的大脑变化似乎可以提高安全有效地实现神经外科目标的能力。
OBJECTIVE
We describe the development of an alternative approach to intraoperative magnetic resonance imaging (iMR)-guided neurosurgery and report our initial experience with 22 craniotomies and 16 brain biopsies. The advantages and disadvantages of each approach are examined.
METHODS
An iMR suite houses a 0.2-T open configuration system (Siemens Medical Systems, Erlangen, Germany) and is equipped with anesthetic gases and a magnetic resonance imaging (MRI)-compatible anesthesia machine and monitor. Standard operating instruments and equipment were tested for safety and compatibility in the magnetic fringe fields surrounding the open MRI system. We then performed brain biopsies and craniotomies in the iMR suite.
RESULTS
Standard operating equipment functioned properly in the 0.5- to 10-mT zone and was not affected by the magnet's attractive force. Twenty-two craniotomies and 16 brain biopsies were performed in the interventional suite, using serial intraoperative MRI guidance, without injury to patients or operating room staff.
CONCLUSION
Full neurosurgical procedures may be performed in the weak fringe fields surrounding an MRI system, using standard operating room equipment. This approach to iMR-guided neurosurgery offers a significant cost advantage over retrofitting an entire operative suite with "MRI-compatible" surgical equipment. The surgeon's familiarity with standard equipment and the reliability of the equipment are additional advantages. Neurosurgery in the fringe fields allows the neurosurgeon to utilize serial MRI with a minimum of inconvenience, disruption, and change to the standard neurosurgical procedure. Serial intraoperative imaging to visualize the changes in the brain that are associated with neurosurgical intervention seems to enhance the ability to safely and effectively accomplish neurosurgical goals.
影响因子：
4.8
作者：
Roberts, DW;Hartov, A;Paulsen, KD
通讯作者：
Paulsen, KD
影响因子：
4.8
作者：
Black, PM;Moriarty, T;Jolesz, FA
通讯作者：
Jolesz, FA