Intraoperative MR imaging guidance for intracranial neurosurgery: experience with the first 200 cases.
Intraoperative MR imaging guidance for intracranial neurosurgery: experience with the first 200 cases.
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DOI：
10.1148/radiology.211.2.r99ma26477
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发表时间：
1999-05
期刊：
影响因子：
19.7
通讯作者：
R. Schwartz;L. Hsu;T. Wong;D. Kacher;A. Zamani;P. Black;E. Alexander;P. Stieg;T. Moriarty
中科院分区：
文献类型：
--
作者：
R. Schwartz;L. Hsu;T. Wong;D. Kacher;A. Zamani;P. Black;E. Alexander;P. Stieg;T. Moriarty
目的：回顾开放孔磁共振（MR）成像系统在颅内外科手术中引导的初步经验。材料和方法垂直定向，开放式配置的0.5-T MR成像仪被安置在无菌手术室。接收和发射表面线圈缠绕在患者头部，图像显示在安装在磁体差距中的监视器上，外科医生可以看到。在2年期间，进行了200例颅内手术。结果在术中MR机上进行了111例开颅术、68例活检、12例颅内囊肿评估、4例硬膜下引流和5例经蝶垂体切除术。在每种情况下，术中MR系统通过允许放射科医生引导外科医生朝向病变并协助治疗而产生了令人满意的结果。在2例患者中，观察到超急性出血并取出。手术时间和并发症发生率与传统手术相似。结论术中MR成像可成功应用于各种颅内手术，并提供连续的视觉反馈，可在神经外科干预的各个阶段提供帮助，而不会影响手术时间或并发症的发生率。在神经外科干预的安全性和有效性方面，该系统与传统的基于框架和无框架立体定向手术相比具有潜在优势。
PURPOSE To review preliminary experience with an open-bore magnetic resonance (MR) imaging system for guidance in intracranial surgical procedures. MATERIALS AND METHODS A vertically oriented, open-configuration 0.5-T MR imager was housed in a sterile procedure room. Receive and transmit surface coils were wrapped around the patient's head, and images were displayed on monitors mounted in the gap of the magnet and visible to surgeons. During 2 years, 200 intracranial procedures were performed. RESULTS There were 111 craniotomies, 68 biopsies, 12 intracranial cyst evaluations, four subdural drainages, and five transsphenoidal pituitary resections performed with the intraoperative MR unit. In each case, the intraoperative MR system yielded satisfactory results by allowing the radiologist to guide surgeons toward lesions and to assist in treatment. In two patients, hyperacute hemorrhage was noted and removed. The duration of the procedure and the complication rate were similar to those of conventional surgery. CONCLUSION Intraoperative MR imaging was successfully implemented for a variety of intracranial procedures and provided continuous visual feedback, which can be helpful in all stages of neurosurgical intervention without affecting the duration of the procedure or the incidence of complications. This system has potential advantages over conventional frame-based and frameless stereotactic procedures with respect to the safety and effectiveness of neurosurgical interventions.