Intraoperative magnetic resonance imaging combined with neuronavigation: A new concept
Intraoperative magnetic resonance imaging combined with neuronavigation: A new concept
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DOI：
10.1097/00006123-200105000-00023
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发表时间：
2001-05-01
期刊：
影响因子：
4.8
通讯作者：
Fahlbusch, R
中科院分区：
文献类型：
--
作者：
Nimsky, C;Ganslandt, O;Fahlbusch, R
目的：术中图像数据不仅可用于评估肿瘤切除的程度，还可用于更新神经导航，补偿脑移位。然而，迄今为止，术中磁共振成像（MRI）只能与与磁场分离的导航显微镜相结合，因此需要花费大量时间来运送术中患者。为了解决这个问题，我们研究了一种新的导航显微镜是否可以在MRI扫描仪的边缘场内使用。方法：将导航显微镜置于0.2 MRI装置的5g线上。患者直接躺在扫描仪的桌子上，头部放置在距离磁铁中心约1.5米的地方，固定在mri兼容的陶瓷头部支架上。使用标准手术器械。术中成像时，我们在不到30秒的时间内将手术台滑入磁铁的中心。结果：使用该装置，我们对22例患者进行了手术。在所有患者中，解剖神经导航可与术中MRI联合使用。此外，在12例患者中，整合了脑磁图或功能性MRI研究的功能数据，从而获得功能性神经导航。我们在航行中没有遇到低磁场的不利影响。此外，术中成像不受导航显微镜干扰，反之亦然。结论：功能神经导航和术中MRI基本上可以同时使用，而不需要长时间的术中患者运输。术中成像与功能性神经导航的结合为更彻底的切除和更少的并发症提供了机会。
OBJECTIVE: Intraoperative image data may be used not only to evaluate the extent of a tumor resection but also to update neuronavigation, compensating for brain shift. To date, however, intraoperative magnetic resonance imaging (MRI) can be combined only with navigation microscopes that are separated from the magnetic field, thus requiring time-consuming intraoperative patient transport. To help solve this problem, we investigated whether a new navigation microscope can be used within the fringe field of the MRI scanner.METHODS: The navigation microscope was placed at the 5-G line of a 0.2 MRI device. Patients were positioned lying down directly on the table of the scanner, with their heads placed approximately 1.5 m from the center of the magnet, fixed in an MRI-compatible ceramic head holder. Standard operating instruments were used. For intraoperative imaging, we slid the table into the center of the magnet in less than 30 seconds.RESULTS: By use of this setup, we operated on 22 patients. In all patients, anatomic neuronavigation could be used in combination with intraoperative MRI. In addition, in 12 patients, functional data from magnetoencephalographic or functional MRI studies were integrated, resulting in functional neuronavigation. We did not encounter adverse effects of the low magnetic field during navigation. Moreover, intraoperative imaging was not disturbed by the navigation microscope and vice versa.CONCLUSION: Functional neuronavigation and intraoperative MRI can be used essentially simultaneously without the need for lengthy intraoperative patient transport. The combination of intraoperative imaging with functional neuronavigation offers the opportunity for more radical resections and fewer complications.