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首页> 外文期刊>Neurosurgical focus >The utility of high-resolution intraoperative MRI in endoscopic transsphenoidal surgery for pituitary macroadenomas: early experience in the Advanced Multimodality Image Guided Operating suite
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The utility of high-resolution intraoperative MRI in endoscopic transsphenoidal surgery for pituitary macroadenomas: early experience in the Advanced Multimodality Image Guided Operating suite

机译：高分辨率术中MRI在垂体大腺瘤内镜经蝶窦手术中的应用：先进的多模态图像引导手术套件的早期经验

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OBJECTIVE Endoscopic skull base surgery has become increasingly popular among the skull base surgery community, with improved illumination and angled visualization potentially improving tumor resection rates. Intraoperative MRI (iMRI) is used to detect residual disease during the course of the resection. This study is an investigation of the utility of 3-T iMRI in combination with transnasal endoscopy with regard to gross-total resection (GTR) of pituitary macroadenomas. METHODS The authors retrospectively reviewed all endoscopic transsphenoidal operations performed in the Advanced Multimodality Image Guided Operating (AMIGO) suite from November 2011 to December 2014. Inclusion criteria were patients harboring presumed pituitary macroadenomas with optic nerve or chiasmal compression and visual loss, operated on by a single surgeon. RESULTS Of the 27 patients who underwent transsphenoidal resection in the AMIGO suite, 20 patients met the inclusion criteria. The endoscope alone, without the use of iMRI, would have correctly predicted extent of resection in 13 (65%) of 20 cases. Gross-total resection was achieved in 12 patients (60%) prior to MRI. Intraoperative MRI helped convert 1 STR and 4 NTRs to GTRs, increasing the number of GTRs from 12 (60%) to 16 (80%). CONCLUSIONS Despite advances in visualization provided by the endoscope, the incidence of residual disease can potentially place the patient at risk for additional surgery. The authors found that iMRI can be useful in detecting unexpected residual tumor. The cost-effectiveness of this tool is yet to be determined.
机译：目的内窥镜颅底手术在颅底手术社区中已变得越来越普遍，改善的照明度和成角度的可视化可能提高肿瘤的切除率。术中MRI（iMRI）用于检测切除过程中的残留疾病。这项研究是对垂体大腺瘤的全切术（GTR）结合鼻内窥镜检查结合3-T iMRI进行的研究。方法作者回顾性回顾了2011年11月至2014年12月在高级多模态图像引导手术（AMIGO）套件中进行的所有内镜经蝶窦手术。纳入标准为患有假性垂体大腺瘤并伴视神经或下颌前突压迫和视力丧失的患者，并由手术治疗。单身外科医生。结果AMIGO套件中27例经蝶窦切除的患者中有20例符合纳入标准。仅使用内窥镜而不使用iMRI，就可以正确预测20例中的13例（65％）的切除范围。 MRI之前有12例（60％）患者完成了全切除。术中MRI帮助将1个STR和4个NTR转换为GTR，使GTR的数量从12个（60％）增加到16个（80％）。结论尽管内窥镜提供了可视化方面的进步，但残留疾病的发生仍可能使患者处于接受额外手术的风险中。作者发现，iMRI可用于检测意外的残留肿瘤。该工具的成本效益尚待确定。

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