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首页> 外文期刊>Techniques in Neurosurgery >Clinical impact of intraoperative magnetic resonance imaging on central nervous system neoplasia
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Clinical impact of intraoperative magnetic resonance imaging on central nervous system neoplasia

机译：术中磁共振成像对中枢神经系统肿瘤的临床影响

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Despite the introduction of neuronavigation, radicality is still an issue in operations for central nervous system neoplasia leading to integration of intraoperative magnetic resonance imaging (iMRI). The aim of the current study was to evaluate its clinical impact with regard to its potential to increase radicality and prolong patient survival. An open MRI scanner (Magnetom Open 0.2 T) was installed in one of the neurosurgical operating rooms. Of 377 procedures performed, 197 microsurgical operations for intraparenchymal tumors were analyzed. Intraoperative images were analyzed with respect to image quality, identification of residual tumor, and update of navigation. The results were controlled with early postoperative high-field MRI. Progression-free and overall survival were determined by patient follow-up. There were no complications. Failure to obtain intraoperative images was noted in only 3%, whereas diagnostic yield was found to be 86.4%. In 21.9% of the procedures, radical resection was confirmed intraoperatively. In 145 cases, navigation could be updated with an accuracy of 1.1 ?0.6 mm. In 63.5% of the operations, resection was continued with intraoperative images leading to significantly increased radicality assessed by early postoperative MRI. Patients with a radically removed tumor had significantly prolonged progression-free and overall survival. Intraoperative MRI is a safe method for identifying residual tumor and compensating for brain shift by updating navigational data. The percentage of radiologically radical resections could be increased significantly. However, with regard to the costs of iMRI, overall clinical impact remains to be determined and alternative methods, such as intraoperative ultrasound, investigated.
机译：尽管引入了神经导航，但根治性手术仍是中枢神经系统肿瘤导致手术中磁共振成像（iMRI）整合的一个问题。本研究的目的是评估其在增加根治性和延长患者生存率方面的临床影响。在其中一个神经外科手术室中安装了开放式MRI扫描仪（Magnetom Open 0.2 T）。在执行的377项手术中，分析了197项针对实质内肿瘤的显微外科手术。分析了术中图像的图像质量，残留肿瘤的识别以及导航的更新。术后早期的高场MRI控制了结果。无进展和总生存期由患者随访确定。没有并发症。仅有3％的患者未能获得术中图像，而诊断率为86.4％。在21.9％的手术中，术中证实了根治性切除。在145种情况下，导航的更新精度为1.1〜0.6 mm。在63.5％的手术中，术中影像学检查继续进行切除，导致术后早期MRI评估的根治性明显增加。彻底切除肿瘤的患者无进展和总体生存期显着延长。术中MRI是通过更新导航数据来识别残留肿瘤并补偿脑移位的安全方法。放射学根治性切除的百分比可以显着增加。但是，关于iMRI的成本，总体临床影响尚待确定，并且需要研究其他方法，例如术中超声检查。

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