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首页> 外文期刊>Neurosurgery >Safety, efficacy, and functionality of high-field strength interventional magnetic resonance imaging for neurosurgery.
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Safety, efficacy, and functionality of high-field strength interventional magnetic resonance imaging for neurosurgery.

机译：用于神经外科的高场强度介入磁共振成像的安全性，有效性和功能性。

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OBJECTIVE: Interventional magnetic resonance imaging (MRI) allows neurosurgeons to interactively perform surgery using MRI guidance. High-field strength (1.5-T) imaging permits exceptional observation of intracranial and spinal pathological features. The development of this technology and its application to a variety of neurosurgical procedures are described. METHODS: We report on the first 101 cases that were treated in the interventional MRI unit (between January 1997 and September 1998). These cases included 39 brain biopsies, 30 tumor resections, 9 functional neurosurgical cases, 8 cyst drainages, 5 laminectomies, and 10 miscellaneous cases. Patients ranged in age from 14 months to 84 years (median, 43 yr); 61 patients were male and 40 were female. Intraoperative functional techniques that were used to influence surgical decision-making included magnetic resonance spectroscopy, functional MRI, magnetic resonance angiography and venography, chemical shift imaging, and diffusion-weighted imaging. All surgery was performed using MRI-compatible instruments within the 5-gauss line and conventional instruments outside that line. RESULTS: All 39 brain biopsies yielded diagnostic tissue. Of the 30 tumor resections, 24 (80%) were considered radiographically complete. The incidence of serious complications was low and was comparable to that associated with conventional operating rooms. One patient developed a Propionibacterium acnes brain abscess 6 weeks after surgery and another patient experienced Staphylococcus aureus scalp cellulitis after a brain biopsy, yielding an infection rate of less than 2%. No clinically significant hemorrhage was observed in immediate postoperative imaging scans, although one patient developed a delayed hematoma after a thalamotomy. One patient experienced a stroke after resection of a hippocampal tumor. No untoward events were associated with MRI-compatible instrumentation or intraoperative patient monitoring. CONCLUSION: High-field (1.5-T) interventional MRI is a safe and effective technology for assisting neurosurgeons in achieving the goals of surgery. Preliminary results suggest that the functional capabilities of this technology can yield data that can significantly influence intraoperative neurosurgical decision-making. The rates of serious complications, such as infection, associated with this new technology were low.
机译：目的：介入磁共振成像（MRI）使神经外科医生能够在MRI指导下以交互方式进行手术。高场强度（1.5-T）成像可出色地观察颅内和脊柱病理特征。描述了该技术的发展及其在各种神经外科手术中的应用。方法：我们报告了在MRI介入科治疗的前101例病例（1997年1月至1998年9月之间）。这些病例包括39例脑活检，30例肿瘤切除，9例功能神经外科手术病例，8例行囊肿引流，5例行腹腔镜切除术和10例其他病例。患者年龄从14个月至84岁（中位数43岁）;男性61例，女性40例。术中用于影响手术决策的功能技术包括磁共振波谱，功能MRI，磁共振血管造影和静脉造影，化学位移成像和扩散加权成像。所有手术均使用5高斯线内的MRI兼容仪器以及该线外的常规仪器进行。结果：所有39例脑活检均产生诊断组织。在30例肿瘤切除术中，有24例（80％）被认为在影像学上已经完成。严重并发症的发生率很低，与常规手术室相当。一名患者在手术后六周出现痤疮丙酸杆菌脑脓肿，另一名患者在进行脑活检后经历了金黄色葡萄球菌头皮蜂窝组织炎，感染率低于2％。术后立即进行影像学检查未观察到临床上明显的出血，尽管一名患者在丘脑置换术后出现了延迟的血肿。一名患者切除海马肿瘤后发生中风。没有与MRI兼容的仪器或术中患者监测相关的不良事件。结论：高场（1.5-T）介入MRI是一种安全有效的技术，可帮助神经外科医师达到手术目的。初步结果表明，这项技术的功能可以产生可显着影响术中神经外科手术决策的数据。与这项新技术相关的严重并发症（如感染）的发生率很低。

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