gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

High-field MRI at 3 Tesla for diagnosis and surgery of perisellar pathologies

Hochfeld MRT (3 Tesla) für Diagnose und Chirurgie perisellärer Prozesse

Meeting Abstract

  • corresponding author S. Wolfsberger - Klinik für Neurochirurgie, Medizinische Universität Wien
  • K. Pinker - Radiodiagnostik, Medizinische Universität Wien
  • F. Marhold - Klinik für Neurochirurgie, Medizinische Universität Wien
  • T. Czech - Klinik für Neurochirurgie, Medizinische Universität Wien
  • S. Trattnig - Radiodiagnostik, Medizinische Universität Wien
  • E. Knosp - Klinik für Neurochirurgie, Medizinische Universität Wien

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc11.05.-07.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0201.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Wolfsberger et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective

To determine the value of high-field magnetic resonance imaging (MRI) for diagnosis and surgery of perisellar pathologies.

Methods

High-field MRI using a 3 Tesla (T) Bruker Medspec® 30/80 scanner was obtained from 30 patients (1) to verify a pituitary microadenoma that was suspected endocrinologically and/or with 1.0 – 1.5T standard MRI (sMRI), (2) to preoperatively delineate perisellar anatomical structures with special regard to the medial border of the cavernous sinus and a possible invasion of a sellar tumour therein and (3) to assess the application of high-resolution images for intraoperative neuronavigation. 3T MRI was compared to the already available sMRI and to intraoperative findings.

Results

Of 5 patients with a suspected pituitary microadenoma, 3T MRI depicted an endosellar hypointensity in 3. Anatomical structures were studied in 60 cavernous sinuses: The medial cavernous sinus border was rated intact in 53% of sMRI, in 72 % of 3T MRI and in 81% intraoperatively. With a positive correlation to surgical findings in 84% of 3T MRI compared to 59% of sMRI, a sensitivity of 83% vs. 67% and a specificity of 84% vs. 58% (P=0.016, McNemar test) 3T MRI was superior in predicting tumour invasion through the medial cavernous sinus border. There was a better delineation of the lateral cavernous sinus compartment using 3T MRI: It was clearly visible in 95% of 3T MRI vs. 81% of sMRI. Identification of the intracavernous cranial nerves III, IV, V1, V2 and VI was improved using 3T MRI: It delineated mean 4 cranial nerves (range 2 – 5 hypointense spots) vs. 3 (range 0 – 4) by sMRI. Intraoperative navigation with fusion of 3T MR and computed tomography (CT) images were performed in 7 patients: 3T MRI was particularly useful for visualization of parasellar tumour extension during microsurgical and/or endoscopic resection.

Conclusions

According to our preliminary results, 3T MRI was found superior to sMRI for diagnosis and surgery of sellar lesions: 3T MRI may be able to visualize microadenomas that can only be suspected on sMRI, to delineate parasellar anatomy to a detail that the medial cavernous sinus border may be visible, and to provide optimal imaging during intraoperative navigation.