gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Implementation of a low field intraoperative MRI (PoleStarTM N20) during surgery for pituitary adenomas

Die Bedeutung der intraoperativen MRT-Bildgebung (PoleStarTM N20) für die Resektionskontrolle von Hypophysenadenomen

Meeting Abstract

  • corresponding author R. Gerlach - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Deutschland
  • G. Marquardt - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Deutschland
  • T. Gasser - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Deutschland
  • R. Krishnan - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Deutschland
  • M. Möhlenbruch - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Deutschland
  • E. Hermann - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Deutschland
  • V. Seifert - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.09.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc189.shtml

Veröffentlicht: 11. April 2007

© 2007 Gerlach 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 report the results of a new compact intraoperative low-field strength magnetic resonance imaging (iMRI) system in terms of resection control during surgery for pituitary adenomas.

Methods: 25 patients underwent microsurgical resection of a pituitary adenoma (PA) (1 micro-, 24 macroadenomas; 7 hormone active PA [5 GH-, 1 ACTH-, 1 PROL), 18 hormone inactive PA]) using the PoleStarTM N20 0.15 T-system (Medtronic). According to a preoperative 1.5T MRI, patients were divided into two groups (intended complete [n=16] and incomplete resection due to invasion of the cavernous sinus [n=9]). All tumors were operated via a transnasal transsphenoidal approach. When the surgeon judged the resection to be complete or when the resection goal was achieved, an iMRI-scan was done (coronar T1-weighted sequences [± gadolinium]). In cases of accessible tumor remnants, surgery was continued until either intended resection was achieved or further removal of residual tumor was impossible. Clinical follow-up and MRI (1.5T±Gd) were routinely performed 3 months after surgery. This data was available in 18 patients.

Results: In all patients, appropriate iMRI images could be obtained and adequate decompression of the optic pathway was documented. iMRI resection control showed residual tumor leading to further resection in 7 patients (2 patients with intended complete and 4 with intended incomplete resection). Although residual tumor was detected in 1 patient, further resection was impossible due to the adherent capsule. Thus intended resection was achieved in 23 (95%) patients. In 2 patients the iMRI showed questionable residual intrasellar tumor, but only minor tumor remnants could be removed, whereas F/u MRI showed a small intrasellar residual tumor. For all other patients, iMRI showed good correlation to the 3 months 1.5 T MRI F/u.

Conclusions: The 0.15T iMRI is a valuable adjunct for surgery of pituitary adenomas to verify residual tumor, and the iMRI has a good correlation to the 3 months follow-up 1.5T MRI.