gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Hemostyptic material in neurosurgical procedures: Perceptibility in MR imaging at 1.5 and 3.0 Tesla

Erkennbarkeit von neurochirurgisch eingesetzten Hämostyptika im MRT bei 1,5 und 3 Tesla

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  • corresponding author J. Beck - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • E. Hattingen - Institut für Neuroradiologie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • A. Raabe - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 024

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc292.shtml

Published: May 30, 2008

© 2008 Beck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To facilitate interpretation of postoperative MR studies, the aim of the study was to evaluate the perceptibility and MR-signal characteristics of local hemostyptic material as commonly used in intracranial neurosurgical operations.

Methods: We analyzed 9 typically used hemostyptic agents in solution in CSF, blood, different blood/CSF compositions, and in CSF after sprinkled with blood, in vitro: Brain-cotton, Spongostan®, Spongostan® (squashed flat), Spongostan powder®, Tabotamb®, Tabotamb Fibrillar®, Tabotamb NuKit®, Ativene®, Tissue-Coll® (fibrin glue). Measurements, including spin-echo and gradient-echo sequences, were performed at 1.5 and 3.0 Tesla at day 0, 1, and 3. Signal intensities and perceptibility of the materials were analyzed.

Results: Apart from proton-weighted sequences, the magnetic field intensity (1.5 or 3.0 Tesla) had no impact on perceptibility of the materials. In CSF or diluted CSF/blood compositions (97:3) all the materials were hypo-intens in the proton-weighted sequences and perceptibility was graded as good or very good. In T1 weighted sequences, however, the perceptibility was poor and completely lacking in the T1 spin echo sequences. In the FLAIR and MPRAGE images the hemostyptic material was mainly hyper-intense. The materials that were sprinkled with blood and then immersed in CSF were markedly hyper-intense in the T1 sequences.

Conclusions: The perceptibility of hemostyptic material is slightly superior at 3.0 Tesla. Hyper-intense signal changes in the early post-op period may be caused by hemostyptic material in MPRAGE and FLAIR with strongly enhanced signal changes after contact with blood. Routine T1-sequences, however, may miss hemostyptic material or it may be miss-interpreted as blood. The T2- and proton-weighted sequences seem to be the most suitable sequences for the early post-operative control MRI to discern hemostyptic material.