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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Intraoperative Blood Oxygenated-Level Dependent MR imaging with breath holding to measure cerebrovascular reserve capacity in patients with intracerebral tumors

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  • Jan-Karl Burkhardt - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Jorn Fierstra - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Marian C. Neidert - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Marco Piccirelli - Klinik für Neuroradiologie, Universitätsspital Zürich, Zürich, Schweiz
  • Athina Pangalu - Klinik für Neuroradiologie, Universitätsspital Zürich, Zürich, Schweiz
  • Roman Kocian - Klinik für Anästhesiologie, Universitätsspital Zürich, Zürich, Schweiz
  • Luca Regli - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz
  • Oliver Bozinov - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Schweiz

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 185

doi: 10.3205/14dgnc579, urn:nbn:de:0183-14dgnc5799

Published: May 13, 2014

© 2014 Burkhardt 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

Text

Objective: Measuring cerebrovascular reserve capacity in intracerebral tumors receives increased attention to better understand tumor hemodynamics and therefore a better understanding of resection margins. We used pre- and intraoperative Blood Oxygenated-Level Dependent (BOLD) MRI with a breath holding maneuver to assess cerebrovascular reserve capacity (CVR) in patients with intracerebral tumors.

Method: We prospectively enrolled 1O patients with various intracranial tumors for this feasibility study. After intubation, patients underwent a pre and/or intraoperative BOLD-MRI assessment with three cycles of “breath holding” by inducing apnea for 40 seconds. BOLD sequences were performed on a 3.0 Tesla Siemens Skyra system using a custom-designed intraoperative head coil.

Results: Ten consecutive patients with intracerebral tumors were successfully examined without any adverse events. BOLD-MRI data revealed spatial CVR alterations in and around the tumor pre-operatively. In some cases the CVR alterations persisted around the resection borders during the second examination.

Conclusions: Intraoperative BOLD-MRI + breath holding is feasible in patients with intracerebral tumors and may provide potential useful hemodynamic data in assessing tumor resection borders. These hypotheses have to be further studied in larger patient cohorts.