gms | German Medical Science

Objective: Intraoperative magnetic resonance imaging (io-MRI) improves the extent of glioma resection. For the io-MRI procedure, patients have to be covered with sterile drapeing and are then transferred into an MRI chamber, where ferromagnetic anesthesia monitors and machines must be kept at distance and can only be applied with limitations. Despite the development of specific paramagnetic equipment for io-MRI use, this method is suspected to carry a higher risk for anesthesiological and surgical complications. Particularly, serial draping and un-draping as well as the extended surgery duration might increase the risk of perioperative infection.

Method: We prospectively evaluated the perioperative anesthesiological and surgical complications for 516 cases of brain tumor surgery involving io-MRI (MRI cohort). As a control group, we evaluated a cohort of 610 cases of brain tumor surgery, performed without io-MRI (control group).

Results: The io-MRI procedure (including draping/undraping, transfer to and from the MRI cabinet and io-MRI scan) significantly extended surgery by 57min ± 16min (p<0.01). Still, we observed low and comparable rates of surgical complications in the MRI cohort and the control group. Postoperative hemorrhage (3.7% vs. 3.0% in MRI cohort vs. control group; p=0.49) and infections (2.2% vs. 1.8% in MRI cohort vs. control group; p=0.69) were not significantly different between both groups. No anesthesiological disturbances were reported.

Conclusions: Despite prolonged surgery and serial draping and un-draping, io-MRI was not associated with higher rates of infections in this study.