Article
Is intraoperative MRI feasaible for non-university departments as well? 3-years experience of “Dual Use-MRI” for intraoperative procedures and outdoor patients
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Authors
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Paul Kremer
- Neurochirurgie
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Claudia Goetz
- Neurochirurgie
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Jörg Dornbusch
- Neurochirurgie
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Joachim Gottschalk
- Pathologie
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Volker Hesselmann
- Neuroradiologie, Asklepios Klinik Nord, Hamburg
| Published: | June 2, 2015 |
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Outline
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Objective: The use of Intraoperative MRI for resection is of great interest for neurosurgeons treating patients with gliomas or skull base tumours. A MRI which is situated within a neurosurgical OR-unit can be used not more than twice per day and therefore seems to be inefficient economically. To solve this problem a concept of dual use of a high-field MRI was set up for intraoperative imaging as well as for imaging of outdoor patients.
Method: In the course of new building for a head and neck-OR-unit a 1.5 T MRI was connected to the neurosurgical OR in such a way that outdoor patients could enter it from one side and intraoperative patients could be brought in through a separate door from the other side. The MR-room as well as its air-conditioning had to be prepared according to hygienic standards requested for neurosurgical ORs . The patient’s head was fixed in a MRI- coil. Transport to the magnet was conducted using a trolly-system.
Results: From July 2011 to November 2014 190 neurosurgical interventions for cerebral tumours of various histology (126 gliomas, 25 pituitary adenomas, 39 others) were scheduled with intraoperative MRI. Intraoperative MR-images were obtained in 186 cases which resulted in further tumour resection in 122 (65,6 %). The medium time for the total procedure contained 287 minutes including the transportation and intraoperative imaging time (approximately 50 minutes). Shortly after the investigation the new data could be transferred to the neuronavigation unit, thus enabling the neurosurgeon to remove eventual tumour remnants safely. The rate of infection was not increased when compared to patients with similar tumours but operated on without intraoperative MRI. During the same period more than 15.000 MRI investigations could be performed on outdoor patients using the same MR-unit.
Conclusions: The concept of intraoperative MR-imaging in dual use is very suitable for intra-operative imaging as well as for imaging of outdoor patients. This concept reduces the enormous costs of a MR-unit assigned for intraoperative investigations alone due to its availability for outdoor patients also.
