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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Use of intraoperative magnetic resonance imaging for the treatment of craniopharyngiomas in pediatric age

Meeting Abstract

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  • Mario Giordano - INI Hannover, Hannover, Deutschland
  • Amir Samii - INI Hannover, Leibniz Institute for neurobiology, Hannover, Deutschland
  • Helmut Bertalanffy - INI Hannover, Zentrum für Vaskuläre Neurochirurgie, Hannover, Deutschland
  • Concezio Di Rocco - INI Hannover, Hannover, Deutschland
  • Madjid Samii - INI Hannover, Hannover, Deutschland
  • Rudolf Fahlbusch - International Neuroscience Institute Hannover, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.16.05

doi: 10.3205/17dgnc270, urn:nbn:de:0183-17dgnc2707

Published: June 9, 2017

© 2017 Giordano et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The use of high field intraoperative magnetic resonance imaging (iMRI) utility has been largely evaluated for the treatment of sellar lesions in adult patients. In this study we investigate the safety, advantages and limitations of high field iMRI for the treatment of craniopharyngiomas in pediatric age.

Methods: We analyzed 15 patients under 16 years of age affected by craniopharyngioma (22 surgeries). All patients were operated using iMRI (BrainSuite 1.5T). Pre- and postoperative neurological and endocrinological status, presence of residual tumor, number of intraoperative scans and complications were evaluated.

Results: The most common preoperative symptoms and signs were visual field deficit, hypophysial-hypothalamic dysfunction and intracranial hypertension. Of the 22 surgeries, 9 cases underwent the first surgery while 13 who suffered from recurrence had previous surgery. Regarding the 9 patients operated for the first time, a total removal of the lesion has been preoperatively planned and could be achieved in all cases. Considering the 13 procedures with recurrent tumors we could achieve a total removal in 10 and subtotal in 3 cases. In the 10 cases that underwent complete resection, 7 needed only 1 iMRI imaging that confirmed the total excision while residual tumor was detected in the other 3 cases at the iMRI imaging and required further removal. We had no intra- or postoperative complications due to the use of iMRI.

Conclusion: Use of iMRI for the treatment of pediatric craniopharyngiomas proved to be safe and effective in achieving complete tumor resection. We had no complications due to intraoperative imaging. The most important drawback of high-field iMRI was the difficult operative positioning, especially in younger children, due to the structure of the surgical table.