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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Ultra-high-field 7 Tesla MRI in neurosurgery – lessons from 335 cases

Ultrahochfeld 7 Tesla MRT in der Neurochirurgie – Erfahrungen von 335 Fällen

Meeting Abstract

  • presenting/speaker Oliver Gembruch - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Bixia Chen - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Tobias Schoemberg - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Harald H. Quick - Universität Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland
  • Karsten Henning Wrede - Universitätsklinikum Essen, Abteilung für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP065

doi: 10.3205/20dgnc353, urn:nbn:de:0183-20dgnc3534

Published: June 26, 2020

© 2020 Gembruch 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

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Objective: To report on clinical application as well as the advantages and disadvantages of ultra-high-field 7T MRI in a neurosurgical setting.

Methods: Since 2008 eligible neurosurgical patients were prospectively examined on a 7T whole-body MR system (Magnetom 7T, Siemens Healthcare Sector) equipped with gradient coils capable of delivering 45 mT/m of maximum amplitude and a slew rate of 220 mT/m/ms. Three different 8-channel and 32-channel radiofrequency transmit/receive head coils were and a custom-built 8-channel radiofrequency transmit/receive array body coil was used. Peripheral nerves were scanned with a custom-built 8-channel radiofrequency transmit/receive meander coil. Pulse sequences included optimized MPRAGE, FLASH-TOF, SWI, T2*, PD, T2, VIBE and TWIST sequences.

Results: The study group comprised 335 patients (161 males) with age ranging between 18 and 82 years. The majority of all patients suffered from cavernomas (n=67) and aneurysms (n=81) as well as other vascular pathologies (n=57). For anatomical scans, the best results were achieved with SWI, T2, T2*, SWI, and the modified MPRAGE pulse sequences. Arterial vasculature was best depicted with the modified FLASH-TOF pulse sequence (0.21 mm in-plane and 0.42 mm through-plane resolution) including the possibility of venous saturation pulses. All but 7 patients could be scanned successfully in 36 to 75 minutes. In 4 cases the scans had to be aborted before the scanning protocol was finished because of claustrophobia. In 3 case the scan had to be aborted due to technical failure of the scanner. The occasional need of rebooting the scanner and long preparation phases are the main disadvantages in application of 7T MRI for neurosurgical patients. The strength of ultra-high-field MRI was especially seen when depicting the vasculature in cavernomas, aneurysms, AVMs and Moyamoya angiopathy patients.

Conclusion: Clinical applicability of 7T MRI as well as the advantages and disadvantages are shown in the worldwide largest neurosurgical cohort. Seven Tesla MRI has clinical potential for dedicated diagnostic questions.