Available online 9 February 2013
Publication year: 2013
Source:World Neurosurgery
Objective We examined the effectiveness of a newly-developed magnetic resonance imaging (MRI) technique, brain surface motion imaging (BSMI), in the preoperative evaluation of tumor-brain adhesion in meningioma surgery. Methods Cine phase-contrast MRI was used to measure cerebrospinal fluid (CSF) pulsations and heart rates at two different time points to create a subtraction image in meningioma patients who underwent BSMI. With no tumor-brain adhesion, a gap was observed in the tumor-brain movements resulting in an outline of the tumor in BSMI. If adhesion was evident, no outline was observed. Patients were evaluated as "exact" if the presence or absence of edema in T2-weighted MR images, BSMI findings, and intraoperative findings all matched, as "effected" when only BSMI findings and intraoperative images matched, and as "false" when BSMI findings and intraoperative findings did not match. Results BSMI judged 27 patients as "adhesion (+)" and 33 as "adhesion (-)", while surgical findings evaluated 22 as "adhesion (+)" and 38 as "adhesion (-)". The sensitivity and specificity were both high, at 95.5% and 84.2%, respectively. Forty-one of 60 patients were evaluated as "exact," 12 as "effected", and seven as "false". World Health Organization tumor grade assessment of "effected" subjects included 16.7% in grade 1 and 36.4% in grade 2. Conclusion BSMI was shown to be effective in evaluating adhesion between the meningioma and the brain, allowing safe and effective removal planning to be carried out preoperatively.
Júlio Leonardo B. Pereira
Phone: (+1) 424-2301706
Linkedin:http://www.linkedin.com/in/juliommais
No comments:
Post a Comment