Document Detail

Intra-operative MRI-guided approaches to the pediatric posterior fossa tumors.
MedLine Citation:
PMID:  11455229     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The posterior fossa in a child poses a considerable challenge to the neurosurgeon. MRI-guided surgery allows for real time interaction between imaging and the neurosurgeon, not permitted by frameless stereotaxy, and with higher resolution than ultrasound or CT. MATERIALS AND METHODS: The University of Minnesota 1.5 T Phillips interventional MRI was used. From 1997 to 2000, nine posterior fossa intraoperative magnet cases out of eleven were pediatric. The mean age was 6.4 years and the median age 7. Seven midline craniotomies were performed, of which three were re-operations. Two were burr hole placements, one for cyst aspiration and P32 instillation, and the other for tumor biopsy. RESULTS: Two tumors were predominantly in the fourth ventricle, four in the cerebellum, two in the brainstem, and one in the prepontine cystern. Four tumors were juvenile pilocytic astrocytomas, two were anaplastic astrocytomas, and one each was ependymoma, craniopharyngioma cyst, and medulloblastoma. Four patients had complete radiologic resection. Two had maximal resections limited by vital structures. P32 instillation and tumor biopsy were done in a single pass. Follow-up ranged from 3 months to 1.4 years. The cyst that was aspirated and had P32 instillation remains absent. The two mortalities were in the patients with medulloblastoma and anaplastic astrocytoma. There were no intra-operative mortalities. The other patient with anaplastic astrocytoma progressed. The remainder had stable imaging. CONCLUSION: MRI-guided surgery results in improved resection imaging and real-time needle guidance in tumor operations. Its value could lie in low-grade lesions, where maximal resection is most beneficial.
C H Lam; W A Hall; C L Truwit; H Liu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  34     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-07-16     Completed Date:  2001-09-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  295-300     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA.
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MeSH Terms
Child, Preschool
Cranial Fossa, Posterior / pathology,  surgery*
Glioma / pathology,  surgery*
Infratentorial Neoplasms / pathology,  surgery*
Intraoperative Period
Magnetic Resonance Imaging*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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