Document Detail


Intraoperative magnetic resonance imaging combined with neuronavigation: a new concept.
MedLine Citation:
PMID:  11334275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Intraoperative image data may be used not only to evaluate the extent of a tumor resection but also to update neuronavigation, compensating for brain shift. To date, however, intraoperative magnetic resonance imaging (MRI) can be combined only with navigation microscopes that are separated from the magnetic field, thus requiring time-consuming intraoperative patient transport. To help solve this problem, we investigated whether a new navigation microscope can be used within the fringe field of the MRI scanner. METHODS: The navigation microscope was placed at the 5-G line of a 0.2 MRI device. Patients were positioned lying down directly on the table of the scanner, with their heads placed approximately 1.5 m from the center of the magnet, fixed in an MRI-compatible ceramic head holder. Standard operating instruments were used. For intraoperative imaging, we slid the table into the center of the magnet in less than 30 seconds. RESULTS: By use of this setup, we operated on 22 patients. In all patients, anatomic neuronavigation could be used in combination with intraoperative MRI. In addition, in 12 patients, functional data from magnetoencephalographic or functional MRI studies were integrated, resulting in functional neuronavigation. We did not encounter adverse effects of the low magnetic field during navigation. Moreover, intraoperative imaging was not disturbed by the navigation microscope and vice versa. CONCLUSION: Functional neuronavigation and intraoperative MRI can be used essentially simultaneously without the need for lengthy intraoperative patient transport. The combination of intraoperative imaging with functional neuronavigation offers the opportunity for more radical resections and fewer complications.
Authors:
C Nimsky; O Ganslandt; H Kober; M Buchfelder; R Fahlbusch
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  48     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-03     Completed Date:  2001-09-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1082-9; discussion 1089-91     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Erlangen-Nürnberg, Germany. nimsky@nch.imed.uni-erlangen.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Brain / pathology,  surgery*
Brain Neoplasms / diagnosis,  surgery
Epilepsy / diagnosis,  surgery
Female
Humans
Intraoperative Period
Magnetic Resonance Imaging*
Magnetoencephalography
Male
Middle Aged
Therapy, Computer-Assisted*

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


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