Accelerated methaemoglobin formation: potential pitfall in early postoperative MRI.
Postoperative magnetic resonance imaging (MRI) of glioblastomas to assess residual tumour should be performed within the first 4 days following surgery. Early methaemoglobin formation near the resection site may mimic residual tumour if only gadolinium-DTPA-enhanced images are obtained. In a prospective study 24 of 54 patients (44%) showed well-defined areas of increased signal intensity on unenhanced T1-weighted images performed soon after surgery. By in vitro experiments we showed that hydrogen peroxide used in neurosurgery as a styptic agent accelerates formation of methaemoglobin when added to whole blood samples.
Department of Neuroradiology, University of Heidelberg, Federal Republic of Germany.
U
U
Meyding-Lamadé
M
M
Forsting
F
F
Albert
S
S
Kunze
K
K
Sartor
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D005909:Glioblastoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D006454:Hemoglobins / Q000737:chemistry; D006490:Hemostatics / Q000737:chemistry; D006801:Humans; D006861:Hydrogen Peroxide / Q000737:chemistry; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008706:Methemoglobin / Q000096:biosynthesis* / Q000737:chemistry; D008875:Middle Aged; D009942:Organometallic Compounds; D010084:Oxidation-Reduction; D004369:Pentetic Acid; D011182:Postoperative Care; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D006454:Hemoglobins; D006490:Hemostatics; D009942:Organometallic Compounds; D004369:Pentetic Acid; D008706:Methemoglobin; D005682:Gadolinium; D006861:Hydrogen Peroxide; D019786:Gadolinium DTPA