Intraoperative magnetic resonance imaging for skull base surgery.
OBJECTIVE
Skull base surgery has evolved over the past several decades. Major improvements in the imaging of skull base pathology led to better target localization and better surgical planning. The objectives of this study were to assess the use of intraoperative magnetic resonance (MR) imaging in the management of a series of patients with skull base pathology. We hypothesized that high-quality intraoperative MR imaging would have an impact on surgery in this patient group.


METHODS
Prospective, non-randomized, cohort study.


METHODS
Thirty-one patients with skull base lesions underwent surgery in a 1.5-Tesla intraoperative MR suite. The concepts of a moving magnet, high magnetic field strength, and radiofrequency coil design are presented.


RESULTS
Eleven of 31 patients had the course of surgery significantly altered by the information acquired from the images obtained during surgery.


CONCLUSIONS
Intraoperative MR imaging is a valuable adjunct to skull base surgery. One third of patients had altered surgery as a result of this adjunct. Intraoperative MR imaging is of particular value in the treatment of pituitary adenomas and benign skull base tumors.
Dort
J C
JC
Department of Surgery, Division of Otolaryngology, The University of Calgary, Calgary, Alberta, Canada. jdort@ucalgary.ca
Sutherland
G R
GR
D000236:Adenoma / Q000473:pathology* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004210:Dissection; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D008297:Male; D008579:Meningioma / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology* / Q000601:surgery*; D018579:Patient Selection; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D019292:Skull Base Neoplasms / Q000473:pathology* / Q000601:surgery*