Intraoperative assessment of aneurysm clipping using magnetic resonance angiography and diffusion-weighted imaging: technical case report.
OBJECTIVE
To use intraoperative magnetic resonance imaging, including magnetic resonance angiography and diffusion-weighted imaging, to monitor the surgical treatment of a patient with an intracranial aneurysm.


METHODS
Intraoperative imaging was performed with a ceiling-mounted, mobile, 1.5-T magnet (developed in collaboration with Innovative Magnetic Resonance Imaging Systems, Inc., Winnipeg, MB, Canada) that included high-performance 20-mT/m gradients. Pre- and postclipping, intraoperative, T1-weighted, angiographic and diffusion-weighted magnetic resonance images were obtained from a patient with an incidental, 8-mm, anterior communicating artery aneurysm.


RESULTS
T1-weighted images demonstrated brain anatomic features, with visible shifts induced by surgery. Magnetic resonance angiography demonstrated the aneurysm and indicated that, after clipping, the A1 and A2 anterior cerebral artery branches were patent. Diffusion-weighted studies demonstrated no evidence of brain ischemia.


CONCLUSIONS
For the first time, intraoperative magnetic resonance imaging has been used to monitor the surgical treatment of a patient with an intracranial aneurysm.
Sutherland
Garnette R
GR
Department of Clinical Neurosciences, Seaman Family Magnetic Resonance Research Centre, University of Calgary, Calgary, Alberta, Canada. garnette@ucalgary.ca
Kaibara
Taro
T
Wallace
Carla
C
Tomanek
Boguslaw
B
Richter
Marlene
M
D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000601:surgery*; D007432:Intraoperative Period; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged