title: Intraoperative 3-Tesla MRI in the management of paediatric cranial tumours--initial experience.
abstract: BACKGROUND
  Intraoperative MRI (ioMRI) has been gaining recognition because of its value in the neurosurgical management of cranial tumours. There is limited documentation of its value in children.
  
  
  OBJECTIVE
  To review the initial experience of a paediatric 3-Tesla ioMRI unit in the management of cranial tumours.
  
  
  METHODS
  Thirty-eight children underwent ioMRI during 40 cranial tumour resections using a 3-Tesla MR scanner co-located with the neurosurgical operating theatre. IoMRI was performed to assess the extent of tumour resection and/or to update neuronavigation. The intraoperative and follow-up scans, and the clinical records were reviewed.
  
  
  RESULTS
  In 27/40 operations, complete resection was intended. IoMRI confirmed complete resection in 15/27 (56%). As a consequence, surgical resection was extended in 5/27 (19%). In 6/27 (22%), ioMRI was equivocal for residual tumour. In 13/40 (33%) operations, the surgical aim was to partially resect the tumour. In 7 of the 13 (54%), surgical resection was extended following ioMRI.
  
  
  CONCLUSIONS
  In our initial experience, ioMRI has increased the rate of complete resection, with intraoperative surgical strategy being modified in 30% of procedures. Collaborative analysis of ioMRI by the radiologist and neurosurgeon is vital to avoid errors in interpretation.
authors: Department of Radiology, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK. shivaram.avula@alderhey.nhs.uk
authors: Shivaram
authors: S
authors: Avula
authors: Connor L
authors: CL
authors: Mallucci
authors: Barry
authors: B
authors: Pizer
authors: Deborah
authors: D
authors: Garlick
authors: Daniel
authors: D
authors: Crooks
authors: Laurence J
authors: LJ
authors: Abernethy
mesh_terms: D000293:Adolescent; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003399:Craniotomy; D005260:Female; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D038361:Neuronavigation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media