title: [First intraoperative magnetic resonance imaging in a Spanish hospital of the public healthcare system: initial experience, feasibility and difficulties in our environment].
abstract: OBJECTIVE
  Intraoperative MRI is considered the gold standard among all intraoperative imaging technologies currently available. Its main indication is in the intraoperative detection of residual disease during tumour resections. We present our initial experience with the first intraoperative low-field MRI in a Spanish hospital of the public healthcare system. We evaluate its usefulness and accuracy to detect residual tumours and compare its intraoperative results with images obtained postoperatively using conventional high-field devices.
  
  
  METHODS
  We retrospectively reviewed the first 21 patients operated on the aid of this technology. Maximal safe resection was the surgical goal in all cases. Surgeries were performed using conventional instrumentation and the required assistance in each case.
  
  
  RESULTS
  The mean number of intraoperative studies was 2.3 per procedure (range: 2 to 4). Intraoperative studies proved that the surgical goal had been achieved in 15 patients (71.4%), and detected residual tumour in 6 cases (28.5%). After comparing the last intraoperative image and the postoperative study, 2 cases (9.5%) were considered as "false negatives".
  
  
  CONCLUSIONS
  Intraoperative MRI is a safe, reliable and useful tool for guided resection of brain tumours. Low-field devices provide images of sufficient quality at a lower cost; therefore their universalisation seems feasible.
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Son Espases, Palma de Mallorca, España. Electronic address: m.brell@telefonica.net.
authors.forename: Marta
authors.initials: M
authors.lastname: Brell
authors.forename: Pedro
authors.initials: P
authors.lastname: Roldán
authors.forename: Elsa
authors.initials: E
authors.lastname: González
authors.forename: Pedro
authors.initials: P
authors.lastname: Llinàs
authors.forename: Javier
authors.initials: J
authors.lastname: Ibáñez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005188:False Negative Reactions; D019786:Gadolinium DTPA; D005910:Glioma / Q000473:pathology / Q000601:surgery; D006779:Hospitals, Public; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000706:statistics & numerical data; D008875:Middle Aged; D018365:Neoplasm, Residual; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013030:Spain; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA