title: Resection of subependymal giant cell astrocytoma guided by intraoperative magnetic resonance imaging and neuronavigation.
abstract: OBJECTIVE
  Subependymal giant cell astrocytoma (SEGA) is a rare, benign tumor that occurs mainly in children; complete resection can achieve cure. Guidance of surgery by combined intraoperative magnetic resonance imaging (iMRI) and functional neuronavigation is reported to achieve more radical resection and reduced complications. However, reports about the resection of SEGA with such guidance are rare. We report here our preliminary experience of the resection of SEGA guided by iMRI and neuronavigation, focusing on the feasibility, benefits, and pitfalls of this combination of techniques.
  
  
  METHODS
  We performed resection of SEGA guided by combined iMRI and functional neuronavigation in seven children. The first iMRI was performed when the surgeon believed that the tumor had been completely resected; the last iMRI was performed immediately after closure. Additional scans were performed as needed.
  
  
  RESULTS
  Successful resection was achieved in all seven patients using this combination of techniques. The iMRI scans detected residual tumor in three patients and a large, remote epidural hematoma in one patient. Further resection or other surgery was performed in these four patients. Complete resection was eventually achieved in all patients. There were no cases of surgery-related neurological dysfunction, except transient memory loss in one patient. No recurrence of tumor or hydrocephalus was observed in any patients during the follow-up period.
  
  
  CONCLUSIONS
  Resection of SEGA in children guided by combined iMRI and neuronavigation is feasible and safe. This combination of techniques enables a higher complete resection rate and reduces brain injury and other unexpected events during surgery.
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.|Medical College of Nankai University, Tianjin, 300071, China.
authors: Hecheng
authors: H
authors: Ren
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors: Xiaolei
authors: X
authors: Chen
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors: Guochen
authors: G
authors: Sun
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.|Medical College of Nankai University, Tianjin, 300071, China.
authors: Shen
authors: S
authors: Hu
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors: Gang
authors: G
authors: Zheng
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors: Fangye
authors: F
authors: Li
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
authors: Jinjiang
authors: J
authors: Li
authors: Department of Neurosurgery, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China. xbn301sjwk@126.com.
authors: Bainan
authors: B
authors: Xu
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000601:surgery*; D001932:Brain Neoplasms / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D038361:Neuronavigation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D011183:Postoperative Complications; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods
keywords: Intraoperative magnetic resonance imaging; Neuronavigation; Subependymal giant cell astrocytoma; Surgery
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