title: MRI-guided stereotactic aspiration of brain abscesses by use of an optical tracking navigation system.
abstract: BACKGROUND
  Owing to the high risk of abscess drainage by craniotomy, imaging-guided stereotactic aspiration is considered an ideal choice in the management of brain abscesses. Interventional magnetic resonance imaging (MRI) represents a valuable technique for the treatment of brain abscess as a guiding modality.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of an interventional MRI system in performing the procedure.
  
  
  METHODS
  Thirteen brain abscesses in 11 patients were treated with percutaneous aspiration. All procedures were performed solely under the guidance of a 0.23-T open-configuration MRI scanner with optical tracking. Clinical and imaging follow-up was at 1 week, 1 month, 3 months, and 6 months. The changes of abscess, MRI features, and clinical symptoms were recorded. Procedure efficacy and safety were evaluated by success rate, procedure time, decrease of abscess, recovery rate, and complication. Descriptive statistical analysis was performed.
  
  
  RESULTS
  MRI-guided stereotactic aspirations were performed successfully in 13/13 (100%) abscesses. The mean operating time was 70 min (range, 45-100 min). Follow-up MRI at 1 week after the procedure showed average reduction of abscesses by 60% (2.1/3.5). And the abscesses continued to get smaller by up to 89.7% (3.14/3.5) at 1-month follow-up. All cavities resolved at the end of the 6-month follow-up period. The recovery rate was 100% for fever, headache, vomiting, papilledema, meningismus, altered sensorium, 75% (3/4) for hemiparesis, and 83.3% (5/6) for epilepsy. There were no complications.
  
  
  CONCLUSIONS
  Punctures of brain abscesses with subsequent aspiration can be performed safely and efficiently by monitoring the procedure using an open interventional MRI system.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, Jinan, PR China.
authors.forename: Yubo
authors.initials: Y
authors.lastname: Lü
authors.forename: Chengli
authors.initials: C
authors.lastname: Li
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Jan
authors.initials: J
authors.lastname: Fritz
authors.forename: John A
authors.initials: JA
authors.lastname: Carrino
authors.forename: Lebin
authors.initials: L
authors.lastname: Wu
authors.forename: Bin
authors.initials: B
authors.lastname: Zhao
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D011677:Punctures; D013238:Stereotaxic Techniques; D013396:Suction; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: Brain abscess; MR-guided; aspiration; interventional MRI