Resonancia magnética intraoperatoria de 3 teslas: Nuestra experiencia en patología tumoral / Intraoperative 3 tesla magnetic resonance imaging: our experience in tumors

Objetivo. Describir nuestra experiencia con la resonancia magnética intraoperatoria (RMio) de 3 teslas en procedimientos neuroquirúrgicos en patología tumoral y evaluar los criterios que condicionaron la ampliación quirúrgica. Material y métodos. Estudio retrospectivo en el que se incluyeron todas las RMio consecutivas realizadas por patología neurooncológica en los primeros 13 meses tras su instalación. Se registraron las posibles complicaciones inmediatas, la presencia de restos tumorales y la modificación de la actitud quirúrgica por los resultados de la RMio. Se midió el tiempo quirúrgico en todos los casos. Resultados. El mayor porcentaje de lesiones resecadas correspondió a glioblastomas recidivados, seguido de glioblastomas primarios y metástasis. Se evidenció una resección completa en un 28% y restos tumorales en un 72%. La RMio permitió a los neurocirujanos mejorar la extensión de la resección en un 85%. La media del tiempo quirúrgico fue de 390±122 minutos. Conclusión. La RMio con equipos de alto campo (3 teslas) es una técnica novedosa y válida, que permite estudiar la resección tumoral de forma precisa y evaluar si se puede continuar la resección sin dañar zonas elocuentes. Aunque su empleo conlleva una prolongación del tiempo quirúrgico, este mejora con la curva de aprendizaje del personal

Objective. To report our experience in the use of 3 tesla intraoperative magnetic resonance imaging (MRI) in neurosurgical procedures for tumors, and to evaluate the criteria for increasing the extension of resection. Material and methods. This retrospective study included all consecutive intraoperative MRI studies done for neuro-oncologic disease in the first 13 months after the implementation of the technique. We registered possible immediate complications, the presence of tumor remnants, and whether the results of the intraoperative MRI study changed the surgical management. We recorded the duration of surgery in all cases. Results. The most common tumor was recurrent glioblastoma, followed by primary glioblastoma and metastases. Complete resection was achieved in 28%, and tumor remnants remained in 72%. Intraoperative MRI enabled neurosurgeons to improve the extent of the resection in 85% of cases. The mean duration of surgery was 390±122minutes. Conclusion. Intraoperative MRI using a strong magnetic field (3 teslas) is a valid new technique that enables precise study of the tumor resection to determine whether the resection can be extended without damaging eloquent zones. Although the use of MRI increases the duration of surgery, the time required decreases as the team becomes more familiar with the technique

Intraoperative 3 tesla magnetic resonance imaging: our experience in tumors. / Resonancia magnética intraoperatoria de 3 teslas: Nuestra experiencia en patología tumoral.

OBJECTIVE: To report our experience in the use of 3 tesla intraoperative magnetic resonance imaging (MRI) in neurosurgical procedures for tumors, and to evaluate the criteria for increasing the extension of resection. MATERIAL AND METHODS: This retrospective study included all consecutive intraoperative MRI studies done for neuro-oncologic disease in the first 13 months after the implementation of the technique. We registered possible immediate complications, the presence of tumor remnants, and whether the results of the intraoperative MRI study changed the surgical management. We recorded the duration of surgery in all cases. RESULTS: The most common tumor was recurrent glioblastoma, followed by primary glioblastoma and metastases. Complete resection was achieved in 28%, and tumor remnants remained in 72%. Intraoperative MRI enabled neurosurgeons to improve the extent of the resection in 85% of cases. The mean duration of surgery was 390±122minutes. CONCLUSION: Intraoperative MRI using a strong magnetic field (3 teslas) is a valid new technique that enables precise study of the tumor resection to determine whether the resection can be extended without damaging eloquent zones. Although the use of MRI increases the duration of surgery, the time required decreases as the team becomes more familiar with the technique.