Early Experience with Intraoperative MRI Scanning during Pituitary Adenoma Resection

Czech version

Authors: D. Netuka ¹; V. Masopust ¹; T. Belšan ²; F. Kramář ¹; V. Beneš ¹
Authors‘ workplace: Neurochirurgická klinika 1. LF UK a IPVZ, ÚVN Praha ¹; Radiologické oddělení ÚVN Praha ²
Published in: Cesk Slov Neurol N 2009; 72/105(1): 45-50
Category: Short Communication

Overview

A multifunctional surgical suite with intraoperative MRI (iMRI) has been in use since April 2008 in the Central Military Hospital, Prague. The authors of the article assess the safety, the quality and the effect of iMRI on the extent of resection. 18 endoscopic endonasal procedures in 16 patients with pituitary adenoma were performed from April 18, 2008 to May 16, 2008. Radical resection was the objective of surgery in 8 cases, and partial resection in 8 cases. No safety issues were recorded. iMRI was always in a good quality. Radical resection was confirmed by iMRI in 6 cases (75%) in the group of patients indicated for radical resection. In two cases, a residuum was disclosed by iMRI. The residuum was resected after iMRI scanning. Further resection after iMRI was performed in 4 cases (50%) in the group of patients indicated for partial resection. Based on iMRI findings, the procedure was classified as radical in one case. A small residuum was disclosed on a postoperative MRI. iMRI changed the extent of surgery in 6 cases (37.5%), and was wrongly interpreted by our team in one case (6.25%). iMRI was observed to have an effect on the extent of pituitary adenoma resection in this small series.

Key words:
pituitary adenoma – transsphenoidal surgery – intraoperative magnetic resonance imaging – extent of resection

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