PDF(Pubmed)
Abstract：
BACKGROUND: Intraoperative MRI (iMRI) has emerged as a useful tool in glioma surgery to safely improve the extent of resection. However, iMRI requires a dedicated operating room (OR) with an integrated MRI scanner solely for this purpose. Due to physical or economical restraints, this may not be feasible in all centers. The aim of this study was to investigate the feasibility of using a non-dedicated MRI scanner at the radiology department for iMRI and to describe the workflow with special focus on time expenditure and surgical implications.
METHODS: In total, 24 patients undergoing glioma surgery were included. When the resection was deemed completed, the wound was temporarily closed, and the patient, under general anesthesia, was transferred to the radiology department for iMRI, which was performed using a dedicated protocol on 1.5 or 3 T scanners. After performing iMRI the patient was returned to the OR for additional tumor resection or final wound closure. All procedural times, timestamps, and adverse events were recorded.
RESULTS: The median time from the decision to initiate iMRI until reopening of the wound after scanning was 68 (52-104) minutes. Residual tumors were found on iMRI in 13 patients (54%). There were no adverse events during the surgeries, transfers, transportations, or iMRI-examinations. There were no wound-related complications or infections in the postoperative period or at follow-up. There were no readmissions within 30 or 90 days due to any complication.
CONCLUSIONS: Performing intraoperative MRI using an MRI located outside the OR department was feasible and safe with no adverse events. It did not require more time than previously reported data for dedicated iMRI scanners. This could be a viable alternative in centers without access to a dedicated iMRI suite.
METHODS: In total, 24 patients undergoing glioma surgery were included. When the resection was deemed completed, the wound was temporarily closed, and the patient, under general anesthesia, was transferred to the radiology department for iMRI, which was performed using a dedicated protocol on 1.5 or 3 T scanners. After performing iMRI the patient was returned to the OR for additional tumor resection or final wound closure. All procedural times, timestamps, and adverse events were recorded.
RESULTS: The median time from the decision to initiate iMRI until reopening of the wound after scanning was 68 (52-104) minutes. Residual tumors were found on iMRI in 13 patients (54%). There were no adverse events during the surgeries, transfers, transportations, or iMRI-examinations. There were no wound-related complications or infections in the postoperative period or at follow-up. There were no readmissions within 30 or 90 days due to any complication.
CONCLUSIONS: Performing intraoperative MRI using an MRI located outside the OR department was feasible and safe with no adverse events. It did not require more time than previously reported data for dedicated iMRI scanners. This could be a viable alternative in centers without access to a dedicated iMRI suite.
摘要：
背景：术中MRI（iMRI）已成为神经胶质瘤手术中安全改善切除范围的有用工具。然而,iMRI需要专门的手术室（OR），仅为此目的配备集成的MRI扫描仪。由于物理或经济限制，这可能不是在所有中心都可行。这项研究的目的是调查在放射科使用非专用MRI扫描仪进行iMRI的可行性，并描述工作流程，特别关注时间支出和手术影响。
方法：总共，包括24例接受神经胶质瘤手术的患者。当认为切除完成时，伤口暂时闭合，和病人，在全身麻醉下，被转移到放射科进行iMRI，在1.5或3T扫描仪上使用专用协议进行。在进行iMRI之后,患者被返回到OR以进行另外的肿瘤切除或最终的伤口闭合。所有程序时间，时间戳,并记录不良事件.
结果：从决定开始iMRI直到扫描后重新打开伤口的中位时间为68（52-104）分钟。在iMRI上发现了13例患者（54％）的残留肿瘤。手术期间无不良事件发生,转账,运输,或iMRI检查。术后或随访期间无伤口相关并发症或感染。在30或90天内没有因任何并发症而再次入院。
结论：使用手术室以外的MRI进行术中MRI是可行且安全的，没有不良事件。它不需要比以前报告的专用iMRI扫描仪数据更多的时间。在没有专用iMRI套件的情况下，这可能是一个可行的替代方案。
方法：总共，包括24例接受神经胶质瘤手术的患者。当认为切除完成时，伤口暂时闭合，和病人，在全身麻醉下，被转移到放射科进行iMRI，在1.5或3T扫描仪上使用专用协议进行。在进行iMRI之后,患者被返回到OR以进行另外的肿瘤切除或最终的伤口闭合。所有程序时间，时间戳,并记录不良事件.
结果：从决定开始iMRI直到扫描后重新打开伤口的中位时间为68（52-104）分钟。在iMRI上发现了13例患者（54％）的残留肿瘤。手术期间无不良事件发生,转账,运输,或iMRI检查。术后或随访期间无伤口相关并发症或感染。在30或90天内没有因任何并发症而再次入院。
结论：使用手术室以外的MRI进行术中MRI是可行且安全的，没有不良事件。它不需要比以前报告的专用iMRI扫描仪数据更多的时间。在没有专用iMRI套件的情况下，这可能是一个可行的替代方案。
