Clinical experience of 3T intraoperative magnetic resonance imaging integrated neurosurgical suite in Shanghai Huashan Hospital

• Published in: Chinese medical journal Vol. 125; no. 24; pp. 4328 - 4333
• Main Authors: Qiu, Tian-ming, Yao, Cheng-jun, Wu, Jin-song, Pan, Zhi-guang, Zhuang, Dong-xiao, Xu, Gen, Zhu, Feng-ping, Lu, Jun-feng, Gong, Xiu, Zhang, Jie, Yang, Zhong, Shi, Jian-bin, Huang, Feng-ping, Mao, Ying, Zhou, Liang-fu
• Format: Journal Article
• Language: English
• Published: China Glioma Surgery Division, Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China 20.12.2012
• Subjects: Adolescent; Adult; Aged; Brain Neoplasms - surgery; Child; Child, Preschool; China; Female; Glioma - surgery; Humans; Magnetic Resonance Imaging - methods; Male; Middle Aged; Neurosurgical Procedures - methods; Young Adult; 上海; 临床经验; 医院; 华山; 套房; 磁共振成像; 神经外科; 集成; China; glioma; intraoperative magnetic resonance imaging; pituitary adenoma
• ISSN: 0366-6999; 2542-5641; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2012.24.002

Background Intraoperative magnetic resonance imaging （iMRI） dates back to the 1990s and has been successfully applied in neurosurgery but they were low-field iMRI （〈1.0T）. This paper reports the clinical experience with a 3T iMRI-integrated neurosurgical suite in Huashan Hospital, Shanghai, China. Methods From September 2010 through March 2012, 373 consecutive patients underwent neurological surgery under guidance with 3T iMRI. A retrospective analysis was conducted regarding clinical efficiency. Results All surgery in the 373 patients was safe. The ratio of gross total resection for cerebral gliomas （n=161） was increased from 55.90% to 87.58%. The ratio of benefit in extent of resection was 39.13%. One hundred and fifty eight of the 161 glioma patients accomplished follow-up at 3 months postoperatively. Twenty of 161 patients （12.42%） suffered from early motor deficit after surgery. Late motor deficit was however observed in five of 158 patients （3.16%）. Twenty-one of 161 patients （13.04%） had early speech deficit and late speech deficit was only observed in six of 158 patients （3.80%）. The ratio of gross total resection for pituitary adenomas （n=49） was increased from 77.55% to 85.71%. The ratio of benefit in extent of resection was 10.2%. There were no iMRI-related adverse events even for patients who underwent awake craniotomy. Conclusion The 3T iMRI integrated neurosurgical suite provides high-quality intraoperative structural and functional imaging for real-time tumor resection control and accurate functional preservation, resulting in an improvement in maximal safe brain surgery.