Portable MRI to assess optic chiasm decompression after endoscopic endonasal resection of sellar and suprasellar lesions.

Autor:	Hong CS; 1Department of Neurosurgery, Yale School of Medicine, New Haven., Lamsam LA; 1Department of Neurosurgery, Yale School of Medicine, New Haven., Yadlapalli V; 2Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven., Parasuram N; 2Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven., Mazurek M; 2Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven., Chavva I; 2Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven., Lalwani D; 2Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven., Zabinska J; 2Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven., Schiff SJ; 1Department of Neurosurgery, Yale School of Medicine, New Haven., Manes RP; 3Department of Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut; and., Vining EM; 3Department of Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut; and., Rimmer RA; 3Department of Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut; and., Kimberly WT; 4Department of Neurology, Division of Neurocritical Care, Massachusetts General Hospital, Boston, Massachusetts., Sheth KN; 1Department of Neurosurgery, Yale School of Medicine, New Haven.; 2Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven., Omay SB; 1Department of Neurosurgery, Yale School of Medicine, New Haven.; 3Department of Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut; and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2023 Jun 16; Vol. 139 (6), pp. 1664-1670. Date of Electronic Publication: 2023 Jun 16 (Print Publication: 2023).
DOI:	10.3171/2023.5.JNS23174
Abstrakt:	Objective: Low-field portable MRI (pMRI) is a recent technological advancement with potential for broad applications. Compared with conventional MRI, pMRI is less resource-intensive with regard to operational costs and scan time. The application of pMRI in neurosurgical oncology has not been previously described. The goal of this study was to demonstrate the efficacy of pMRI in assessing optic nerve decompression after endoscopic endonasal surgery for sellar and suprasellar pathologies. Methods: Patients who underwent endoscopic endonasal surgery for sellar and suprasellar lesions at a single institution and for whom pMRI and routine MRI were performed postoperatively were retrospectively reviewed to compare the two imaging systems. To assess the relative resolution of pMRI compared with MRI, the distance from the optic chiasm to the top of the third ventricle was measured, and the measurements were compared between paired equivalent slices on T2-weighted coronal images. The inter- and intrarater correlations were analyzed. Results: Twelve patients were included in this study (10 with pituitary adenomas and 2 with craniopharyngiomas) with varying degrees of optic chiasm compression on preoperative imaging. Measurements were averaged across raters before calculating agreement between pMRI and MRI, which demonstrated significant interrater reliability (intraclass correlation coefficient [ICC] = 0.78, p < 0.01). Agreement between raters within the pMRI measurements was also significantly reliable (ICC = 0.93, p < 0.01). Finally, a linear mixed-effects model was specified to demonstrate that MRI measurement could be predicted using the pMRI measurement with the patient and rater set as random effects (pMRI β coefficient = 0.80, p < 0.01). Conclusions: The results of this study suggest that resolution of pMRI is comparable to that of conventional MRI in assessing the optic chiasm position in relation to the third ventricle. Portable MRI sufficiently demonstrates decompression of the optic chiasm after endoscopic endonasal surgery. It can be an alternative strategy in cases in which cost, scan-time considerations, or lack of intraoperative MRI availability may preclude the ability to assess adequate optic nerve decompression after endoscopic endonasal surgery for sellar and suprasellar lesions.
Databáze:	MEDLINE
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