The Significance of Intraoperative Magnetic Resonance Imaging in Resection of Skull Base Chordomas
| Autor: | Rudolf Fahlbusch, Hussam Metwali, Madjid Samii, Mario Giordano, Venelin Gerganov, Amir Samii |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Neoplasm Residual Adolescent Decompression Interventional magnetic resonance imaging Skull Base Neoplasms Resection Young Adult 03 medical and health sciences 0302 clinical medicine Clivus Chordoma Humans Medicine Karnofsky Performance Status Retrospective Studies Intraoperative Care medicine.diagnostic_test business.industry Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Skull Base Chordoma Skull medicine.anatomical_structure Cranial Fossa Posterior 030220 oncology & carcinogenesis Female Surgery Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 128:e185-e194 |
| ISSN: | 1878-8750 |
| Popis: | Background Skull base chordoma can be a challenging surgical entity because of its invasive nature. Objective In this study, the role of intraoperative magnetic resonance imaging (iMRI) to optimize the resection of skull base chordomas is evaluated. Methods We performed a retrospective analysis of operated patients with skull base chordomas in the setting of iMRI. The clinical records, operative notes, radiologic images, tumor volumetry, location of the residual tumor, and surgical outcome were evaluated. Results Fifteen patients were operated on for resection of skull base chordomas between 2010 and 2017 in our institution. Gross total resection was planned and achieved in 8 patients and partial resection in 7 patients. In 8 patients (53.3%), the preoperatively planned volume of resection was achieved and confirmed in the first iMRI control. In 7 patients, repeated iMRI controls were required to achieve the surgical target. In 3 patients, the tumor residual requiring further resection was located in the clivus and in 4 patients in the intradural space. The improvement of the preoperative deficits showed a significant statistical association with the resection of the intradural component and decompression of the brainstem. Conclusions This study shows that iMRI is a safe method for intraoperative assessment of the degree of resection and the volume and location of residual tumor when resecting skull base chordomas. When gross total resection of the tumor is not feasible, iMRI can be a useful tool for targeted tumor resection. |
| Databáze: | OpenAIRE |
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