Abstract
BACKGROUND
The intraoperative magnetic resonance scanner (ioMR) is a diagnostic tool that can be used to improve brain tumor resection in pediatric patients. was introduced in our unit in 2009, and has been used routinely since then.
OBJECTIVE
To describe indications, radiological features and clinical outcomes of the patients operated on with ioMRI and analyze our experience.
METHODS
A retrospective analysis of a prospective surgical database has been performed, including surgical procedure, intent, radiological reports, need for second look surgery and complications, supplemented by further review of the clinical notes and the scans.
RESULTS
From 2009 to 2015, 216 surgical procedures with ioMR for patients with brain tumors were performed: 204 were craniotomies and 12 were biopsies or cyst drainages. The mean age was 9.3y. One ioMR was performed in 56% patients; the mean duration of the MR was 32 min. In 129 cases (60%) no actions followed the ioMR. When the aim of the surgery was debulking of the tumor, the percentage of patients in which the ioMR was followed by resection was higher than when complete resection was the aim (55 vs 29%). The complication rate was not increased when compared with our previous results (infection 1%, neurological deficits 12%).
CONCLUSION
We have demonstrated that the ioMR can be used safely and routinely in pediatric neurosurgical procedures for brain tumors at any age, assisting the surgeon in achieving the best extent of resection and aiding in intra-operative decision-making for tumor related intracranial pathology.