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Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation
BACKGROUND: Intraparenchymal cerebral cavernous malformation is difficult to localize intraoperatively with conventional frameless navigation due to the “brain shift” effect. We conducted this study to evaluate the efficacy and safety of intraoperative magnetic resonance image (iMRI)-assisted neuro-...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398321/ https://www.ncbi.nlm.nih.gov/pubmed/32922922 http://dx.doi.org/10.1186/s41016-019-0171-x |
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author | Zhao, Min Lu, Changyu Liang, Jianfeng Zhao, Yuanli Chen, Xiaolei |
author_facet | Zhao, Min Lu, Changyu Liang, Jianfeng Zhao, Yuanli Chen, Xiaolei |
author_sort | Zhao, Min |
collection | PubMed |
description | BACKGROUND: Intraparenchymal cerebral cavernous malformation is difficult to localize intraoperatively with conventional frameless navigation due to the “brain shift” effect. We conducted this study to evaluate the efficacy and safety of intraoperative magnetic resonance image (iMRI)-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation. METHODS: Between April 2016 and December 2017, 54 consecutive patients with intraparenchymal cerebral cavernous malformation who get surgical treatment in our hospital were enrolled into this study. Twenty-one patients were treated using iMRI-assisted neuro-port surgery (experiment group), and 33 patients underwent treatment by conventional microsurgery (control group). The iMRI was used in all cases for the compensation of the “brain shift” effect and keeping the navigation system up-to-date. The surgical resection rate, the total operation time, and the preoperative and postoperative Karnofsky Performance Status (KPS) scores were determined to evaluate the operative procedures. RESULTS: There were no significant differences between the two groups in mean age, gender ratio, and volume of lesions (P > 0.05). For the experiment group, the average duration of the procedure was 188.8 min with total resection of the lesions achieved in all 21 cases. For the control group, the average duration of the procedure was 238.2 min with total resection of the lesions achieved in 25 of 33 cases. The differences in the average duration of the procedure and the number of totally resected lesions between the two groups were statistically significant (P < 0.05). Regarding postoperative neurological function, postoperative KPS scores for the experiment group were significantly higher than those of the control group (P = 0.018). CONCLUSION: Our results show that iMRI-assisted neuro-port surgery is helpful for intraparenchymal cerebral cavernous malformation surgery. The method provides high accuracy and efficiency for lesion targeting and permits excellent anatomic orientation. With the assistance of iMRI technology, we achieved a higher resection rate and a lower incidence of postoperative neurological deficits. Additionally, iMRI is helpful for the compensation of the “brain shift” effect, and it can update the navigation system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s41016-019-0171-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7398321 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73983212020-09-10 Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation Zhao, Min Lu, Changyu Liang, Jianfeng Zhao, Yuanli Chen, Xiaolei Chin Neurosurg J Research BACKGROUND: Intraparenchymal cerebral cavernous malformation is difficult to localize intraoperatively with conventional frameless navigation due to the “brain shift” effect. We conducted this study to evaluate the efficacy and safety of intraoperative magnetic resonance image (iMRI)-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation. METHODS: Between April 2016 and December 2017, 54 consecutive patients with intraparenchymal cerebral cavernous malformation who get surgical treatment in our hospital were enrolled into this study. Twenty-one patients were treated using iMRI-assisted neuro-port surgery (experiment group), and 33 patients underwent treatment by conventional microsurgery (control group). The iMRI was used in all cases for the compensation of the “brain shift” effect and keeping the navigation system up-to-date. The surgical resection rate, the total operation time, and the preoperative and postoperative Karnofsky Performance Status (KPS) scores were determined to evaluate the operative procedures. RESULTS: There were no significant differences between the two groups in mean age, gender ratio, and volume of lesions (P > 0.05). For the experiment group, the average duration of the procedure was 188.8 min with total resection of the lesions achieved in all 21 cases. For the control group, the average duration of the procedure was 238.2 min with total resection of the lesions achieved in 25 of 33 cases. The differences in the average duration of the procedure and the number of totally resected lesions between the two groups were statistically significant (P < 0.05). Regarding postoperative neurological function, postoperative KPS scores for the experiment group were significantly higher than those of the control group (P = 0.018). CONCLUSION: Our results show that iMRI-assisted neuro-port surgery is helpful for intraparenchymal cerebral cavernous malformation surgery. The method provides high accuracy and efficiency for lesion targeting and permits excellent anatomic orientation. With the assistance of iMRI technology, we achieved a higher resection rate and a lower incidence of postoperative neurological deficits. Additionally, iMRI is helpful for the compensation of the “brain shift” effect, and it can update the navigation system. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s41016-019-0171-x) contains supplementary material, which is available to authorized users. BioMed Central 2019-09-11 /pmc/articles/PMC7398321/ /pubmed/32922922 http://dx.doi.org/10.1186/s41016-019-0171-x Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Zhao, Min Lu, Changyu Liang, Jianfeng Zhao, Yuanli Chen, Xiaolei Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation |
title | Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation |
title_full | Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation |
title_fullStr | Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation |
title_full_unstemmed | Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation |
title_short | Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation |
title_sort | intraoperative mri-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398321/ https://www.ncbi.nlm.nih.gov/pubmed/32922922 http://dx.doi.org/10.1186/s41016-019-0171-x |
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