The Significance of Intraoperative Magnetic Resonance Imaging in Resection of Skull Base Chordomas.
Adolescent
Adult
Chordoma
/ diagnostic imaging
Cranial Fossa, Posterior
/ diagnostic imaging
Female
Humans
Intraoperative Care
/ methods
Karnofsky Performance Status
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Neoplasm, Residual
Retrospective Studies
Skull Base Neoplasms
/ diagnostic imaging
Young Adult
Chordoma
Intraoperative magnetic resonance imaging
Outcome
Skull base
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
20
01
2019
revised:
08
04
2019
accepted:
09
04
2019
pubmed:
20
4
2019
medline:
21
1
2020
entrez:
20
4
2019
Statut:
ppublish
Résumé
Skull base chordoma can be a challenging surgical entity because of its invasive nature. In this study, the role of intraoperative magnetic resonance imaging (iMRI) to optimize the resection of skull base chordomas is evaluated. 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. 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. 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.
Sections du résumé
BACKGROUND
BACKGROUND
Skull base chordoma can be a challenging surgical entity because of its invasive nature.
OBJECTIVE
OBJECTIVE
In this study, the role of intraoperative magnetic resonance imaging (iMRI) to optimize the resection of skull base chordomas is evaluated.
METHODS
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
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
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.
Identifiants
pubmed: 31003024
pii: S1878-8750(19)31078-2
doi: 10.1016/j.wneu.2019.04.086
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e185-e194Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.