scholarly journals P04.18 Management of diffuse gliomas using hypnosis-aided awake surgery: oncological and functional preliminary results in a series of 16 cases

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii33-iii33
Author(s):  
T Picart ◽  
G Pardey Bracho ◽  
R Ameli ◽  
L Berner ◽  
L Thomas ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Awake Surgery ◽  
Motor Deficit ◽  
Resonance Imaging ◽  
Preliminary Results ◽  
Diffuse Gliomas ◽  
Grade Ii ◽  
Awake Resection ◽  
Grade Iii

Abstract BACKGROUND Awake resection of diffuse gliomas aims to find a tailored onco-functional balance for each patient. Hypnosis represents an innovative technique able to optimize the comfort and well-being of the patient during such procedures. The aim of the present study is to analyse the oncological and functional outcome in a cohort of patients operated on with hypnosis-aided awake surgery. MATERIAL AND METHODS All consecutive adult patients that underwent hypnosis-aided resection for a diffuse glioma between January 2018 and January 2019 were recorded. Neurological and cognitive status were assessed preoperatively and at 3 months postoperatively. Extent of tumor resection was quantified by a radiologist on magnetic resonance imaging. RESULTS Sixteen patients (6 males and 10 females), with a mean age of 39 years, were included. Gliomas were revealed by epileptic seizures (62.5%), motor deficit (6.25%) or incidentally discovered (31.25%) and were either located in the right hemisphere (50%) or in the left hemisphere (50%), with a mean initial volume of 42 mL. Histologically, there were six grade II-astrocytomas, three grade III-astrocytomas, five grade II-oligodendroglioma, one grade III-oligodendroglioma and one ganglioglioma. Under HAS, the awake-time after the anaesthesia drugs stop was short, because low doses of drugs were required thanks to the hypnotic state. All patients were able to reliably performed the different tests until functional subcortical limits were reached. Postoperative magnetic resonance imaging showed complete resection in 8 cases (50%), subtotal resection in 2 cases (12.5%) and partial resection in 6 cases (37.5%), with a mean resection rate of 84.6%. At 3 months after surgery, there was only a new motor deficit (6.25%). The language and neuropsychological assessments were improved in 7 patients (43.75%), stable in 7 patients (43.75%) and deteriorated in some tests in 2 patients (12.5%). After surgery, no patient reported negative emotion concerning the awake glioma resection and all patient declared being ready for a second awake resection in the future, if indicated. CONCLUSION According to these preliminary results, hypnosis-aided awake resection of diffuse gliomas appears to be safe and effective from an onco-functional viewpoint and parallelly contributes to decrease intra-operative pain, anxiety and major discomfort.

scholarly journals Diagnostic Accuracy and Validity of Magnetic Resonance Imaging in the Detection of Speci!c Type of Brain Tumour

2019 ◽  
Vol 46 (3) ◽  
pp. 85-89
Author(s):  
Swati Munshi ◽  
Farid Ahmed ◽  
Bibekananda Halder ◽  
Abdullah Yousuf ◽  
Md Mahbubur Rahman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Brain Tumour ◽  
Brain Tumours ◽  
Histopathological Examination ◽  
Test Validity ◽  
Resonance Imaging ◽  
Grade Ii ◽  
Grade Iii

Magnetic Resonance Imaging (MRI) is a widely accessible imaging technique for the detection of brain tumours and cancer, which are further confirmed by histopathological examination. Accurate detection of the tumours and its extent is very difficult. The present study attempted to evaluate the convenience of MRI in detection of different grades of astrocytomas, which are the most commonly occurring brain tumours. This cross-sectional study was conducted at the Department of Radiology and Imaging with the collaboration of Department of Neurosurgery and Department of Pathology at Sir Salimullah Medical College (SSMC & MH), Dhaka from January 2013 to December 2013 for a period of one year. The study population was all the diagnosed cases of intracranial astrocytoma patients regardless of their age and sex. The studied included 48 brain tumour (astrocytoma) patients, ages between 13 and 69 years old. All cases having no contraindication for MRI underwent MR examination followed by histopathological examination of the postoperative resected tissues. The findings of the MRI and histopathological examination were compared to find out the test validity of the MRI findings of the different grades of astrocytoma’s. The highest sensitivity was found in grade III astrocytoma (90.5%) followed by grade II (85.7%) grade IV (75.0%) and grade I (60.0%). The highest specificity was found in grade I astrocytoma (97.7%) followed by Grade III (96.3%), grade IV (92.5%) and grade II (91.5%). The highest accuracy was found in both grade I astrocytoma (93.7%) and grade III (93.7%) followed by grade II (92.5%) and grade IV (89.6%). As per the study findings it can be concluded that,MRI has a high diagnostic accuracy and validity for the detection of different grades of astrocytoma. Bangladesh Med J. 2017 Sep; 46 (3): 85-89

Relationship between IDH1 mutation status and magnetic resonance imaging features in WHO grade II and III oligodendroglial tumors.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 2082-2082
Author(s):  
Frederique Toulgoat ◽  
Pierre Paul Arrigoni ◽  
Delphine Loussouarn ◽  
Christophe Leux ◽  
Jean-Sebastien Frenel ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Mr Spectroscopy ◽  
Resonance Imaging ◽  
Who Grade ◽  
Oligodendroglial Tumors ◽  
Mri Features ◽  
Grade Ii ◽  
Idh1 Mutations ◽  
Grade Iii

2082 Background: In gliomas, relationship between radiological characteristics and several biomarkers was the subject of numerous publications. Mutations in the isocitrate dehydrogenase 1 (IDH1) gene have been identified recently to play a key role in these tumors occuring in up to 75% of low-grade diffuse (WHO grade II) and anaplastic (WHO grade III) astrocytic, oligodendroglial and mixed oligodendroglial neoplasms. However, the correlation with magnetic resonance imaging (MRI) features has been little studied. Methods: Patients treated for WHO grade II and III oligodendroglial tumors between 2005 and 2011 were retrospectively identified. Each case has been reviewed by the same neuropathologist. IDH1 and IDH2 mutations were available. Preoperative MRI, including T1 weighted, T2 weighted, T1 contrast enhanced, FLAIR, T2* weighted, diffusion weighted (ADC ratio), perfusion weighted (CBV ratio) and MR spectroscopy, were analyzed by two radiologists blinded from molecular data. Logistic regression analysis and Fisher’s test were used to develop predictive models of genetic profile from imaging. Results: Sixty eight patients, WHO grade II (n= 37) and grade III (n=31) patients were identified. Mean age at diagnosis was 46 years; ratio male/female was 40/28. IDH1 mutations were identified in 42 patients (62 %), IDH2 in 4 patients (6 %). Analysis of tumor location, size, borders, morphological aspect, and signal did not shown any significant difference between IDH1 mutated group and IDH1 non mutated group neither in grade II nor in grade III oligodendroglial tumors. In the same way, MR spectroscopy (Choline/NAA ratio and detection of lipid and lactate) was not relevant to discern the two groups. As well, ADC ratio (1,5 versus 1,4; p=0,35) and CBV ratio (3,4 versus 4,2; p= 0,46) did not reveal any difference between mutated group and non mutated group. Conclusions: In our study, IDH1 mutations were not correlated with MRI features available during routine MRI. Nevertheless, recent studies suggest the ability of MR spectroscopy to detect 2-hydroxyglutarate as an MRI marker of IDH1 mutated tumors, which encourage carrying on research in molecular imaging.

Magnetic Resonance Imaging Spatial and Time Study of Lung Water Content in Newborn Lamb: Methods and Preliminary Results

2008 ◽  
Vol 43 (6) ◽  
pp. 470-480 ◽  
Author(s):  
Romain Viard ◽  
Pierre Tourneux ◽  
Laurent Storme ◽  
Julie-Marie Girard ◽  
Nacim Betrouni ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Water Content ◽  
Time Study ◽  
Resonance Imaging ◽  
Lung Water ◽  
Newborn Lamb ◽  
Preliminary Results ◽  
Lung Water Content

scholarly journals Kernohan-Woltman Notch Phenomenon—Case Report

2016 ◽  
Vol 38 (01) ◽  
pp. 056-059
Author(s):  
Carlos Pereira
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Chronic Subdural Hematoma ◽  
Motor Deficit ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Present Case Report ◽  
Magnetic Resonance Imaging Mri

AbstractThe Kernohan-Woltman notch phenomenon is a paradoxical neurological manifestation consisting of a motor deficit ipsilateral to a primary brain injury. It has been observed in patients with brain tumors and with supratentorial hematomas. It is considered a false localizing neurological sign. Magnetic resonance imaging (MRI) scan has been the test of choice. The recognition of this phenomenon is important to prevent a surgical procedure on the opposite side of the lesion. The present case report describes a case of chronic subdural hematoma with a probable finding of the Kernohan-Woltman phenomenon, and it discusses its pathophysiology, imaging findings, treatment, and prognosis.

Prognostic value of initial magnetic resonance imaging growth rates for World Health Organization grade II gliomas

2006 ◽  
Vol 60 (3) ◽  
pp. 380-383 ◽  
Author(s):  
Johan Pallud ◽  
Emmanuel Mandonnet ◽  
Hugues Duffau ◽  
Michèle Kujas ◽  
Rémy Guillevin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
World Health Organization ◽  
Growth Rates ◽  
Prognostic Value ◽  
World Health ◽  
Resonance Imaging ◽  
Grade Ii ◽  
Health Organization

Intraoperative Motor Evoked Potential Alteration in Intracranial Tumor Surgery and Its Relation to Signal Alteration in Postoperative Magnetic Resonance Imaging

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 302-313 ◽  
Author(s):  
Andrea Szelényi ◽  
Elke Hattingen ◽  
Stefan Weidauer ◽  
Volker Seifert ◽  
Ulf Ziemann
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Motor Cortex ◽  
Evoked Potential ◽  
Corticospinal Tract ◽  
Motor Evoked Potential ◽  
Motor Deficit ◽  
Warning Sign ◽  
Precentral Gyrus ◽  
Resonance Imaging

Abstract OBJECTIVE To determine the degree to which the pattern of intraoperative isolated, unilateral alteration of motor evoked potential (MEP) in intracranial surgery was related to motor outcome and location of new postoperative signal alterations on magnetic resonance imaging (MRI). METHODS In 29 patients (age, 42.8 ± 18.2 years; 15 female patients; 25 supratentorial, 4 infratentorial procedures), intraoperative MEP alterations in isolation (without significant alteration in other evoked potential modalities) were classified as deterioration (> 50% amplitude decrease and/or motor threshold increase) or loss, respectively, or reversible and irreversible. Postoperative MRI was described for the location and type of new signal alteration. RESULTS New motor deficit was present in all 5 patients with irreversible MEP loss, in 7 of 10 patients with irreversible MEP deterioration, in 1 of 6 patients with reversible MEP loss, and in 0 of 8 patients with reversible MEP deterioration. Irreversible compared with reversible MEP alteration was significantly more often correlated with postoperative motor deficit (P < .0001). In 20 patients, 22 new signal alterations affected 29 various locations (precentral gyrus, n = 5; corticospinal tract, n = 19). Irreversible MEP alteration was more often associated with postoperative new signal alteration in MRI compared with reversible MEP alteration (P = .02). MEP loss was significantly more often associated with subcortically located new signal alteration (P = .006). MEP deterioration was significantly more often followed by new signal alterations located in the precentral gyrus (P = .04). CONCLUSION MEP loss bears a higher risk than MEP deterioration for postoperative motor deficit resulting from subcortical postoperative MR changes in the corticospinal tract. In contrast, MEP deterioration points to motor cortex lesion. Thus, even MEP deterioration should be considered a warning sign if surgery close to the motor cortex is performed.

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