scholarly journals Do We Need Intraoperative Magnetic Resonance Imaging in All Endoscopic Endonasal Pituitary Adenoma Surgery Cases? A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Emrah Celtikci ◽  
Muammer Melih Sahin ◽  
Mustafa Caglar Sahin ◽  
Emetullah Cindil ◽  
Zuhal Demirtaş ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pituitary Adenoma ◽  
Magnetic Resonance ◽  
Cavernous Sinus ◽  
Residual Tumor ◽  
Correct Prediction ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Endoscopic Endonasal ◽  
Grade 3

There are previous reports investigating effectiveness of intraoperative magnetic resonance imaging (IO-MRI) in pituitary adenoma surgery but there is no clear data in the literature recommending when there is no need of intraoperative scan. This retrospective analysis was based on determining which patients does not need any IO-MRI scan following endoscopic endonasal pituitary adenoma surgery. Patients with functional or non-functional pituitary adenomas that were operated via endoscopic endonasal approach (EEA) between June 2017 and May 2019 were enrolled. Patients younger than 18 years old, patients who did not underwent IO-MRI procedure or not operated via EEA were excluded from the study. Hence, this study is designed to clarify if IO-MRI is useful in both functional and non-functional pituitary adenomas, functional adenomas did not split into subgroups. A total of 200 patients treated with pituitary adenoma were included. In Knosp Grade 0 – 2 group, primary surgeon’s opinion and IO-MRI findings were compatible in 150 patients (98.6%). In Knosp Grade 3 – 4 correct prediction were performed in 32 (66.6%) patients. When incorrectly predicted Knosp Grade 3 – 4 patients (n = 16) was analyzed, in 13 patients there were still residual tumor in cavernous sinus and in 3 patients there were no residual tumor. Fisher’s exact test showed there is a statistically significant difference of correct prediction between two different Knosp Grade groups (two-tailed P < 0.0001). Eighteen patients had a residual tumor extending to the suprasellar and parasellar regions which second most common site for residual tumor. Our findings demonstrate that there is no need of IO-MRI scan while operating adenomas limited in the sellae and not invading the cavernous sinus. However, we strongly recommend IO-MRI if there is any suprasellar and parasellar extension and/or cavernous sinus invasion.

scholarly journals Intraoperative Magnetic Resonance Imaging Assisted Endoscopic Endonasal Resection of Clival Chordomas

2022 ◽  
Vol 11 ◽  
Author(s):  
Beste Gulsuna ◽  
Burak Karaaslan ◽  
Memduh Kaymaz ◽  
Hakan Emmez ◽  
Emetullah Cindil ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Skull Base ◽  
Residual Tumor ◽  
Gross Total Resection ◽  
Resonance Imaging ◽  
Total Resection ◽  
Endoscopic Endonasal ◽  
Intraoperative Magnetic Resonance Imaging ◽  
Skull Base Chordomas

BackgroundCranial base chordomas are typically indolent and usually appear as encapsulated tumors. They slowly grow by infiltrating the bone, along with the lines of least resistance. Due to its relationship with important neurovascular structures, skull base chordoma surgery is challenging.ObjectiveThe usefulness of intraoperative magnetic resonance imaging (IO-MRI) in achieving the goal of surgery, is evaluated in this study.MethodsBetween March 2018 and March 2020, 42 patients were operated on for resection of skull base chordomas in our institution. All of them were operated on under IO-MRI. Patients were analyzed retrospectively for identifying common residue locations, complications and early post-operative outcomes.ResultsIn 22 patients (52,4%) gross total resection was achieved according to the final IO-MRI. In 20 patients (47,6%) complete tumor removal was not possible because of extension to the petrous bone (8 patients), pontocerebellar angle (6 patients), prepontine cistern (4 patients), temporobasal (1 patient), cervical axis (1 patient). In 13 patients, the surgery was continued after the first IO-MRI control was performed, which showed a resectable residual tumor. 7 of these patients achieved total resection according to the second IO-MRI, in the other 6 patients all efforts were made to ensure maximal resection of the tumor as much as possible without morbidity. Repeated IO-MRI helped achieve gross total resection in 7 patients (53.8%).ConclusionsOur study proves that the use of IO-MRI is a safe method that provides the opportunity to show the degree of resection in skull base chordomas and to evaluate the volume and location of the residual tumor intraoperatively. Hence IO-MRI can improve the life expectancy of patients because it provides an opportunity for both gross total resection and maximal safe resection in cases where total resection is not possible.

Endoscopic Transsphenoidal Pituitary Surgery with Intraoperative Magnetic Resonance Imaging

2006 ◽  
Vol 58 (suppl_1) ◽  
pp. ONS-44-ONS-51 ◽  
Author(s):  
Theodore H. Schwartz ◽  
Phillip E. Stieg ◽  
Vijay K. Anand
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Liquid Crystal Display ◽  
Residual Tumor ◽  
Pituitary Surgery ◽  
Resonance Imaging ◽  
Endoscopic Endonasal ◽  
Intraoperative Magnetic Resonance Imaging ◽  
Small Series ◽  
Cathode Ray Tube

Abstract OBJECTIVE: The two most recent significant advances in pituitary surgery have been the endonasal endoscopic approach and intraoperative magnetic resonance imaging (IMRI). Each provides improved visualization of intra- and parasellar anatomy with the goal of attaining a complete resection. The combination of the two techniques has not been previously reported in the literature. METHODS: We performed endoscopic, endonasal resection of pituitary macroadenomas in 15 patients using the Polestar N-10 (0.12T) IMRI (Odin Medical Technologies, Inc., Newton, MA). Eleven patients had nonfunctioning tumors, three had acromegaly, and one had a medication-resistant prolactinoma. The effect of the magnetic field on the cathode ray tube screen and the image quality of the IMRI images were assessed. The presence of residual tumor on IMRI was noted and then re-examined with the endoscope. RESULTS: Although the Polestar N-10 is a low Tesla magnet, the IMRI caused significant distortion of the cathode ray tube screen regardless of the viewing angle. This was overcome with the use of a wall-mounted plasma screen. IMRI images were obtained in all cases and were of sufficiently high quality to demonstrate adequate decompression of the optic chiasm and the removal of all suprasellar tumor. In three cases, residual tumor was found with IMRI that was resected endoscopically before the completion of surgery. In four other cases, potential residual tumor was examined endoscopically and found to be normal postoperative change. In eight cases no residual intrasellar tumor was seen on the IMRI. Preresection visual deficits improved in all cases and the insulin-like growth factor levels normalized in two of three cases. There were no delayed cerebrospinal fluid leaks. CONCLUSION: Combining intraoperative endoscopy and IMRI is feasible and distortion of the cathode ray tube screen can be overcome with the use of either a plasma or liquid crystal display screen. Each technology provides complementary information, which can assist the surgeon in safely maximizing the extent of resection. In this small series using a low-field magnet, rates of residual tumor following endoscopic trans-sphenoidal surgery were less than have been reported following microscope-based transsphenoidal surgery.

Transdermal Patch Administration and Magnetic Resonance Imaging (MRI)—2020

2021 ◽  
pp. 001857872098713
Author(s):  
Janna Afanasjeva ◽  
Michael Gabay ◽  
Thomas Poznanski ◽  
Stefanie Kerns
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Drug Administration ◽  
Hospital Pharmacy ◽  
Transdermal Patch ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Transdermal Patches ◽  
Magnetic Resonance Imaging Mri ◽  
Prescribing Information

This is an update to the 2010 article published in Hospital Pharmacy on safety concerns involving transdermal patches and magnetic resonance imaging (MRI). Since publication of the original article, new brand and generic transdermal medications have become available and notable changes regarding the presence or absence of metallic content among existing transdermal formulations occurred. To update the tables within the article, Food and Drug Administration (FDA)-approved transdermal medications through October 2020 were researched in order to determine metallic content and procedures for reapplication after MRI, if applicable. Readers should consult the prescribing information or manufacturer for the most current information on use of transdermal medications in the MRI setting. Of note, manufacturers have not evaluated the use of transdermal products while patients undergo a MRI scan.

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.

Radiation Necrosis of the Optic Chiasm, Optic Tract, Hypothalamus, and Upper Pons after Radiotherapy for Pituitary Adenoma, Detected by Gadolinium-Enhanced, T1-Weighted Magnetic Resonance Imaging: Case Report

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 640-643 ◽  
Author(s):  
Osamu Tachibana ◽  
Narihito Yamaguchi ◽  
Tetsumori Yamashima ◽  
Junkoh Yamashita
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pituitary Adenoma ◽  
Magnetic Resonance ◽  
Radiation Necrosis ◽  
Optic Tract ◽  
Optic Chiasm ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Weighted Magnetic Resonance Imaging ◽  
Resonance Imaging Scan

Abstract A 26-year-old woman was treated for a prolactin secreting pituitary adenoma by surgery and radiotherapy (5860 rads). Fourteen months later, she developed right hemiparesis and dysarthria. A T1-weighted magnetic resonance imaging scan using gadolinium contrast showed a small, enhanced lesion in the upper pons. Seven months later, she had a sudden onset of loss of vision, and radiation optic neuropathy was diagnosed. A T1-weighted magnetic resonance imaging scan showed widespread gadolinium-enhanced lesions in the optic chiasm, optic tract, and hypothalamus. Magnetic resonance imaging is indispensable for the early diagnosis of radiation necrosis, which is not visualized by radiography or computed tomography.

Diagnostic significance of magnetic resonance imaging in patients with cervical cancer after brachytherapy: a meta-analysis

2018 ◽  
Vol 60 (5) ◽  
pp. 670-676
Author(s):  
Ji Zhang ◽  
Weizhong Tian ◽  
Xinhua Bu ◽  
Xiulan Wang ◽  
Fangzheng Tian ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Residual Tumor ◽  
Uterine Cervical Cancer ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
Diagnostic Significance ◽  
Gynecology And Obstetrics

Background Patients with uterine cervical cancer suffer high mortality. Accurate detection of a residual tumor by magnetic resonance imaging (MRI) during and after directed brachytherapy (BCT) is crucial for the success of cancer treatment and is a significant predictor of patient survival. Purpose To determine the diagnostic significance of MRI in detecting residual tumor tissue after BCT. Material and Methods The Web of Knowledge, Cochrane Library, and PubMed were systematically searched (January 1997 to December 2016) for post-brachytherapy MRI studies that measured residual tumors in patients with uterine cervical cancer. All data were analyzed using the Meta-Disc 1.4 program. Results Four clinical studies consisting of 163 patients (147 of whom were included in the present analysis) who were diagnosed with uterine cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) staging system were included in the study. All the patients received BCT and underwent MRI detection of residual tumors tissue. In studies where the accuracy of MRI detection was confirmed by histological tests or gynecological tests, the summary estimates of specificity, sensitivity, positive predictive value, negative predictive value, and accuracy were 88.5%, 83.5%, 53.5%, 97.1%, and 84.3%, respectively. Conclusion MRI-directed BCT is commonly used for cervical cancer patients. Based on our investigation of four independent studies, MRI showed better prediction of positive results than negative results in patients with cervical cancer after BCT. However, more data on the greater numbers of patients are needed to establish the accuracy of MRI detection of cervical cancer after BCT.

Sign in / Sign up

Export Citation Format

Share Document