Cited 38 times in
How to overcome the limitations to determine the resection margin of pituitary tumours with low-field intra-operative MRI during trans-sphenoidal surgery: usefulness of Gadolinium-soaked cotton pledgets
DC Field | Value | Language |
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dc.contributor.author | 김선호 | - |
dc.contributor.author | 김진아 | - |
dc.contributor.author | 안정용 | - |
dc.contributor.author | 이규성 | - |
dc.contributor.author | 정진영 | - |
dc.date.accessioned | 2015-05-19T16:44:04Z | - |
dc.date.available | 2015-05-19T16:44:04Z | - |
dc.date.issued | 2008 | - |
dc.identifier.issn | 0001-6268 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/106845 | - |
dc.description.abstract | OBJECTIVE: Intra-operative MRI (iMRI) is used as an immediate intra-operative quality control, allowing surgeons to extend resections in situations involving residual tumour remnants. Despite these advantages, low-field iMRI has some limitations with regards to image quality and artefacts. The aim of this study is to report our experience with bone wax and Gadolinium-soaked cotton pledgets in obtaining precise tumour resection margins using low-field iMRI. PATIENTS AND METHODS: The study group included 63 consecutive patients who underwent endonasal trans-sphenoidal surgery with use of intra-operative low-field iMRI (0.15 T, PoleStar N20, Medtronic Navigation, Louisville, CO, U.S.A.). The indications for intra-operative MRI use included a suprasellar or retrosellar extension (n = 23), cavernous sinus invasion (n = 21), a tumour located in the vicinity of critical anatomic structures (such as the internal carotid artery, n = 10), recurrent or revision procedures (n = 5), and pre-operative imaging revealing unusual anatomy (n = 4). RESULTS: Overall, among the 51 patients with intended complete tumour removal, iMRI revealed definite tumour remnants or suspicious findings in 13 patients (25.5%), leading to an extended resection and allowing completion of the resection in 10 patients. There was an increased rate of complete tumour removal from 74.5% (38 out of 51) to 94.1% (48 out of 51). The iMRI scan for complete tumour removal was more efficient in the group receiving Gadolinium-soaked cotton pledgets (85.2-100%) than in the group receiving bone wax or the conventional method (62.5-87.5%). The results of iMRI and the estimation by the surgeon concerning the extent of resection revealed a discrepancy in five patients (15.6%) in the Gadolinium-soaked cotton pledgets application group, and in 14 (45.2%) of the bone wax application group. CONCLUSIONS: More valuable information for determining the resection margin can be obtained with the use of contrast-soaked cottonoid packing in the tumour resection cavity during iMRI scanning. We believe that the use of this simple method reduces the false-positive results and also overcomes the disadvantages of low-field iMRI. | - |
dc.description.statementOfResponsibility | open | - |
dc.format.extent | 763~771 | - |
dc.relation.isPartOf | ACTA NEUROCHIRURGICA | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Administration, Topical | - |
dc.subject.MESH | Adolescent | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Artifacts | - |
dc.subject.MESH | Contrast Media/administration & dosage* | - |
dc.subject.MESH | Endoscopy/methods* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Gadolinium DTPA*/administration & dosage | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Image Enhancement* | - |
dc.subject.MESH | Image Processing, Computer-Assisted* | - |
dc.subject.MESH | Intraoperative Period | - |
dc.subject.MESH | Magnetic Resonance Imaging* | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Neoplasm Invasiveness | - |
dc.subject.MESH | Neurosurgical Procedures/methods* | - |
dc.subject.MESH | Pituitary Neoplasms/pathology | - |
dc.subject.MESH | Pituitary Neoplasms/surgery* | - |
dc.subject.MESH | Sphenoid Sinus/surgery | - |
dc.subject.MESH | Surgery, Computer-Assisted/methods* | - |
dc.title | How to overcome the limitations to determine the resection margin of pituitary tumours with low-field intra-operative MRI during trans-sphenoidal surgery: usefulness of Gadolinium-soaked cotton pledgets | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Neurosurgery (신경외과학) | - |
dc.contributor.googleauthor | Ahn JY | - |
dc.contributor.googleauthor | Jung JY | - |
dc.contributor.googleauthor | Kim J | - |
dc.contributor.googleauthor | Lee KS | - |
dc.contributor.googleauthor | Kim SH | - |
dc.identifier.doi | 10.1007/s00701-008-1505-1 | - |
dc.admin.author | false | - |
dc.admin.mapping | false | - |
dc.contributor.localId | A00560 | - |
dc.contributor.localId | A02260 | - |
dc.contributor.localId | A02682 | - |
dc.contributor.localId | A01022 | - |
dc.relation.journalcode | J00018 | - |
dc.identifier.eissn | 0942-0940 | - |
dc.identifier.pmid | 18594752 | - |
dc.identifier.url | http://link.springer.com/article/10.1007/s00701-008-1505-1 | - |
dc.subject.keyword | Intra-operative magnetic resonance imaging | - |
dc.subject.keyword | resection margin | - |
dc.subject.keyword | pituitary tumour | - |
dc.subject.keyword | trans-sphenoidal approach | - |
dc.contributor.alternativeName | Kim, Sun Ho | - |
dc.contributor.alternativeName | Kim, Jinna | - |
dc.contributor.alternativeName | Ahn, Jung Yong | - |
dc.contributor.alternativeName | Lee, Kyu Sung | - |
dc.contributor.alternativeName | Jung, Jin Young | - |
dc.contributor.affiliatedAuthor | Kim, Sun Ho | - |
dc.contributor.affiliatedAuthor | Ahn, Jung Yong | - |
dc.contributor.affiliatedAuthor | Lee, Kyu Sung | - |
dc.contributor.affiliatedAuthor | Kim, Jinna | - |
dc.rights.accessRights | not free | - |
dc.citation.volume | 150 | - |
dc.citation.number | 8 | - |
dc.citation.startPage | 763 | - |
dc.citation.endPage | 771 | - |
dc.identifier.bibliographicCitation | ACTA NEUROCHIRURGICA, Vol.150(8) : 763-771, 2008 | - |
dc.identifier.rimsid | 50881 | - |
dc.type.rims | ART | - |
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