학술논문
SAH-Like Pattern in FLAIR Imaging After Intraoperative MRI Guidance in Patients with Malignant Gliomas Surgery
0016
0016
Document Type
Academic Journal
Author
Source
Clinical Neuroradiology. October 2014, Vol. 24 Issue S1, p54, 1 p.
Subject
Language
English
ISSN
1869-1439
Abstract
S. Lescher (1), S. Schniewindt (1), A. Jurcoane (1), C. Senft (2), E. Hattingen (1) (1) Uniklinik Frankfurt, Institut fur Neuroradiologie, Frankfurt am Main, Germany (2) Uniklinik Frankfurt, Neurochirurgie, Frankfurt [...]
Introduction: In recent years the use of intraoperative MRI (iMRI) has increased in glioma neurosurgery. To date, no study had analyzed whether the intraoperative application of contrast agent might influence the early postsurgical MRI. Preceding iMRI could influence the signals of MR sequences in the early postsurgical MRI, especially in sequences which are influenced by T1 contrast. We suggested that the intraoperative application of contrast agent might influence the FLAIR sequence. Methods: We retrospectively analyzed postsurgical MRI by visual inspection and by signal measurements in 46 patients with malignant gliomas after tumor resection. In part, the patients were operated with intraoperative MRI guidance. Results: Intraoperative MRI-guided procedure with application of intravenous contrast agent was performed in 21 patients. In 18 patients the FLAIR sequence revealed hyperintense signal chances of the CSF in the subarachnoideal or ventricular spaces. 17 of the 18 patients with increased CSF signal had received intraoperative MRI. Signal of the CSF in the ventricles were significantly different between patients with and without iMRI on FLAIR and T1-weighted images. Conclusion: Postsurgical MRI within the first 72 hours is significantly influenced by the intraoperative application of contrast agent which is used for iMRI. We found hyperintense signal changes of the CSF in the FLAIR sequence in the subarachnoideal and intraventricular spaces mimicking subarachnoid hemorrhage. The findings may result in a misdiagnosis of SAH in these patients.
Introduction: In recent years the use of intraoperative MRI (iMRI) has increased in glioma neurosurgery. To date, no study had analyzed whether the intraoperative application of contrast agent might influence the early postsurgical MRI. Preceding iMRI could influence the signals of MR sequences in the early postsurgical MRI, especially in sequences which are influenced by T1 contrast. We suggested that the intraoperative application of contrast agent might influence the FLAIR sequence. Methods: We retrospectively analyzed postsurgical MRI by visual inspection and by signal measurements in 46 patients with malignant gliomas after tumor resection. In part, the patients were operated with intraoperative MRI guidance. Results: Intraoperative MRI-guided procedure with application of intravenous contrast agent was performed in 21 patients. In 18 patients the FLAIR sequence revealed hyperintense signal chances of the CSF in the subarachnoideal or ventricular spaces. 17 of the 18 patients with increased CSF signal had received intraoperative MRI. Signal of the CSF in the ventricles were significantly different between patients with and without iMRI on FLAIR and T1-weighted images. Conclusion: Postsurgical MRI within the first 72 hours is significantly influenced by the intraoperative application of contrast agent which is used for iMRI. We found hyperintense signal changes of the CSF in the FLAIR sequence in the subarachnoideal and intraventricular spaces mimicking subarachnoid hemorrhage. The findings may result in a misdiagnosis of SAH in these patients.