当前位置： SCI文献检索 > NEUROSURGERY期刊下所有文献 > Preoperative imaging to predict intraoperative changes in tumor-to-corticospinal tract distance: an analysis of 45 cases using high-field intraoperative magnetic resonance imaging.

Preoperative imaging to predict intraoperative changes in tumor-to-corticospinal tract distance: an analysis of 45 cases using high-field intraoperative magnetic resonance imaging.

Abstract：

BACKGROUND:Preoperative diffusion tensor imaging (DTI) is used to demonstrate corticospinal tract (CST) position. Intraoperative brain shifts may limit preoperative DTI value, and studies characterizing such shifts are lacking. OBJECTIVE:To examine tumor characteristics that could predict intraoperative shift in tumor-to-CST distance using high-field intraoperative magnetic resonance imaging. METHODS:We retrospectively evaluated preoperative and intraoperative DTIs, tumor pathology, and imaging characteristics of patients who underwent resection of an intra-axial tumor adjacent to the CST to identify covariates that significantly affected shift in tumor-to-CST distance. For validation, we analyzed data from a separate, 20-patient cohort. RESULTS:In the first cohort, the mean intraoperative shift in the tumor-to-CST distance was 3.18 ± 3.58 mm. The mean shift for the 20 patients with contrast and the 5 patients with non-contrast-enhancing tumors was 3.93 ± 3.64 and 0.18 ± 0.18 mm, respectively (P < .001). No association was found between intraoperative shift in tumor-to-CST distance and tumor pathology, tumor volume, edema volume, preoperative tumor-to-CST distance, or extent of resection. According to receiver-operating characteristic analysis, nonenhancement predicted a tumor-to-CST distance shift of ≤ 0.5 mm, with a sensitivity of 100% and a specificity of 75%. We validated these findings using the second cohort. CONCLUSION:For nonenhancing intra-axial tumors, preoperative DTI is a reliable method for assessing intraoperative tumor-to-CST distance because of minimal intraoperative shift, a finding that is important in the interpretation of subcortical motor evoked potential to maximize extent of resection and to preserve motor function. In resection of intra-axial enhancing tumors, intraoperative imaging studies are crucial to compensate for brain shift.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Shahar T,Rozovski U,Marko NF,Tummala S,Ziu M,Weinberg JS,Rao G,Kumar VA,Sawaya R,Prabhu SS

doi

10.1227/NEU.0000000000000338

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

23-30

issue

eissn

0148-396X

issn

1524-4040

journal_volume

pub_type

杂志文章

在线工具

Preoperative imaging to predict intraoperative changes in tumor-to-corticospinal tract distance: an analysis of 45 cases using high-field intraoperative magnetic resonance imaging.