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| FIGURE 1.
Axial T2-weighted fast spin echo image
showing a right parietal, inhomogenous, hyperintense
mass lesion. TR 6000, TE 99, ETL 8, FOV 22, matrix
256x128, NEX 2. |
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IMAGING PROTOCOL
3D-SPGR, T2-weighted fast spin echo and T1-weighted spin echo axial images
were performed before skin incision, during the resection and after dura
closure on a SIGNA SP 0.5 T open configuration MR System (General Electric,
Milwaukee, WI). After opening dura, a IV injection of MAGNEVIST®
(0.1 mmol/kg) was administered for visualization of the peripheral, fast
growing tumor area.
The ability to visualize surgical lesion margins with intraoperative MRI
permits resections to be more complete with less damage to adjacent normal
tissues. Also, intraoperative complications, such as hemorrhage or edema,
can be readily identified and immediate treatment instituted.
This 44-year-old female patient presented with left sided hemiparesis. Previously,
she underwent a stereotactic biopsy at another institution (anaplastic astrocytoma).
The preoperative MRI shows a cystic mass in the right fronto-parietal region
with peripheral contrast enhancement. Extensive edema is also noted. There
is mass effect with anterior displacement of the right central sulcus, but
no definite infiltration of the motor strip. Under intraoperative MRI guidance
and using the 3D-Slicer software for navigation, the mass was debulked.
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