ABSTRACT
BACKGROUND: Intraoperative MRI (iMRI) is a definitive technology
in neurosurgery that has been used effectively to maximize outcomes for
transsphenoidal resection of pituitary tumors. IMRI has been seen to
provide optimal visualization of surrounding vital neurovascular
structures and has helped surgeons achieve gross total resection. The
use of iMRI in the community hospital setting has not been documented in
the current literature as of yet.
OBJECTIVE: This study aims to provide insight into the
experiences of iMRI use in a community hospital setting and add to the
growing literature of iMRi use for transsphenoidal resection of
pituitary tumors.
METHODS: A retrospective review of 56 patients who underwent iMRI
guided transsphenoidal pituitary tumor resection at Northwestern
Medicine Central Dupage Hospital (from November 2011 to April 2018) was
performed.
RESULTS: Gross total resection was found in 67% (n=37) of
patients who underwent iMRI. 33% (n=19) did not achieve gross total
resection of their pituitary mass. IMRi was used exactly one time during
the case in 96% (n=54) of patients. IMRi was used more than once during
the case in 4% (n=2) of patients. Post operative tumor residual was
found in 32% (n=6) of patients who had available post-operative MRI
studies (n=19).
CONCLUSIONS: Our study shows that iMRI can be useful in a
community hospital setting to achieve gross total resection during
transsphenoidal pituitary tumor resection. It also demonstrates the
ability and need to utilize iMRI only one time during a case which lends
itself to operative efficiency.
LEVEL OF EVIDENCE: Level 5