Intraoperative magnetic resonance imaging for skull base surgery

Objectives/Hypothesis. Skull base surgery has evolved over the past several decades. Major improvements in the imaging of skull base pathology led to better target localization and better surgical planning. The objectives of this study were to assess the use of intraoperative magnetic resonance (MR) imaging in the management of a series of patients with skull base patholog y. We hypothesized that high-quality intraoperative MR imaging would have a n impact on surgery in this patient group. Study Design: Prospective, non-r andomized, cohort study. Methods. Thirty-one patients with skull base lesio ns underwent surgery in a 1.5-Tesla intraoperative MR suite. The concepts o f a moving magnet, high magnetic field strength, and radiofrequency coil de sign are presented. Results. Eleven of 31 patients had the course of surger y significantly altered by the information acquired from the images obtaine d during surgery. Conclusions: Intraoperative MR imaging is a valuable adju nct to skull base surgery. One third of patients had altered surgery as a r esult of this adjunct. Intraoperative MR imaging is of particular value in the treatment of pituitary adenomas and benign skull base tumors.