Hall W A, Liu H, Martin A J, Truwit C L
Department of Neurosurgery, University of Minnesota School of Medicine, Minneapolis, USA.
Top Magn Reson Imaging. 2000 Jun;11(3):203-12. doi: 10.1097/00002142-200006000-00006.
Intraoperative magnetic resonance imaging (MRI) allows neurosurgeons to perform surgery interactively using magnetic resonance (MR) guidance. Low-field and high-field strength MRI has been developed and implemented for multiple neurosurgical procedures, including brain biopsies, craniotomies for resection of mass lesions, cyst drainages, laminectomies, thermal ablations, functional neurosurgery, and a variety of miscellaneous cases. Both technologies have the advantage over frameless neuronavigational systems of being able to perform near real-time imaging, which allows the surgeon to compensate for intraoperative brain shift. Intraoperative functional techniques such as MR spectroscopy, functional MRI, MR angiography and venography, and diffusion-weighted imaging, which have become routine at some high-field MR units, can significantly influence surgical decision making. The potential complications associated with intraoperative MR-guided neurosurgery are similar in incidence to those seen in the conventional neurosurgical operating room. However, the immediate recognition of such intraoperative complications with MRI should lead to improved outcomes and decreased medical costs. Untoward events associated with performing surgery in an MR environment are uncommon. Intraoperative MR-guided neurosurgery represents a natural progression from framed and frameless stereotactic techniques. Intraoperative MRI is still in its infancy, and the full capabilities of this technology have yet to be determined or implemented.
术中磁共振成像（MRI）使神经外科医生能够在磁共振（MR）引导下交互式地进行手术。低场和高场强MRI已被开发并应用于多种神经外科手术，包括脑活检、切除肿块病变的开颅手术、囊肿引流、椎板切除术、热消融、功能神经外科手术以及各种杂症病例。这两种技术相对于无框架神经导航系统的优势在于能够进行近实时成像，这使外科医生能够补偿术中脑移位。术中功能技术，如磁共振波谱、功能MRI、磁共振血管造影和静脉造影以及扩散加权成像，在一些高场MR设备中已成为常规技术，可显著影响手术决策。与术中MR引导神经外科手术相关的潜在并发症发生率与传统神经外科手术室中的并发症相似。然而，通过MRI对这些术中并发症的即时识别应能改善治疗效果并降低医疗成本。在MR环境中进行手术相关的不良事件并不常见。术中MR引导神经外科手术是从有框架和无框架立体定向技术自然发展而来的。术中MRI仍处于起步阶段，这项技术的全部能力尚未确定或实现。
