Brundage Cord M, Packer Rebecca A, Jones Matthew D
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.
Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.
Vet Surg. 2016 Nov;45(8):996-1004. doi: 10.1111/vsu.12551. Epub 2016 Sep 23.
To describe the magnetic resonance (MR) image appearance of 5 hemostatic agents placed in the brain, and to review their clinical application.
Descriptive ex vivo and in vivo study.
Canine cadavers (n=4), client-owned dogs (n=4).
Heads from 4 canine cadavers were used, each with 5 hemostatic agents placed in specific locations in the brain. Hemostatic agents were used in their native form in 2 cadaveric brains, and in 2 others the materials were saturated with fresh whole blood prior to placement to mimic application in a field of active hemorrhage. The heads underwent MR imaging and the images were reviewed. Postoperative MRI images from 4 dogs undergoing brain tumor resection were retrospectively reviewed and compared to the images from the cadavers. All clinical cases and cadaveric specimens underwent surgical closure prior to MR imaging including placement of titanium mesh over the craniotomy defect with a dural graft of porcine small intestinal submucosa (SIS) sealed with Tisseel (fibrin sealant).
The SIS and Tisseel used in the dural graft were consistently indistinguishable from the surrounding tissues on MR images. The MR imaging appearance of the remaining 4 hemostatic agents (Gelfoam, Avitene, Surgicel, and Floseal) placed on the surface or in the parenchyma of canine brain, varied with MR sequence weighting and blood saturation.
Accurate evaluation of the degree of brain tumor resection on postoperative MR images requires careful differentiation between hemorrhage, residual tumor, and hemostatic agents implanted.
描述置于脑内的5种止血剂的磁共振（MR）图像表现，并综述其临床应用。
描述性离体和体内研究。
犬类尸体（n = 4）、宠物犬（n = 4）。
使用4具犬类尸体的头部，每具在脑内特定位置放置5种止血剂。在2具尸体脑内以其原始形态使用止血剂，另外2具在放置前将材料用新鲜全血饱和以模拟在活动性出血区域的应用。对这些头部进行MR成像并对图像进行评估。回顾性分析4只接受脑肿瘤切除的犬的术后MRI图像，并与尸体的图像进行比较。所有临床病例和尸体标本在MR成像前均进行手术闭合，包括在开颅缺损处放置钛网，并使用猪小肠黏膜下层（SIS）硬脑膜移植物，用Tisseel（纤维蛋白密封剂）密封。
硬脑膜移植物中使用的SIS和Tisseel在MR图像上与周围组织始终无法区分。置于犬脑表面或实质内的其余4种止血剂（明胶海绵、阿维停、速即纱和弗洛塞尔）的MR成像表现随MR序列权重和血液饱和度而变化。
术后MR图像上对脑肿瘤切除程度的准确评估需要仔细区分出血、残留肿瘤和植入的止血剂。
