Application of high-field intraoperative magnetic resonance imaging in stereotactic aspiration and drainage of hypertensive hematomas

Abstract

To explore the application values of high-field intraoperative magnetic resonance imaging (MRI) in stereotactic aspiration and drainage of hypertensive hematomas. During a period of August 2011 to January 2012, 11 patients with hypertensive hemorrhage were examined preoperatively by conventional MRI and diffusion tensor imaging (DTI) with 1.5T intraoperative MRI system (Signa HDi, GE, USA) at Tianjin Medical University General Hospital. The anatomic relationship of corticospinal tract (CST) and hematoma was used for the operative planning with the neuronavigation planning workstation (iPlan Cranial 3.0 software, BrainLab, Germany) for 3D reconstruction. During stereotactic surgery, intraoperative MRI scan was performed. According to the clearance rate of hematomas, the operators decided to finish the operation or update the operative planning to continue hematoma removal. All patients were reexamined by conventional MRI and DTI at Week 3 postoperation. Then comparative analysis was performed for the preoperative and postoperative integrity of CST. No death or severe complications occurred. All patients showed improvement of motor function and the postoperative integrity of CST. The intracranial condition may be monitored effectively by intraoperative MRI throughout surgery so as to increase the rate of hematoma removal and reduce the postoperative complications.