دورية أكاديمية
Rapid brain MRI for image-guided ventricular catheter placement in pediatric patients: protocol and preliminary clinical outcomes.
| العنوان: | Rapid brain MRI for image-guided ventricular catheter placement in pediatric patients: protocol and preliminary clinical outcomes. |
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| المؤلفون: | Lai GY; 1Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Nebraska Medical Center and Children's Hospital and Medical Center, Omaha, Nebraska.; 2Department of Neurological Surgery, Division of Pediatric Neurosurgery, UCSF Benioff Children's Hospitals, University of California, San Francisco, California., Powers A; 3Department of Radiology, University of Nebraska Medical Center and Children's Hospital and Medical Center, Omaha, Nebraska; and., Chung T; 4Department of Radiology and Diagnostic Imaging, Section of Oakland Pediatric Radiology, UCSF Benioff Children's Hospital, Oakland, California., Sun PP; 2Department of Neurological Surgery, Division of Pediatric Neurosurgery, UCSF Benioff Children's Hospitals, University of California, San Francisco, California. |
| المصدر: | Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2024 Jan 26; Vol. 33 (4), pp. 343-348. Date of Electronic Publication: 2024 Jan 26 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 101463759 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1933-0715 (Electronic) Linking ISSN: 19330707 NLM ISO Abbreviation: J Neurosurg Pediatr Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Charlottesville, VA : American Association of Neurological Surgeons, 2004- |
| مواضيع طبية MeSH: | Cerebral Ventricles*/diagnostic imaging , Cerebral Ventricles*/surgery , Hydrocephalus*/diagnostic imaging , Hydrocephalus*/etiology , Hydrocephalus*/surgery, Humans ; Child ; Child, Preschool ; Retrospective Studies ; Neuronavigation/methods ; Catheters/adverse effects ; Magnetic Resonance Imaging ; Ventriculoperitoneal Shunt/adverse effects |
| مستخلص: | Objective: Neuronavigation is a useful adjunct for catheter placement during neurosurgical procedures for hydrocephalus or ventricular access. MRI protocols for navigation are lengthy and require sedation for young children. CT involves ionizing radiation. In this study, the authors introduce the clinical application of a 1-minute rapid MRI sequence that does not require sedation in young children and report their preliminary clinical experience using this technique in their pediatric population. Methods: All patients who underwent ventricular catheter placement at a children's hospital using a rapid noncontrast MRI protocol, standard MRI, or head CT from July 2021 to August 2023 were included. Type of procedure, etiology of hydrocephalus, ventricle configuration and size, morphology of ventricles, need for adjunctive intraoperative ultrasound, duration of procedure, accuracy of catheter placement, and need for proximal revision within 90 days were retrospectively recorded and compared across imaging modalities. Results: Sixty-eight patients underwent 83 procedures: 21 underwent CT navigation, 29 standard MRI, and 33 rapid MRI. Patients who received standard MRI more often had tumor etiology, while those who underwent CT and rapid MRI had posthemorrhagic etiology (χ2 = 13.04, p = 0.042). Intraoperative ultrasound was required for 1 patient in the standard MRI group and 1 patient in the CT group. There was no difference in procedure time across groups (p = 0.831). On multivariable analysis, procedure time differed by procedure type, where external ventricular drain placement and proximal revision were faster (p < 0.001 and p < 0.028, respectively). Proximal revision due to obstruction within 90 days occurred in 3 cases (in the same patient with complex loculated hydrocephalus) in the rapid MRI group and 2 cases in the CT group. Conclusions: Although this study was not powered for statistical inference, the authors report on the clinical use of a 1-minute rapid MRI sequence for neuronavigation in hydrocephalus or ventricular access surgery. There were no instances in which intraoperative ultrasound was required as an adjunct for procedures navigated with rapid MRI, and intraoperative time did not differ from that of standard navigation protocols. |
| فهرسة مساهمة: | Keywords: endoscopic third ventriculostomy; external ventricular drain; hydrocephalus; image-guided surgery; neuronavigation; pediatric neurosurgery; rapid MRI; ventriculoperitoneal shunt |
| تواريخ الأحداث: | Date Created: 20240126 Date Completed: 20240403 Latest Revision: 20240403 |
| رمز التحديث: | 20240403 |
| DOI: | 10.3171/2023.11.PEDS23412 |
| PMID: | 38277648 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1933-0715 |
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| DOI: | 10.3171/2023.11.PEDS23412 |