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Research ArticleBRAIN

Intraoperative MR Imaging Increases the Extent of Tumor Resection in Patients with High-Grade Gliomas

Michael Knauth, Christian R. Wirtz, Volker M. Tronnier, Nurdagül Aras, Stefan Kunze and Klaus Sartor
American Journal of Neuroradiology October 1999, 20 (9) 1642-1646;
Michael Knauth
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Christian R. Wirtz
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Volker M. Tronnier
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Nurdagül Aras
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Stefan Kunze
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Klaus Sartor
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    fig 1.

    Surgically induced enhancement in the “uncertain” case of a 45-year-old man with a glioblastoma multiforme. The tumor is above the level of these T1-weighted images.

    Left, Preoperative MR image (674/20/2) does not show enhancement in the head of the right caudate nucleus. Problems with hemostasis necessitated repeated electrocoagulations in this region.

    Middle, Intraoperative MR image (532/15/3) shows partially solid-appearing contrast enhancement of the head of the caudate nucleus. A small biopsy was obtained from this region and did not show residual tumor histologically. Surgery was terminated.

    Right, Early postoperative MR image (674/20/2) does not show persistent enhancement of the head of the caudate nucleus. The intraoperative enhancement probably represented transient blood-brain barrier disruption.

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    fig 2.

    A 41-year-old woman with a recurrent glioblastoma multiforme.

    Left, Preoperative T1-weighted image shows a left-hemispheric lesion (674/20/2).

    Middle, Intraoperative MR image (532/15/3) shows residual enhancing tumor (arrowhead).

    Right, Surgery was continued, and the residual tumor was removed, as shown in this early postoperative MR image (674/20/2).

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    fig 3.

    A 55-year-old man with a glioblastoma multiforme. The bulk of the tumor is above the level of these T1-weighted images.

    Left, Preoperative MR image shows a right-hemispheric lesion (674/20/2).

    Middle, Intraoperative MR image (532/15/3) shows residual tumor at the bottom of the resection cavity (arrowhead).

    Right, Surgery was continued, and this residual tumor was removed, as shown in this early postoperative MR image (674/20/2).

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    fig 4.

    “Failure” of the intraoperative MR imaging approach in a 46-year-old man with an anaplastic glioma.

    Left, Preoperative MR image shows a right-hemispheric lesion (674/20/2).

    Middle, Intraoperative MR image (532/15/3) shows massive residual tumor. Surgery was continued with extensive further tumor resection.

    Right, Early postoperative MR image (674/20/2), however, still shows residual enhancing tumor (arrowheads).

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    Summary of the findings of intraoperative MR and early postoperative MR

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American Journal of Neuroradiology
Vol. 20, Issue 9
1 Oct 1999
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Cite this article
Michael Knauth, Christian R. Wirtz, Volker M. Tronnier, Nurdagül Aras, Stefan Kunze, Klaus Sartor
Intraoperative MR Imaging Increases the Extent of Tumor Resection in Patients with High-Grade Gliomas
American Journal of Neuroradiology Oct 1999, 20 (9) 1642-1646;

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Intraoperative MR Imaging Increases the Extent of Tumor Resection in Patients with High-Grade Gliomas
Michael Knauth, Christian R. Wirtz, Volker M. Tronnier, Nurdagül Aras, Stefan Kunze, Klaus Sartor
American Journal of Neuroradiology Oct 1999, 20 (9) 1642-1646;
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