Article Figures & Data
Figures
- Fig 1.
A 27-year-old man who has sequential resection of 2 brain metastases. Hemostasis of the first resection bed in the left parietal lobe is achieved with the standard technique. The gelatin-thrombin matrix is used in the subsequent second resection bed in the right parietal lobe to decrease operative time and effectively control bleeding from hypervascular sarcoma metastasis. A, Axial T2WI demonstrates the left parietal bed (thick arrow) filled with CSF containing a small amount of blood products posteriorly (asterisk) and the right parietal bed filled with a distinctive organized cluster of T2-hypointense speckles (thin arrows) almost in stacked layers in the T2-hyperintense background, characteristic of the gelatin-thrombin matrix. B, Axial GRE image demonstrates the corresponding complete hypointensity of the gelatin-thrombin matrix (thin arrows) filling the right cavity, different from the focal susceptibility of blood products (asterisk) in the left cavity. C, Axial T1WI shows CSF signal in the left cavity and isointensity in the right cavity without enhancement. Scattered bubbles of air (arrowheads) are present in the nondependent portion of the surgical beds with susceptibility on GRE.
- Fig 2.
A 48-year-old woman who has a resection of a 5-cm pineal region meningioma. A and B, Axial CT images of the pineal resection bed in brain and lung windows, respectively, demonstrate the characteristic pseudoair hypoattenuation of the gelatin-thrombin matrix (thin and thick arrows), which can be easily mistaken for pneumocephalus. C, Axial T2WI illustrates characteristic T2-hypointense speckles of the gelatin-thrombin matrix (thin arrow) in the background of T2-hyperintensity. Note the less distinct speckles in the background of T2-isointensity (thick arrow), which may result in a falsenegative for the detection of the gelatin-thrombin matrix on MR imaging if CT is not available for correlation. Residual T2-isointense meningioma (M) shows avid enhancement on postcontrast T1WI (T1WI not shown).
Tables
Diagnostic performances of different imaging features for the detection of gelatin-thrombin matrix
Imaging Sequence Sensitivity Specificity Accuracy P Value T2 0.81 0.85 0.82 <.001 GRE 1 0.92 0.97 <.001 T2+GRE 0.81 1 0.88 <.001 CT 0.88 1 0.90 .067 CT+MRI 0.75 1 0.80 .133
