Abstract
Purpose
Subependymal giant cell astrocytoma (SEGA) is a rare, benign tumor that occurs mainly in children; complete resection can achieve cure. Guidance of surgery by combined intraoperative magnetic resonance imaging (iMRI) and functional neuronavigation is reported to achieve more radical resection and reduced complications. However, reports about the resection of SEGA with such guidance are rare. We report here our preliminary experience of the resection of SEGA guided by iMRI and neuronavigation, focusing on the feasibility, benefits, and pitfalls of this combination of techniques.
Methods
We performed resection of SEGA guided by combined iMRI and functional neuronavigation in seven children. The first iMRI was performed when the surgeon believed that the tumor had been completely resected; the last iMRI was performed immediately after closure. Additional scans were performed as needed.
Results
Successful resection was achieved in all seven patients using this combination of techniques. The iMRI scans detected residual tumor in three patients and a large, remote epidural hematoma in one patient. Further resection or other surgery was performed in these four patients. Complete resection was eventually achieved in all patients. There were no cases of surgery-related neurological dysfunction, except transient memory loss in one patient. No recurrence of tumor or hydrocephalus was observed in any patients during the follow-up period.
Conclusions
Resection of SEGA in children guided by combined iMRI and neuronavigation is feasible and safe. This combination of techniques enables a higher complete resection rate and reduces brain injury and other unexpected events during surgery.
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Acknowledgments
We would like to thank Jinli Jiang, Jun Zhang, Zhenghui Sun, Xiaodong Ma, and Bu Bo, who work in our department, for their help in this study.
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The authors declare that they have no conflict of interests.
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Hecheng Ren and Xiaolei Chen contributed equally to this study.
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Ren, H., Chen, X., Sun, G. et al. Resection of subependymal giant cell astrocytoma guided by intraoperative magnetic resonance imaging and neuronavigation. Childs Nerv Syst 29, 1113–1121 (2013). https://doi.org/10.1007/s00381-013-2045-4
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DOI: https://doi.org/10.1007/s00381-013-2045-4