Presurgical role of MRI tractography in a case of extensive cervicothoracic spinal ependymoma

Granata, Francesca; Racchiusa, Sergio; Mormina, Enricomaria; Barresi, Valeria; Garufi, Giada; Grasso, Giovanni; Salpietro, Francesco M.; Longo, Marcello; Alafaci, Concetta

doi:10.4103/sni.sni_33_17

Cited by 10 publications

(1 citation statement)

References 12 publications

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“…Treatment of these pathologies is surgical, and in recent years effective results have resulted in tumor surgery from the use of technological innovations. Intraoperative neuromonitorisation (IONM), magnetic resonance (MR) tractography, and ultrasonography (USG) have been used for safe and maximum surgical resection (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Furthermore, surgery under the guidance of Sodium-fluorescein (Na-fluorescein) has earned a place in neurosurgery for tumor resection and tumor volume reduction.…”

Section: Introductionmentioning

confidence: 99%

Sodium Fluorescein for Spinal Intradural Tumors

et al. 2021

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Technological innovations in spinal intradural tumor surgery simplify treatment. Surgical treatment of cranial benign and malignant pathologies under microscope with sodium (Na)-fluorescein guidance has often been reported, but few studies have focused on spinal intradural tumors. We aimed to investigate the usefulness of Na-fluorescein under yellow filter in intradural spinal tumor surgery by retrospectively reviewing cases involving intramedullary and extramedullary tumors operated under the guidance of Na-fluorescein. Forty-nine adult patients with a diagnosis of spinal intradural tumor operated under a yellow filter (560 nm) microscope using Na-fluorescein dye were included in the study. Demographic data, such as age and sex, neurological status, extent of tumor resection, histopathological diagnosis, Na-fluorescein staining pattern, and its usefulness during surgery were noted and statistically analyzed. Of all recruited patients, 26 women (53.1%) and 23 men (46.9%), were included for analysis. The age range of the patients was 18–64 years, with a mean age of 41.6 ± 13.9. An intradural intramedullary mass was found in 30.6% (n = 15) of the patients, and an intradural extramedullary mass in 69.4% (n: 34). While Na-fluorescein staining was homogeneous in all intradural extramedullary tumors, 73.3% (n: 11) of intradural intramedullary tumors were homogeneous, and 13.3% (n: 2) moderately heterogeneous. In the whole study group, the Na-fluorescein staining pattern was helpful in surgical resection in 47 cases (95.9%). While 34/34 (100%) found it helpful for extramedullary tumors, 13/15 (86.7%) did in intramedullary tumors, and for 2/15 (13.3%) it was not. In conclusion, Na-fluorescein helps in distinguishing tumor from healthy tissue in intradural extramedullary and intramedullary tumor surgery under a yellow filter microscope in most cases, thus providing convenient assistance to surgeons.

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Section: Introductionmentioning

confidence: 99%

Sodium Fluorescein for Spinal Intradural Tumors

et al. 2021

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Diffusion Tractography in Neurosurgical Planning: Overview of Advanced Clinical Applications

Miao,

Feuerwerker,

Hafazalla

et al. 2023

Functional Neuroradiology

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The use of diffusion tensor imaging in spinal pathology: a comprehensive literature review

Scullen,

Milburn,

Aria

et al. 2024

Eur Spine J

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Study design We reviewed the available literature systematically without meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Objective To evaluate contemporary literature on use of spinal diffusion tensor imaging(sDTI) in spinal pathology. Background sDTI reveals the location and functional state of critical long tracts and is a potentially useful adjunct in disease management. Methods Studies were included if they presented or discussed data from investigative or therapeutic procedures involving sDTI on human subjects in the setting of surgically amenable spinal pathology. Studies were excluded if they were (1) restricted to computational models investigating parameters using data not obtained clinically, (2) about cranial DTI methods, (3) about spinal pathology data not related to surgical management, (4) discussions or overviews of methods/techniques with minimal inclusion of objective experimental or clinical data. Results Degenerative pathologies of interest were restricted to either cervical myelopathy (22/29,75.9%) or lumbar spondylosis 7/29,24.1%). Mass-occupying lesions included intradural pathology and discussed preoperative (7/9,77.8%) and intraoperative imaging(2/9,22.2%) as an adjunct to surgery 22.2%. Traumatic pathology focused on spinal cord injury prognosis and severity grading. Conclusions sDTI seems useful in surgical decision making and outcome measurements and in establishing clinical prognoses over a wide range of surgical pathologies. Further research is warranted with longer follow-up and larger population sizes in a prospective and controlled protocol.

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Presurgical role of MRI tractography in a case of extensive cervicothoracic spinal ependymoma

Cited by 10 publications

References 12 publications

Sodium Fluorescein for Spinal Intradural Tumors

Sodium Fluorescein for Spinal Intradural Tumors

Diffusion Tractography in Neurosurgical Planning: Overview of Advanced Clinical Applications

The use of diffusion tensor imaging in spinal pathology: a comprehensive literature review

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