Intraoperative mri imaging strategies to evaluate for complications during dbs surgery
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Intraoperative MRI Imaging Strategies to Evaluate for Complications during DBS Surgery. Olivia Huston Kendall Lee MD, PhD Robert Watson MD, PhD Matt Bernstein PhD John Huston MD Kiaran McGee PhD. Mayo Clinic Rochester, MN. Intraoperative MRI During DBS Surgery Purpose.

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Intraoperative mri imaging strategies to evaluate for complications during dbs surgery

Intraoperative MRI Imaging Strategies to Evaluate for Complications during DBS Surgery

Olivia Huston

Kendall Lee MD, PhD

Robert Watson MD, PhD

Matt Bernstein PhD

John Huston MD

Kiaran McGee PhD

Mayo Clinic Rochester, MN


Intraoperative mri during dbs surgery purpose
Intraoperative MRI During DBS Surgery Complications during DBS SurgeryPurpose

To determine the optimal imaging sequences, the imaging findings and the clinical consequences of those findings for MRI performed during DBS surgery.


Intraoperative mri during dbs surgery methods
Intraoperative MRI During DBS Surgery Complications during DBS SurgeryMethods

  • 143 patients underwent 152 DBS surgeries utilizing intraoperative 1.5T MRI.

  • MRI sequences utilized:

    - T1 MP-RAGE pre and intra-op

    - T2* GRE intra-op

    - T2 FLAIR selectively

    - T2 FSE selectively


Intraoperative mri during dbs surgery results
Intraoperative MRI During DBS Surgery Complications during DBS SurgeryResults

Number of Surgeries: 152

  • Subdural Hematomas: 5

  • Subarachnoid Hemorrhages: 3

  • Intraparenchymal Hemorrhage: 1

  • Subarachnoid Air: 4

  • Brain Shift: 144


Intraoperative mri during dbs surgery subdural hematoma
Intraoperative MRI During DBS Surgery Complications during DBS SurgerySubdural Hematoma

  • Number of SDH: 5

  • Average thickness: 5.2 mm

  • Range: 4-8 mm


Subdural Hematoma Complications during DBS Surgery


Intraoperative mri during dbs surgery subarachnoid hemorrhage
Intraoperative MRI During DBS Surgery Complications during DBS SurgerySubarachnoid Hemorrhage

  • Number of SAH: 3

  • One patient experienced headache and disorientation requiring 2 additional days of hospitalization. Symptoms cleared prior to discharge.


Subarachnoid Hemorrhage Complications during DBS Surgery


Intraoperative mri during dbs surgery intraparenchymal hemorrhage
Intraoperative MRI During DBS Surgery Complications during DBS SurgeryIntraparenchymal Hemorrhage

  • Number Hemorrhages: 1

  • 5 x 5 mm


Intraparenchymal Hemorrhage Complications during DBS Surgery


Intraoperative mri during dbs surgery subarachnoid air
Intraoperative MRI During DBS Surgery Complications during DBS SurgerySubarachnoid Air

  • Number of SA Air: 4


Subarachnoid Air Complications during DBS Surgery


Intraoperative mri during dbs surgery brain shift
Intraoperative MRI During DBS Surgery Complications during DBS SurgeryBrain Shift

  • Number with Shift: 144

  • Average: 0.6 cm

  • Range: 0.1-1.3 cm


Brain Shift Complications during DBS Surgery


Intraoperative mri during dbs surgery conclusions
Intraoperative MRI During DBS Surgery Complications during DBS SurgeryConclusions

  • Intracranial hemorrhage is occasionally identified but is rarely clinically significant. One delayed SDH required evacuation.

  • Brain shift during DBS surgery is common.

  • Subarachnoid air mimics subarachnoid blood on GRE.

  • Selective use of T2 FLAIR and T2 FSE imaging can confirm the presence hemorrhage or air and precludes the need for CT exams.


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