Intraoperative magnetic resonance imaging for cranial and spinal cases using preexisting “C” shaped three side open 0.2 Tesla magnetic resonance imaging
Vinod Kumar Tewari1, Ravindra Tripathi2, Subodh Aggarwal3, Mazhar Hussain4, Hari Kishan Das Gupta5
1 Department of Neurosurgery, Neuro Center, Lucknow, Uttar Pradesh, India
2 Department of Radiodiagnosis, MVT Diagnostics, Lucknow, Uttar Pradesh, India
3 Department of Anasthesia, Vivekanand Hospital, Lucknow, Uttar Pradesh, India
4 Department of Neurosurgery, Sahara Hospital, Lucknow, Uttar Pradesh, India
5 Department of Urology, Neuro Center, Lucknow, Uttar Pradesh, India
Vinod Kumar Tewari,
Neuro Center, PSS Complex, Vishal Khand 3, Gomti Nagar, Lucknow - 226 010, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Background: The existing Intraoperative MRI (IMRI) of developed countries is too costly to be affordable in any developing country and out of the reach of common and poor people of developing country at remote areas. We have used the pre-existing (refurbished) 3 side open “C” shaped 0.2 Tesla MRI for IMRI in a very remote area.
Materials and Methods: In this technique the 0.2 Tesla MRI and the operating theatre were merged. MRI table was used as an operation table. We have operated 36 cases via IMRI from November 2005 to till date. First case operated was on 13th nov 2005.
Results: Low (0.2) Tesla open setup costs very low (around Rs 40 lakhs) so highly affordable to management and thus to patients, used for diagnostic and therapeutic purposes both, the equipments like Nitrous, oxygen and suction is outside the MRI room so no noise inside operative room, positioning the patient didn't take much time due to manual adjustments, no special training to nurses and technicians required because of low (0.2) Tesla power of magnet and same instruments and techniques, sequencing took only 1.31 mints per sequence and re registration is not required since we always note down the two orthogonal axis in x and y axis in preoperative imaging and we were able to operate on posterior fossa tumors as well because of no head fixation except with leucoplast strap. Moreover the images we got intraoperative are highly acceptable.
Conclusion: Three side open 0.2 Tesla MRI system, if used for intraoperative guidance, is highly affordable and overcomes the limitations of western setup of IMRI. Postoperative MRI images were highly acceptable and also highly affordable too.