• Huaping Zhang, Fuyu Wang, Tao Zhou, Peng Wang, Xiaolei Chen, Jiashu Zhang, and Dingbiao Zhou.
• Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China; Department of Neurosurgery, The Second Clinical Medical College, Yangtze University, Jingzhou, Hubei, China.
• World Neurosurg. 2017 Aug 1; 104: 802-815.

BackgroundPure endoscopic resection has become the most popular surgical approach for pituitary adenoma. Intraoperative magnetic resonance imaging (iMRI) systems have been in use for endoscopic resection of pituitary adenomas. This study aimed to evaluate the effectiveness of iMRI and neuroimaging navigation techniques during endoscopic endonasal transsphenoidal surgery of pituitary adenomas.MethodsData from 137 patients who underwent resection of endoscopic pituitary adenoma under 1.5T iMRI navigation were collected and analyzed.ResultsOf patients, 92 underwent complete resection and 45 had residual tumor on real-time iMRI. Twenty-three patients underwent further surgery, and total resection was achieved in 19. Extent of total resection increased from 67.15% to 81.02%. iMRI revealed 3 patients with bleeding in the surgical area, which was successfully treated during the surgery. Review images obtained 3 months after surgery showed 26 patients with residual tumor; 14 patients had the same volume as intraoperatively, and 12 patients had a volume less than that observed intraoperatively. Residual tumor volume in the suprasellar region was less than that seen intraoperatively in 11 of 15 (73.3%) patients.ConclusionsThe use of iMRI and neuronavigation not only leads to a higher rate of tumor resection but also helps in detecting and removing hematomas in the surgical area. Follow-up examinations of extent of residual tumor at 3 months postoperatively were consistent with intraoperative results. Residual tumor volume in the suprasellar region was usually less than that observed intraoperatively.Copyright © 2017. Published by Elsevier Inc.

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