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Enhanced Magnetic Resonance Imaging and Subtraction Techniques in the Postoperative Evaluation of Craniofacial Resection for Sinonasal Malignancy
Author(s) -
Lund Valerie J.,
Lloyd Glyn A.S.,
Howard David J.,
Cheesman Anthony D.,
Phelps Peter D.
Publication year - 1996
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199605000-00007
Subject(s) - medicine , magnetic resonance imaging , radiology , malignancy , skull , subtraction , craniofacial , vascularity , laryngology , nuclear medicine , surgery , pathology , arithmetic , mathematics , psychiatry
The use of magnetic resonance imaging (MRI) enhanced with gadolinium and diethylenetriamine pentaacetic acid (DTPA) in the preoperative evaluation of sinonasal malignancy is well established and has an accuracy of over 98%. Since 1979, 208 patients have undergone craniofacial resection at London's Institute of Laryngology & Otology, primarily for sinonasal neoplasia affecting the anterior skull base. Thirty‐five “high‐risk” patients had MRI at follow‐up. The MRI scans were assessed before the patients were examined under anesthesia. MRI was assessed before examination under anesthesia and the results compared with histologic findings demonstrating a reasonable degree of positive correlation but one which is inferior to that found preoperatively (80%). An extension of this technique using the subtraction of T1‐weighted MRI with Gd‐DTPA highlights areas of increased vascularity, which significantly improves the ability to predict recurrence at the skull base and above the surgical repair in the anterior cranial fossa (94%). Laryngoscope, 106:553‐558, 1996