MRI-guided stereotactic aspiration of brain abscesses by use of an optical tracking navigation system

Yubo Lü, Chengli Li, Ming Liu, Jan Fritz, John A. Carrino, Lebin Wu, Bin Zhao

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Owing to the high risk of abscess drainage by craniotomy, imaging-guided stereotactic aspiration is considered an ideal choice in the management of brain abscesses. Interventional magnetic resonance imaging (MRI) represents a valuable technique for the treatment of brain abscess as a guiding modality. Purpose: To evaluate the safety and efficacy of an interventional MRI system in performing the procedure. Material and Methods: Thirteen brain abscesses in 11 patients were treated with percutaneous aspiration. All procedures were performed solely under the guidance of a 0.23-T open-configuration MRI scanner with optical tracking. Clinical and imaging follow-up was at 1 week, 1 month, 3 months, and 6 months. The changes of abscess, MRI features, and clinical symptoms were recorded. Procedure efficacy and safety were evaluated by success rate, procedure time, decrease of abscess, recovery rate, and complication. Descriptive statistical analysis was performed. Results: MRI-guided stereotactic aspirations were performed successfully in 13/13 (100%) abscesses. The mean operating time was 70 min (range, 45-100 min). Follow-up MRI at 1 week after the procedure showed average reduction of abscesses by 60% (2.1/3.5). And the abscesses continued to get smaller by up to 89.7% (3.14/3.5) at 1-month follow-up. All cavities resolved at the end of the 6-month follow-up period. The recovery rate was 100% for fever, headache, vomiting, papilledema, meningismus, altered sensorium, 75% (3/4) for hemiparesis, and 83.3% (5/6) for epilepsy. There were no complications. Conclusion: Punctures of brain abscesses with subsequent aspiration can be performed safely and efficiently by monitoring the procedure using an open interventional MRI system.

Original languageEnglish (US)
Pages (from-to)121-128
Number of pages8
JournalActa Radiologica
Volume55
Issue number1
DOIs
StatePublished - Feb 2014

Keywords

  • Aspiration
  • Brain abscess
  • Interventional MRI
  • MR-guided

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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