J Korean Neurosurg Soc.  2013 Jan;53(1):39-42. 10.3340/jkns.2013.53.1.39.

Mobile Computed Tomography : Three Year Clinical Experience in Korea

• Jeon JS
• Lee SH
• Son YJ
• Yang HJ
• Chung YS
• Jung HW

• KMID: 2066983
• DOI: http://doi.org/10.3340/jkns.2013.53.1.39

Abstract

OBJECTIVE
Obtaining real-time image is essential for neurosurgeons to minimize invasion of normal brain tissue and to prompt diagnosis of intracranial event. The aim of this study was to report our three-year experience with a mobile computed tomography (mCT) for intraoperative and bedside scanning.
METHODS
A total of 357 mCT (297 patients) scans from January 2009 to December 2011 in single institution were reviewed. After excluding post-operative routine follow-up, 202 mCT were included for analysis. Their medical records such as diagnosis, clinical application, impact on decision making, times, image quality and radiologic findings were assessed.
RESULTS
Two-hundred-two mCT scans were performed in the operation room (n=192, 95%) or intensive care unit (ICU) (n=10, 5%). Regarding intraoperative images, extent of resection of tumor (n=55, 27.2%), degree of hematoma removal (n=42, 20.8%), confirmation of catheter placement (n=91, 45.0%) and monitoring unexpected complications (n=4, 2.0%) were evaluated. A total of 14 additional procedures were introduced after confirmation of residual tumor (n=7, 50%), hematoma (n=2, 14.3%), malpositioned catheter (n=3, 21.4%) and newly developed intracranial events (n=2, 14.3%). Every image was obtained within 15 minutes and image quality was sufficient for interpretation.
CONCLUSION
mCT is feasible for prompt intraoperative and ICU monitoring with enhanced diagnostic certainty, safety and efficiency.

Keyword

Computed tomography; Intensive care unit

MeSH Terms

Brain
Catheters
Decision Making
Follow-Up Studies
Hematoma
Intensive Care Units
Korea
Medical Records
Neoplasm, Residual

Figure

• 

  Fig. 1 Mobile CT for diffuse astrocytoma. A and B : Axial T2WI magnetic resonance (MR) and Contrast-enhanced axial T1WI MR show a diffuse hyperintense lesion in the left frontal lobe with focal enhancement (white arrow) and low signal lesion (arrowhead). C : Intra-operative CT-MR image fusion discloses a residual mass (white arrow) close to anterior corpus callosum. D : Fused CT-MR image illustrates complete resection of remnant tumor (arrow) without injury to corpus callosum.

• 

  Fig. 2 Mobile CT for the detection of increased subdural hematoma in the contralateral side. A : Initial CT showed acute subdural hemorrhage on both side with midline shift to the left. B : Mobile CT scan revealed the brain shift towards the right by increased hematoma. C : Subdural hematoma on the left side was evacuated without delay.

• 

  Fig. 3 Mobile CT (mCT) for the detection of acute hematoma on the same side of operation. A : Initial CT revealed mixed density of subdural hemorrhages, and followed by closed drainage insertion under local anesthesia. B : Emergent mCT showed acute subdural hematoma on the operation side. C : Open craniotomy and hematoma evacuation was performed without delay.

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