• J Neuroimaging · Oct 2012

    Case Reports

    Alterations in surgical plan based on intraoperative portable head computed tomography imaging.

    • Andrew P Carlson, Jeremy Phelps, and Howard Yonas.
    • Department of Neurosurgery, University of New Mexico, Albuquerque, NM 87131–0001, USA.
    • J Neuroimaging. 2012 Oct 1;22(4):324-8.

    BackgroundIntraoperative imaging offers potential for utility in many clinical scenarios. Portable computed tomography (CT) offers a versatile potential alternative when immediate imaging may alter the surgical plan and magnetic resonance imaging is not practical.MethodsThe medical records from the University or New Mexico were reviewed for portable head CT scans done in the operating room since the scanner has been available. Operative reports and imaging studies were reviewed to determine changes in surgical decision after the CT scan.FindingsThe portable head CT scanner was used in 50 cases from May 2007 through March 2010. Average operative time overall was 121 minutes and for reservoir placement was 54 minutes. Procedures included reservoir placement (28%), tumor resection (24%), cerebrospinal fluid shunting (24%), vascular lesion resection (8%), trauma craniotomy (6%), abscess drainage (4%), stereotactic biopsy (4%), and open reduction internal fixation of facial fractures (2%). Findings on the CT scan lead to alterations in the surgical plan 16 times (32%).ConclusionIn select cases, intraoperative portable head CT leads to changes in the surgical plan in 32% of cases. This potentially prevents a return to the operating room and offers a cost-effective alternative to fixed intraoperative imaging facilities.Copyright © 2011 by the American Society of Neuroimaging.

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