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Vol. 12. Issue 1.
Pages 43-50 (January 2001)
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Vol. 12. Issue 1.
Pages 43-50 (January 2001)
Valoración del grado de resección de los gliomas supratentoriales de alto grado con resonancia magnética postoperatoria precoz
Assessment of the degree of tumor removal in supratentorial high grade gliomas by early postoperative magnetic resonance imaging
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J.V. Pesudo Martínez, J.M. González-Darder, R. Felíu Tatay, J.L. Gil Salú
Servicio de Neurocirugía. Hospital General de Castellón
V. Belloch Ugarte*, J. Vera Román**
* ERESA. Castellón. Hospital General de Castellón
** Servicio de Anatomía Patológica. Hospital General de Castellón
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Resumen

En este trabajo se presentan los resultados de un Estudio prospectivo consistente en valorar el grado de resección de 25 gliomas supratentoriales de alto grado mediante RM realizada en el postoperatorio inmediato. En todos los casos existía captación de contraste preoperatoria. 8 pacientes habían sido ya previamente intervenidos mientras que el resto fue una primera intervención. En todos los casos la RM postoperatoria fue practicada en la primera semana tras la intervención y en 15 casos en los 3 primeros días. Para valorar el grado de resección conseguido, se tuvo en cuenta la presencia o no de captación de contraste y en el caso de existir ésta, se clasificó en lineal y nodular. Resultados: para conseguir imágenes libres de artefactos y valorables, es importante realizar la RM postoperatoria de forma lo más precoz posible, preferentemente en los 3 primeros días. En general, la captación lineal desapareció a lo largo del seguimiento, demostrando no estar probablemente en relación con el resto tumoral, mientras que la captación nodular casi siempre demostró revelar un resto tumoral. La supervivencia para los tumores de alto grado fue ligeramente mayor en el easo de que en la RM postoperatoria precoz no haya captación o bien ésta sea lineal que en el caso de que sea nodular, pero sin que existan diferencias significativas.

Palabras clave:
Análisis de supervivencia
Glioma
Neoplasias cerebrales
Resonancia magnética
Summary

In this paper we report the results of a prospective study in wich we evaluate the degree of tumor removal of 25 supratentorial high grade gliomas by means of an MRI performed in the early postoperative period. In all cases, there was preoperative enhancement 8 patients had been previously operated on while the others had their first operation. In all cases the postoperative early MRI was performed within the first week and in 15 within the first 3 days. In order to evaluate the degree of tumor removal the presence or not of enhancement was considered and if it existed, classified as linear or nodular.

Results

to avoid postsurgical artifacts it is important to perform the MRI as soon as possible after surgery, especially within the first 3 days. Generally, linear enhancement disappeared on subsequent follow-up examinations, showing that it probably does no represent residual, tumor while nodular enhancement usually does. Survival with the high-grade tumors was slightly higher in the group without postoperative enhacement or linear one than in the group with nodular enhancement but the diference was not significant.

Key words:
Brain neoplasms
Glioma
Magnetic resonance
Imaging
Survival analysis

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