Preoperative imaging of superficially located glioma resection using short inversion-time inversion recovery images in high-field magnetic resonance imaging.

OBJECTIVES: Short inversion-time inversion recovery (STIR) is the only magnetic resonance imaging (MRI) sequence able to produce high contrast images of both brain-CSF and gray matter-white matter in the central nervous system. The aim of the present study is to evaluate the effectiveness of STIR in imaging tumor involvement of the cortical surface and intra-axial structures, its usefulness in the resection of superficially located gliomas.

PATIENTS AND METHODS: In this study, we perform conventional MRI (1.5 T) and STIR (3.0 T) before surgery in 10 patients with superficially located glioma. We estimate the spatial relationship between the tumor bulk, the adjacent cortical surface and intra-axial structures on T2WI (1.5 T) and STIR (3.0 T). STIR findings are applied to resection of the tumor in each case.

RESULTS: For all patients, STIR provided more satisfactory images than T2WI of both the cortical surface structures and intra-axial structures surrounding the tumor. During surgery, the clear demonstration of cortical surface structures on preoperative STIR images assisted in determining tumor location and the sulci to be split for the trans-sulcal approach for patients whose cortex was normal in colour. Clear contrast on STIR between the tumor margin and peritumoral edema was useful for tumor resection.

CONCLUSION: STIR is able to demonstrate anatomical details of the cortical surface and intra-axial structures of the brain and is therefore suitable for the preoperative evaluation of superficially located gliomas.