Proton magnetic resonance spectroscopy and intraoperative MRI navigation for frameless biopsy [Çerçevesiz Biyopsi için İntraoperatif MRG ve Proton Manyetik Rezonans Spektroskopi]

Objective: to assess the clinical efficacy of the combined application of proton magnetic resonance spectroscopy ( 1h-mrs) and intraoperative magnetic resonance imaging (imri) navigation in frameless biopsy of intracranial lesions. method: 1h-mrs was used to analyze the metabolism of the lesions and to locate appropriate biopsy point. we selected target points with the highest cho/naa ratio as shown by 1h-mrs for frameless biopsies. thirty-one cerebral biopsy procedures were performed to identify the pathological diagnosis with the help of a 1.5t imri and a navigation system. after the biopsy,we routinely injected 0.5-1.0ml of air to the target zone through the biopsy needle. it can either serve as a marker and confirm that the targeted tissue has already been acquired,or form an air plug for local hemostasis. results: frameless biopsies were successfully performed in all 31 cases,and pathological diagnosis were made in 30 patients,with a success rate of 96.8% (30/31). none of the patients suffered from significant complications,such as intracranial bleeding or new neurological deficit. conclusion: 1h-mrs assists in finding the best biopsy lesion point and imri can guide biopsy accurately. the combined application of 1h-mrs and imri navigation is technically feasible and safe for frameless biopsy of intracerebral lesions.