Using intra-operative MRI to assess bleeding

Immediate detection of any surgically induced hemorrhage prior to the closure is important for minimizing the unnecessary post surgical complications. In the case of hemorrhage, the surgical site of interests often involves hemorrhagic blood in the presence of CSF as well as air pockets. It is known that the hemorrhagic blood or air has a different magnetic susceptibility from its surrounding tissue, and CSF has long T1 and T2. Based on these differences, a set of complimentary imaging techniques (T2, FLAIR, and GE) were optimized to reveal the existence of surgically induced acute hemorrhage. Among 330 neurosurgical cases, one relatively severe hemorrhage has been successfully found intra-operatively using the concept. During the case, a new hyperintense area close to the primary motor cortex was initially noticed on T2 weighted Haste images. As soon as it was found to increase in size rapidly, the patient was treated immediately via craniotomy for aspiration of the intra-parenchymal blood. Owing to early detection and treatment, the patient was completely free of motor deficits. Besides, there were ten much less severe hemorrhages have been noticed using the method. The proper post-surgical care was planned to closely follow-up the patient for any sign of hemorrhage.