The Impact of 3T-MRI on Neurosurgery(<SPECIAL ISSUE>Progress in Neuroimaging)

Abstract

The recent introduction of 3.0T magnetic resonance imaging (3T-MRI) brought about a number of significant changes in neurosurgery, such as improvements in the development of surgical strategies, the preservation of brain functions including cortical and axonal functions, and the detection of brain lesions. The main characteristics of 3T-MRI leading to these changes include increases in signal-to-ratio and magnetic susceptibility, a diminution of T1 contrast, and an enhancement of T2 contrast, which are not only advantageous but also disadvantageous to MR imaging. The advantageous characteristics of 3T-MRI contributed to the development and advancement of various MR imaging techniques, such as T2R (T2 reversed), 3DAC PROPELLER (three-dimensional anisotropy contrast periodically rotated overlapping parallel line with enhanced reconstruction), fMRI (functional MRI), and MRSI (MR spectroscopic imaging). T2R imaging has been found to be the most suitable for routine clinical investigations on 3T-MRI, and it is also capable of providing high-resolution images. 3DAC PROPELLER provides the most efficient single contrast images for any physiological and pathological structural analyses in the clinical setting. Functional analysis utilizing fMRI with 3T-MRI is now considered to be the gold standard for clinical activation studies. Appropriately performed fMRI is capable of providing powerful preoperative information regarding eloquent areas of the brain such as the motor areas and language areas. MRSI, the imaging version of ^1H-MRS, can obtain spatial metabolic information of brain lesions such as brain tumors. On the other hand, several characteristics of 3T-MRI, such as greater susceptibility and diminished T1 contrast, are disadvantageous to MR imaging, resulting in unfavorable effects including fictitious activations in fMRI, susceptibility artifacts and diminished contrast in T1-weighted images. Hence, it is extremely important to utilize 3T-MRI in neurosurgical settings with careful consideration of both its advantages and disadvantages.