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Updated: Jan 24, 2026
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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
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Intraoperative MRI for endoscopic endonasal transsphenoidal surgery in children
Neevya Balasubramaniam1, Jean-Pierre Farmer1, Marc A Tewfik2,3
11Department of Pediatric Surgery, Division of Neurosurgery, Montreal Children's Hospital, Montreal, Quebec.
Journal of Neurosurgery. Pediatrics
|January 22, 2026
Summary
Intraoperative MRI (iMRI) shows promise for pediatric endoscopic endonasal transsphenoidal surgery (EETS), aiding in goal verification. However, outcomes were not superior to procedures without iMRI in this study.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Imaging
Background:
- Intraoperative MRI (iMRI) is established for adult endoscopic endonasal transsphenoidal surgery (EETS).
- Limited data exists on iMRI's application in pediatric EETS.
- This study evaluates iMRI's utility in pediatric EETS.
Purpose of the Study:
- Assess the usefulness, efficacy, and safety of iMRI in pediatric EETS.
- Compare surgical outcomes between pediatric EETS with and without iMRI.
- Determine if iMRI improves achievement of surgical goals.
Main Methods:
- Retrospective review of pediatric EETS cases (under 18) from 2005-2024.
- Comparison of cases with and without iMRI use.
- Data collected: surgical goals, iMRI timing/findings, surgical management impact, outcomes, complications, and recurrence.
Main Results:
- 13 pediatric EETS cases utilized iMRI (age 6-17), primarily for craniopharyngiomas and pituitary adenomas.
- Surgical goals were achieved in 92.3% of iMRI cases.
- No statistically significant difference in goal achievement (p=0.264), operative time, LOS, or complication rates between iMRI and non-iMRI groups.
Conclusions:
- iMRI appears safe and effective as an adjunct in pediatric EETS for intraoperative goal verification.
- Current outcome measures did not demonstrate superiority compared to EETS without iMRI.
- Further research may clarify iMRI's specific benefits in pediatric neurosurgery.
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