Three-dimensional MR reconstruction images of skull base tumors

Forty-eight patients with skull base tumors were evaluated prospectively with T1-weighted spin-echo two-dimensional (2D) magnetic resonance (MR) sequences, a three-dimensional (3D) MR TurboFLASH (fast low-angle shot) sequence, and a 3D reconstruction window technique. All patients underwent surgery with histopathologic correlation, and the three MR imaging techniques were compared to assess representation of tumor margins and the topographic relationship of tumor to surrounding tissue and adjacent vasculature. The best results were obtained with standard 2D spin-echo sequences after administration of the paramagnetic contrast agent gadopentetate dimeglumine. The 2D MR sequences gave the highest contrast-to-noise ratios, with decreasing values for 3D sequences and 3D reconstructions, respectively. Nevertheless, 3D MR imaging, by virtue of its good representation of adjacent structures, aided surgeons in planning surgical intervention. This study presents the technical features of 3D imaging of the skull base, the choices involved in its implementation, and its potential clinical applications.