实时术中超声引导在脑胶质瘤切除术中的应用

目的探讨实时术中超声显像对脑胶质瘤术中定位、实时监测及引导切除的应用价值。方法对CT或MRI疑为脑胶质瘤且均被术后病理检查证实的22例患者,在术中用超声对肿瘤进行定位,了解病灶的大小、病灶与周围结构的关系,引导手术路径,监测病灶切除范围和程度。结果实时术中超声对脑胶质瘤定位准确率达100%,超声图像显示病灶为不同于正常脑组织的异常回声区,形态多不规则,无明确包膜;在实时超声引导下对22例脑胶质瘤患者中行全切除14例(64%),次全切除8例(36%),出院时患者症状明显改善18例(82%),无明显变化4例(18%)。结论实时术中超声对脑胶质瘤定位准确、可靠,有助于指导临床对肿瘤病灶尽可能全地切除,并保护神经功能,降低手术并发症的发生。

The application of real-time intraoperative sonography in resection of cerebral gliomas

Objective To evaluate the application value of real-time intraoperative sonography in locating cerebral gliomas and real-time monitoring and assisting the resection.Methods Twenty-two patients who were doubted cerebral gliomas by computed tomography(CT) or magnetic resonance(MRI) were involved(who were postoperative histopathologic examination confirmed).We used ultrasound locate the lesion,understand the size of the lesion,the relationship between lesion and surrounding structures,guide the surgical path,real-time guide the resection and evaluate the localization of residual tumor tissue in surgery.Results The located accuracy of cerebral gliomas was 100%.All lesions were abnormal echogenic compared with normal brain tissue on ultrasound.These lesions were mostly displayed irregular shapes and indistinct margins.Total removal of the lesion was achieved in 14 cases(64%),subtotal removal in 8 cases(36%),in real-time ultrasound-guided in 22 cases of glioma patients.Neurological symptoms were improved in 18 cases(82%),unchanged obviously in 4 cases(18%) in follow-up study.Conclusion Real-time intraoperative ultrasound can locate the lesion reliably and accurately,help protect neurological function and reduce complications in cerebral gliomas operation.