颅内血管性疾病术中超声应用研究

目的探讨颅脑血管性疾病的回声和血流变化特点,指导精确手术。方法204例颅内血管性疾病患者行术中超声检查,确定病变的数目、位置、深度、大小、范围及其与周边组织结构的关系,动静脉畸形患者术前寻找供血动脉和引流静脉,术后评价手术切除情况。结果(1)术中超声可准确定位畸形血管团,显示供血动脉及引流静脉的位置和走行,其诊断畸形血管团残留的敏感性和特异性分别为85%和100%。(2)66例海绵状血管瘤在超声引导下均快速找到病灶,清晰显示并准确定位。(3)11例颅内动脉瘤患者术中超声清晰显示9例,并可评价动脉瘤内有无血栓形成。(4)35个血管母瘤术中超声发现32个,囊结节型及囊实质型血管母细胞瘤术中超声探查结果与MRI结果一致。结论术中超声可准确定位颅内血管性疾病,确定病变边界,评价病灶内血流动力学特征,指导精确手术,及时发现病灶残留。

Study on Intraoperative Ultrasound in Cerebral Vascular Disease

Objective To realize echoes and blood flows in different tumors and to explore the significance of ultrasound in directing operation, improving the operation safety and finding residues.Methods Intraoperative ultrasound findings in 204 patients with cerebral vascular disease were analyzed retrospectively,record the numbers,location,depth,size of different tumors and relationship of the tumors with surrounding tissues.For the patients of AVM (arteriovenous malformation),feeding arteries and draining veins need to distinguish from normal vessels.Results (1) Intraoperative ultrasound can accurately locate AVM and demonstrate feeding arteries and draining veins,the sensitivity and specificity of diagnosing resedue was 85% and 100%.(2) All of cavernous hemangiomas (66 cases) were found quickly and accurately by intraoperative ultrasound.(3) 9 of 11 aneurysms were demonstrated as well as thrombus.(4) 32 of 35 hemangioblastoma were found by intraoperative ultrasound.Except parenchyma types,the tumors of intraoperative ultrasound found were conformity with MRI.Conclusion lntraoperative ultrasound may define location and orientation of cerebral vascular disease,define the border,evaluate blood flows,reduce injury,and improve the diagnostic accuracy and found residues in time.