脑外伤的术中超声应用研究

目的探讨术中超声在颅脑外伤中的临床应用价值，并初步探讨超声造影对脑外伤的诊断价值。方法对12例脑外伤患者行术中超声检查，应用灰阶及彩色多普勒超声探测损伤灶，确定病灶的部位、深度、大小、内部回声及中线结构是否移位等。对血肿清除术中出现急性脑膨出的患者及时行超声检查，以观察是否有迟发性血肿出现。其中选取4例脑挫裂伤伴出血患者行术中超声造影检查，了解脑挫裂伤、脑出血及周围腑组织的造影增强情况。结果本研究中12例患者，术前CT检查发现病灶15个，术中超声探测发现病灶18个；术中超声探测发现迟发性硬膜外血肿4个，1个经急诊CT证实为对侧硬膜外血肿，另3个经超声诊断为迟发性硬膜外血肿后，在超声引导下清除血肿。不同类型的脑外伤有不同超声表现，超声能对病变进行定位。造影前脑挫裂伤病灶边界显示不清，超声造影后损伤灶边界显示清晰。结论术中超声可对脑外伤灶进行定位以指导手术，并可发现迟发性血肿。超声造影可了解脑外伤后损伤灶及周围脑组织灌注情况，为脑外伤后脑灌注提供了重要信息。

Application of intraoperative ultrasonography in traumatic brain injury

Objective To discuss the application of the intraoperative uhrasonography in traumatic brain injury and to explore the initial value of contrast-enhanced ultrasound （ CEUS ） with brain injury. Methods A total of 12 patients with traumatic brain injury were enrolled to perform intraoperative uhrasonography. The location, depth, size, internal echo and boundary of were clearly displayed. Four patients were chosen to take contrast-enhanced ultrasound. Results Different brain injuries had their special ultrasound findings. The border of intracranial hematoma and brain contusion was more distinguishable from healthy brain on CEUS than that on conventional ultrasound during the operation. Conclusions Intraoperative ultrasound could show the location and size of injury to guide the approach. Thus the intraoperative CEUS has the potential to be a very useful imaging technique in traumatic brain injury.