小脑占位性病变的术中超声应用研究

目的 探讨术中超声在小脑占位性病变切除术中的临床应用价值.方法 对41例小脑占位性病变患者进行术中超声探测,其中胶质瘤12例,血管网织细胞瘤10例,动静脉畸形10例,转移癌4例,海绵状血管瘤3例,神经节细胞瘤及脑膜瘤各1例.应用灰阶及彩色多普勒超声探测病变,确定病变的位置、深度、大小、病变回声、范围、与周围邻近组织的关系及血流情况等.对小脑动静脉畸形,应用彩色多普勒及脉冲多普勒超声寻找供血动脉及引流静脉,观察其来源及走行,确定手术切除入路;对较大血管网织细胞瘤实性部分,应用脉冲多普勒观察其频谱特点.病变切除后,残腔灌注生理盐水,超声探测并了解病变切除程度.结果 ①血管网织细胞瘤术前MRI显示肿瘤16个,超声探测到14个,漏诊2个,其余占位性病变术中显示率100%,并作出精确定位;②小脑不同占位性病变有不同的回声特点和血流变化情况;③小脑占位性病变在术中经超声判断其切除程度,与术后CT、MRI所见结果一致.结论 超声对小脑占位性病变可定位、定向,确定病变边界,对术中彻底切除病变有指导意义.

Application of intraoperative ultrasonography in space-occupying cerebellar lesions GUO Zhi-xiang, HE Wen,

Objective To discuss the clinical value of the intraoperative ultrasonography in space-occupying cerebellar lesions. Methods Forty-one patients with space-occupying cerebellar lesions were collected to perform intraoperative ultrasonography, including 12 glioma, 10 hemangioblastoma, 10 arteriovenous malformations (AVM) ,4 metastatic carcinoma,3 angioeavernoma, 1 meningeoma and 1 paraganglioma. The location,depth, size, there were 16 nodes in 10 hemangioblastoma,and intraoperative ultrasonography found 14 of them. The rest space-ultrasonography showed a good correspondence in the degree of resection with postoperative CT or MRI. Conclusions Intraoperative ultrasonography could display clearly the location, size and boundary of cerebellar lesions, guide exactly the approach to resect the lesions in real time, it is of great value in cerebellar occupying lesions resection.