术中实时超声检测在颅脑手术中的应用

目的 探讨术中实时超声检测在神经外科手术中的应用价值.方法 收集2007年1月至2010年4月69例神经外科手术术中超声检测影像资料,与术前CT、MRI所见结合,观察正常脑组织、脑室和中线结构等的超声图像;记录颅内病变的大小、形态、深度和内部回声;在超声实时引导下穿刺;利用多普勒技术探测病变周围大血管分布情况.并将术后CT或MRI所见与术中超声图像对比,了解病变切除程度.结果 术中69例病变均在超声图像上清晰显示,其中36例位于脑内深部的病灶准确定位,33例脑内肿瘤边界较清晰,6例发现病灶残留而得以进一步切除,8例结合彩色多普勒技术探测病灶与周围脑血管的毗邻关系及局部血流速度,区分动、静脉.结论 术中实时超声检测可清晰显示颅脑正常结构和颅内病变部位、大小、形态,可对深部小病灶进行准确定位,实时指导手术入路和手术进展,判断病变有无残留;能在超声引导下进行穿刺手术,并观察有无出血等并发症;可以评价病变周围大血管的分布状况,避免损伤.

Application of real-time ultrasonography in neurosurgical operation

Objective To evaluate the application of real-time ultrasonography in neurosurgical operation.Methods Type B ultrasound imaging technique was applied during neurosurgical operations in 69 cases with brain lesions from January 2007 to April 2010. From the ultrasonic images, normal structures and characteristics of the lesions were easily differentiated. The sonography was applied in three main ways： 1） measure the size of the lesion, 2） puncture under b-sonography real-time guiding, 3） detect the distribution of great vessels around the lesion using detection of regional blood flow velocity. Results All the lesions were clearly displayed in ultrasound images, 36 intracephalic lesions were accurately located, and the residual tumors were resected with the guidance of sonography in 6 cases. The vessels adjacent to the tumor or intra-tumor were distinguished by the intra-operative ultrasound. Conclusion Intraoperative ultrasonography provides good real-time imaging, which can be used to accurately detect tumor location, and to monitor the procedure during neurosurgical operations.