术中超声造影评价脑胶质瘤病理分级及瘤周水肿

目的 探讨术中超声造影技术在评价脑胶质瘤病理分级及区分肿瘤、瘤周水肿脑组织与正常脑组织范围中的价值.方法 对80例脑胶质瘤患者的术中超声造影图像进行回顾性分析,观察肿瘤、瘤周水肿脑组织与正常脑组织的强化情况,定量分析不同部位造影参数.结果 正常脑组织呈等增强,高级别胶质瘤瘤体组织与瘤周水肿脑组织呈高增强,瘤体组织增强强度高于瘤周水肿脑组织；低级别胶质瘤瘤体组织呈高增强,但瘤周水肿脑组织增强强度与正常脑组织相近.瘤体组织的绝对峰值强度高于瘤周水肿脑组织与正常脑组织,组间比较差异有统计学意义(P＜0.05)；高级别胶质瘤瘤体组织的造影达峰时间早于瘤周水肿脑组织与正常脑组织,组间比较差异有统计学意义(P＜0.05)；低级别胶质瘤瘤体组织造影达峰时间与瘤周水肿脑组织和正常脑组织比较,差异无统计学意义(P＞0.05).结论 术中超声造影技术有助于切除肿瘤前判断胶质瘤病理级别及确定瘤周水肿脑组织的边界,有效指导临床手术.

Intraoperative contrast-enhanced ultrasonic imaging in the evaluation of pathologic grades of cerebral gliomas and peritumoral cerebral edema

Objective To explore the value of intraoperative contrast-enhanced ultrasonography in distinguishing gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues,and grading cerebral gliomas.Methods Intraoperative contrast-enhanced ultrasonic imaging in 80 patients diagnosed cerebral gliomas were studied retrospectively.The blood perfusion patterns of gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues were observed closely after contrast and parameters were recorded.Results After contrast-enhanced ultrasound,peripheral normal cerebral tissues showed homogeneous enhancement,the tumor tissues and peritumorous cerebral edema of high-grade gliomas (HGG) showed high enhancement,but peritumorous cerebral edema of low-grade gliomas (LGG) showed nearly homogeneous enhancement.Absolute peak intensity(API) of the tumor tissues were higher than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜0.05).Time to peak (TTP) of the tumor tissues in HGG were shorter than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜ 0.05).TTP of the tumor tissues in LGG compared with those of peripheral normal cerebral tissues and peritumorous cerebral edema,two groups had no statistical significance ( P ＞ 0.05).Conclusions Intraoperative contrast-enhanced ultrasonography can reflect the boundary of the brain edema,which is useful to guide surgical resection effectively and helpful to grade cerebral gliomas.