超声显像在脑胶质瘤切除术中的应用价值

目的探讨二维超声显像对脑胶质瘤术中定位、实时监测及引导切除的应用价值。方法对CT或MRI疑为脑胶质瘤(均在术后病理检查证实)的40例患者在术中分别用低频或高频探头对肿瘤进行定位、了解病灶与周围结构的关系,监测病灶切除范围和程度。结果术中超声对脑胶质瘤定位准确率达100%,超声图像显示病灶为不同于正常脑组织的异常回声区,形态多不规则,无明确包膜,31例(77%)脑胶质瘤患者可显示低于病灶回声的水肿带。在引导下对40例脑胶质瘤患者中行全切除29例(73%)、次全切除11例(27%),出院时患者症状明显改善33例(83%)、无明显变化7例(17%)。结论术中实时超声显像对脑胶质瘤定位准确、可靠,有助于指导临床进行肿瘤全切除及保护神经功能和降低手术并发症的发生。

Value of intraoperative sonography in resection of cerebral gl iomas

Objective To evaluate the value of intraoperative sonography in locating cerebral gliomas and assisting the resection. Methods Forty patients who were doubted cerebral gliomas by computed tomography (CT) or magnetic resonance (MR) were involved. We used handy ultrasound probe of 3.5 or 7.5 MHz to locate the lesion, real-time guide the resection and evaluate the localization of residual tumor tissue in surgery. Results The located accuracy of cerebral gliomas was 100%. All lesions were hyperechoic compared with normal brain tissue on ultrasound. These lesions were mostly displayed irregular shapes and indistinct margins. Thirty-one (75%) cerebral gliomas were showed the edemata surrounding the lesions, they were moderate echo lower than the lesions. Total removal of the lesion was achieved in 29 cases (73%), subtotal removal in 11 cases (27%). Neurological symptoms were improved in 33 cases (83%), unchanged obviously in 7 cases (17%) in follow-up study. Conclusion Intraoperative sonography can locate the lesion reliably and accurately, help protect neurological function and reduce complications in cerebral gliomas operation.