超声在颅内微小占位性病变显微切除术中的应用

目的评估术中实时超声引导下显微切除颅内微小病变的手术疗效,探讨术中超声的临床应用价值。方法对本组18例颅内微小占位性病变患者,其中14例海绵状血管畸形(cavernous malformation)、4例胶质细胞瘤患者进行术中实时超声定位检查。结果 18例患者的病变术中定位准确,其中13例非功能区病变超声引导均全切除,术后无神经功能废损;5例功能区病变全切除。术后2例瘫痪加重,随访半年恢复正常。结论术中超声对病变可精确定位、指导手术入路、提高病灶全切率及手术疗效、降低术后并发症的发生,有较高的临床应用价值。

The Clinical application value of intraoperative ultrasound in microsurgical resection of small intracerebral lesions

Objective To evaluate the surgical outcome after resecting small intracerebral lesions by means of realtime intraoperative ultrasound （IOUS） and to explore its cIinical application value. Methods 18 cases were involved in this study, including 14 cavernous malformations and 4 gliomas, with their diameter less than 3cm. After craniotomy, IOUS is used to locate the lesions and help to select the surgical approach pre-resection, define the range and observe the residue during and after operative procedure. Results All lesions are localized accurately and resected completely. No neurological dysfunction occurred in 13 patients whose lesions lie in non-functional area, while 2 cases presented slight hemiplegia in 5 cases whose lesions were in eloquent area. During half year＇s follow-up, the 2 patients recovered with normal muscular strength. Conclusion Intra-operative ultrasound can accurately locate small intraeerebral lesions and it is helpful for selecting the proper approach, increasing the total resection rate and improving surgical outcome as well as reducing morbidity and mortality.