颅内血管网织细胞瘤的术中超声应用研究

Application of intraoperative ultrasound in the surgical treatment of hemangioblastoma

目的探讨术中超声在颅内血管网织细胞瘤手术中的应用价值。方法对17例颅内血管网织细胞瘤患者(术前均行核磁共振检查发现35个肿瘤)行术中超声检查,常规及彩色多普勒超声定位肿瘤及瘤结节,确定肿瘤位置、深度、大小、范围及其与周边组织结构的关系,确定造瘘口的位置及造瘘方向。对于较大的实性肿瘤,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。肿瘤切除后,残腔灌注生理盐水,超声探查并了解肿瘤切除程度。结果17例患者术中超声探及32个肿瘤。术中超声探及最小实性肿瘤的直径为7mm。囊实质型及囊结节型肿瘤术中超声与核磁共振诊断结果一致,13个实质型肿瘤中术中超声漏诊3个,此3个肿瘤大小为3～6mm,距脑表面2～5cm。结论术中超声对颅内血管网织细胞瘤的检出率较高,可协助临床提高颅内病变全切率。

Objective To investigate the value of intraoperative ultrasound in the resection of hemangioblastoma. Methods Intraoperative ultrasound was applied in 17 patients who underwent resection. The size, number,location , depth, feeding arteries and draining veins of the tumors were clearly displayed. Results Intraoperative ultrasound could real-time locate the tumor with high accuracy. Totally there were 35 tumors in 17 patients, and intraoperative ultrasound found 32 of them. The diameter of thr smallest tumor was 7 mm. Intraoperative ultrasound could displayed clearly the feeding arteries and draining veins in bigger tumors. Conclusions Intraoperative ultrasound should be routinely used in the operation of hemangioblastoma for its high detection rate.