术中超声与病理评价颅脑胶质瘤切除程度的对照研究

A comparative study for intraoperative ultrasound and pathologic evaluation on resection of parenchymal brain tumours

目的探讨术中超声评价脑胶质瘤切除程度的应用价值。方法对48例颅内胶质瘤患者术前采用超声定位病灶,肿瘤切除术后,应用超声评价肿瘤切除程度,对超声判断的瘤腔周围残余肿瘤及脑组织进行活检,以病理结果为金标准,评价术中超声判断残余肿瘤的敏感度和特异度。结果48例颅内胶质瘤患者中,低级别胶质瘤26例,高级别胶质瘤22例,术中共活检150次。术中超声诊断残余肿瘤的敏感度为69.6%,特异度为91.4%,术中超声判断低级别胶质瘤的敏感度和特异度高于高级别胶质瘤,以向残腔周围脑组织突入的不规则偏强回声团为超声诊断残余肿瘤标准具有较高的诊断特异度。结论术中超声评价肿瘤切除程度具有较高的敏感度和特异度,可提高颅脑胶质瘤全切除率。

Objective To explore the value of intra-operative ultrasound （IOUS）in determining the extent of resection of brain gliomas. Methods Fourty-eight patients with brain gliomas were included in the study. The IOUS was used to localize tumours, define their margins and assess the extent of resection at the end of surgery. The multiple samples from the tumour brain interface which were reported as tumour or normal tissue on IOUS were submitted to histopathology. The IOUS findings were compared with those of histo- pathology. Results A total of 150 samples were taken from fourty-eight patients including 11 low-grade and 22 high-grade tumours. The sensitivity and specificity of IOUS in determining the extent of resection of brain gliomas were 69.6% and 91.4% , respectively. The residual tumors are readily identified by IOUS in low grade gliomas than high grade gliomas. Irregular hyperechoic areas extending from the cavity into the isoechogenic brain tissue have high specificity as IOUS diagnosis criteria. Conclusions IOUS is a useful tool for determining the extent of resection and improve the operation resection rate.