术中超声引导切除212例脑胶质瘤

The using of intra - operative ultrasound in gliomas（212 cases reports）

目的 探讨术中应用二维超声辅助切除脑胶质瘤的价值.方法 2007年7月至2009年8月收治幕上胶质瘤手术患者212例,按照肿瘤位置分为浅部（距皮层距离＜2 cm）及深部（距皮层距离≥2 cm）两组,手术中肿瘤切除前、中、后均进行超声探查,判定肿瘤边界并对可疑回声进行活检,术后5 d内进行MRI复查,判定肿瘤切除程度.结果 术后MRI显示212例患者全切除192例,近全切除20例.其中位于表浅部位的110例肿瘤中,超声判断敏感度为93.9%,特异度为95.1%;位于深部及脑室内102例肿瘤中,超声判断敏感度为95.7%,特异度为36.4%.结论 术中超声辅助确定胶质瘤边界,有一定的应用价值和优势,对于位置深在的胶质瘤的切除更具指导性,可以作为术中常规应用.

Objective To share the experience in using intra-operative ultrasound（IOUS）for brain gliomas removal. Method From July 2007 to August 2009,212 patients with brain gliomas were included in the study. Depending on the distance to the cortex,we divided the patiens into shallow location（〈 2 cm）groups and deep location（≥2 cm）groups. The IOUS was used before,during and after tumors resection to localize the tumors, define their margins and assess the extent of resection at the end of surgery. The suspected signal region in the tumor-brain interface which were reported as tumor or normal tissue on IOUSwere submitted to histopathology. MRI review in 5 days after operation to assessment the tumor resection. Results Total resection in 192 cases and subtotal resection in 20 cases in MRI. There were 110cases in shallow group and 102 cases in deep group. The sensitivity and specificity of IOUS was 93.9% and 95.1% in shallow location group,and 95.7% and 36.4% in deep location group. Conclusions IOUS is a useful tool for determining the extent of resection and improve the operation resection rate, especially to the deep location tumors. IOUS should be routine use in the glioma operation.