术中超声实时导航在大脑半球肿瘤切除术中的应用

Real-time navigation of intraoperative ultrasound for cerebral hemisphere tumor resection

目的比较术前MR图像与术中超声图像对手术指导的差异,评价术中B超的应用价值。方法回顾性分析26例应用术前1.5T场强MRI及术中超声辅助切除的大脑半球肿瘤患者,对比两种方法对肿瘤血供的探测能力和对肿瘤边界大小的判断能力的差异。结果对肿瘤的血供判断方面,术中B超有探测能力强,实时、随时探测的术中指导能力;对肿瘤的大小边界判断方面,术中B超判断边界与MR图像无统计学差别,虽然图像清晰度不及MR图像,但由于其实时探测能力而在手术中更具实时指导的优越性。结论对于大脑半球肿瘤,术中超声辅助切除能有效提高无创探查效率,减少神经损伤,及早控制肿瘤供血,指导肿瘤全切。

Objective To compare the advantages and disadvantages for operation instruction between preoperative MRI and intraoperative ultrasound, and evaluate the application value of intraoperative ultrasound. Methods 26 patients with cerebral hemisphere tumor who were performed 1.5T MRI for preoperative assessment and intraoperative ultrasound-assisted resection were analyzed retrospectively. Two methods＂ abilities for detection of the tumor blood supply and their difference of capacity for determining tumor boundary were compared. Results In the respect of detecting the tumor blood supply, intraoperative ultrasound had such advantages including better detection, powerful intraoperative guidance ability by real-time and any time detection. In the respect of determining tumor boundary and of estimating tumor size, there was no statistically significant difference between intra-operative ultrasound and preoperative magnetic resonance images. Although preoperative MRI had a better image definition, intraoperative ultrasound might have better ability for intraoperative guidance by its real-time and any time detection. Conclusion For cerebral hemisphere tumor resection, by the assist of intraoperative ultrasound, noninvasive detection efficiency can be increased, neurological damage can be reduced, the control the tumor blood supply can be more efficient and the total removal for tumor can be more anatomical structure assisted in real-time.