术中超声诊断幕上胶质瘤术后残余的可行性研究

The evaluation of intraoperative ultrasound in diagnosis of residual tumor after resection of supratentorial glioma

目的 评价术中超声对判断幕上胶质瘤术后残余的诊断价值。方法 选择专用术中超声探头，对44例拟行肿瘤根治术脑胶质瘤患者常规显微手术结束时行术中超声检查，并判断是否有残余。以病理结果 作为金标准并与之对照，建立ROC曲线，分析术中超声对幕上胶质瘤术后残余的诊断价值。结果 44例患者共160个残余病灶，术中超声对诊断胶质瘤切除术后残余肿瘤的敏感度为88％，特异度为63．3％，阳性预测值为80％，阴性预测值为76％，Kappa值为0．531。通过ROC曲线，确定术中超声诊断残余肿瘤的最佳临界点为2．5～3．0mm，计算ROC曲线下面积为0．788。结论 在幕上胶质瘤切除术中，术中超声对发现残余肿瘤具有较高的特异性，可为临床达到彻底根治性切除幕上胶质瘤提供重要的参考价值。

Objective To evaluate the value of intraoperative ultrasound （IOUS） in diagnosis of the residual tumor tissue of supratentorial glioma. Methods With high frequency probe, 160 residual tumor tissue in 44 patients were detected by IOUS; the results of IOUS as well as the pathological examination of the residual tumor tissue were compared. The value of IOUS in diagnosis of the residual tumor tissue of supratentorial glioma was analyzed. Results In the diagnosis of the residual tumor tissue of supratentorial glioma, the sensitivity, specificity, positive and negative predictive value were 88%, 63.3%, 80%, 76% for IOUS, and the Kappa：0.531. The area under the ROC was 0.788, the doubtable value interval was 2.5- 3.0 mm. Conclusion IOUS has a higher specificity in the diagnosis of the residual tumor tissue of supratentorial glioma, so as to provide an important reference value in radical resection of supratentorial glioma.