术中超声引导下脑实质内小病灶切除的应用研究  

Resection of the small lesions in the brain parenchyma guided by intraoperative ultrasound

作　　者：龚瑾[1] 秦峰[1] 李文胜[1] 叶卓鹏[1] 黄振超[1] 王辉[1] 

机构地区：[1]中山大学附属第三医院神经外科,广州510630

出　　处：《中华医学超声杂志（电子版）》2013年第4期309-312,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨术中超声在指导脑实质内小病灶切除中的应用价值。方法开颅术中超声引导下对12例脑实质内小病灶进行手术切除,分析术中超声引导病灶定位及指导手术切除情况。结果 12例12个病灶术中超声均能清晰显示,准确定位,位于运动功能区6例、语言功能区2例、非功能区4例。不同病灶有其特征性的声像图表现,利用彩色多普勒模式可清楚显示血管畸形或血供丰富的肿瘤内的血流动力学情况。术中超声引导下对2例脑胶质瘤、2例转移瘤、2例动静脉畸形、2例寄生虫、1例海绵状血管瘤和1例脑脓肿病变均完整切除;1例胶质瘤大部分切除,1例胶质瘤病部分切除。结论术中超声可对脑实质内小病灶实时、精准定位,有助于将病灶完整切除,减轻脑组织损伤。Objective To discuss the value of the intraoperative ultrasound in the guidance of brain parenchymal small lesions resection. Methods Twenty cases of the small lesions were removed in the brain parenchyma using the intraoperative ultrasound real-time location. Results All lesions were precisely displayed and located in the operation. Six cases were in motor areas,2 cases were in language areas,and 4 cases were in the nonfunctional areas. Different lesions had characteristic ultrasound images,color Doppler flow imaging( CDFI) can distinctly reveal the hemodynamics of the arteriovenous malformation and tumor with rich blood supply. With the intraoperative ultrasound guidance,2 cases of gliomas,2 cases of metastatic tumors,2 cases of parasites,1 case of cavernous hemangiomas and 1 case of abscess were totally resected,1 case of gliomas was subtotal resection and 1 case of gliomatosis cerebri was partial resection. Conclusion Intraoperative ultrasound provided a real-time and precisely locating,which was helpful for the resection of the small lesions in the brain parenchyma,and relieved the brain damages.

关 键 词：超声检查 多普勒 经颅 脑肿瘤 脑脓肿 中枢神经系统血管畸形 

分 类 号：R651.1[医药卫生—外科学]