术中实时超声在脑功能区胶质瘤手术中的应用价值  

Applied value of intraoperative real-time ultrasound in resection of gliomas located in the eloquent brain regions

作　　者：张忠[1] 江涛[1] 谢坚[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《中国微侵袭神经外科杂志》2007年第11期497-498,共2页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：首都医学发展科研基金(2005-2024)

摘　　要：目的探讨实时超声在功能区胶质瘤术中的应用价值。方法对45例大脑功能区胶质瘤,采用术中实时超声定位肿瘤的解剖边界,在唤醒麻醉下结合皮质电刺激确定功能边界,根据解剖-功能边界切除肿瘤,同时采用实时超声监测病灶切除程度。结果本组肿瘤均定位准确。低级别胶质瘤病灶回声均匀,周围无明显水肿带;高级别胶质瘤病灶形态不规则,边界欠清。肿瘤全切除27例,近全切除7例,大部分切除11例。结论唤醒麻醉下结合术中皮质电刺激定位肿瘤切除边界,同时采用术中超声辅助切除功能区胶质瘤,疗效较好。Objective To explore the application value of intraoperative ultrasound （IOUS） in the resection of gliomas located in the eloquent brain regions. Methods Intraoperative real-time ultrasound was used to locate the anatomical boundary of the lesions and evaluate the extent to be resected in 45 patients with primary gliomas in the eloquent brain regions. The functional boundary was determined by intraoperative cortical electrical stimulation under conscious anesthesia. The brain lesions were removed according to anatomic-functional boundaries. Results All the 45 lesions were accurately defined by IOUS. The echoes were homogeneous and no marked surrounding edema bands were observed in low grade gliomas. The ultrasound imaging of high grade glioma showed irregular shapes and poorly defined boundaries. Total removal of the lesion was achieved in 27 cases, subtotal removal in 7, partly removal in 11. Conclusion Under anesthesia with a waking state of patient, intraoperative cortical electrical stimulation is helpful to locate resection boundaries, adjunct IOUS for the resection of gliomas within the eloquent brain region can result in a better outcome.

关 键 词：监测 手术中 术中超声 神经胶质瘤 功能区 唤醒麻醉 术中皮质电刺激 

分 类 号：R739.4[医药卫生—肿瘤]