实时超声导航在脑深部病灶手术中的应用  

Application of intraoperative real-time ultrasound combined with neuronavigation for resecting deep intracranial lesions

作　　者：江涛[1] 傅先明[2] 姜晓峰[2] 牛朝诗[2] 计颖[2] 魏祥品[2] 李光群[2] 

机构地区：[1]安徽医科大学第二附属医院神经外科,合肥230601 [2]安徽医科大学附属安徽省立医院神经外科,安徽省立体定向神经外科研究所,合肥230032

出　　处：《中华神经医学杂志》2009年第8期832-835,838,共5页Chinese Journal of Neuromedicine

摘　　要：目的评价实时超声导航系统在脑深部病变手术中的应用，总结应用术中实时超声解决脑移位、指导病灶切除的经验。方法应用Vector Vision Compact神经导航系统结合术中实时超声对15例脑深部病灶行手术治疗。术中应用超声指示病灶位置．在脑组织移位时利用实时超声对病灶进行手术中再定位、导向，并监测残余病灶的切除。结果术中经超声探查和术前导航影像对比，发现有11例病灶有不同程度的移位，在实时超声的引导下纠正脑移位及切除病灶，全切除12例，近全切除2例，1例炎性病灶行活组织检查证实为慢性肉芽肿。结论术中实时超声能进行病灶的实时定位引导，监测病灶深度，确定切除范围，避开功能区皮质和深部重要结构．对手术残余进行判断和指导再次切除，故有助于提高手术疗效，降低手术并发症。Objective To evaluate the application of intraoperative real-time ultrasound combined with neuronavigation in surgical resection of deep intracranial lesions. Methods Fifteen patients with deep intracranial lesions underwent surgical resection of the lesions with guidance by Brain-Lab neuronavigation and intraoperative real-time ultrasound. The lesions were localized by ultrasound, and in cases of brain shift, intraoperative real-time ultrasound was used for lesion relocalization, surgical guidance, and monitoring of the tumor remnants during the operation. Results The lesions and their surrounding structures were accurately localized. Intraoperative real-time ultrasound identified brain shift of varying degrees, which was corrected under ultrasound guidance. Total resection of the lesions was achieved in 12 cases, and subtotal resection was performed in 2 cases. In the other case, the inflammatory lesion was identified as chronic granuloma by biopsy. All the patients showed improvements of the clinical symptoms after the operations. Conclusion Intraoperative real-time ultrasound during neuronavigation allows accurate localization of deep intracranial lesions and facilitates preoperative surgical planning to define the scope of resection, avoid the cortical brain tissue and important deep structures, and help evaluate the lesion residues for a second operation. Intraoperative real-time ultrasound may help improve the therapeutic effects and reduce the surgical complications.

关 键 词：神经导航 术中实时超声 脑深部病灶 

分 类 号：R686[医药卫生—骨科学]