术中灰阶及彩色多普勒超声在颅内病变诊断中的应用价值  

The application value of intraoperative gray scale ultrasound and color Doppler sonography in intracalvarium lesions resection

作　　者：郭宏燕[1] 杨秀华[1] 张羽[1] 安婷婷[1] 王秀云[1] 

机构地区：[1]哈尔滨医科大学附属第一临床医学院腹部超声科,150001

出　　处：《中华医学超声杂志（电子版）》2011年第1期70-73,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的评价术中灰阶及彩色多普勒超声在颅内病变诊断中的作用。方法对36例疑诊为脑肿瘤的患者去骨瓣后术中超声实时监测颅内实性肿瘤切除范围,显示颅内实性肿瘤部位、大小、深度、回声、内部血流信号及毗邻组织,引导术者确认脑动脉瘤位置、载瘤动脉及实性肿瘤的边界。手术结束前探查有无残余肿瘤及是否确切夹闭动脉瘤,对可疑残余颅内肿瘤取小块组织行病理检查。对实性病灶术中彩色多普勒超声图像与术前增强MR对比;夹闭动脉瘤后声像图与术后CT血管成像(CTA)对比分析。结果 (1)36例(39个病灶)术中超声清晰显示38个颅内病灶并准确定位,1例髓内病变未显示。(2)术中超声成功引导术者完全切除26例(26/28)胶质瘤,2例转移瘤(3个病灶),1例脑脓肿,1例脑缺血性梗死灶。2例脑胶质瘤不完全切除。完全夹闭2例动脉瘤及1例动脉瘤破裂机化灶的载瘤动脉。不完全切除的2例胶质瘤术后半年复发,术中超声不能区分复发肿瘤与首次手术填塞物。结论术中超声可准确定位并有助于制定手术方案,实时监测肿瘤切除情况,评价手术效果,最大程度降低手术对脑组织的损伤。Objective To assess the value of intraoperative gray scale ultrasound and color Doppler sonography in intracalvarium lesions resection. Methods The location, size, depth, uhrasonography, CDFI and adjacent tissue of the lesions were observed by intraoperative gray scale ultrasound and color Doppler ul- trasound after deboning in 36 patients with 39 lesions. Residual occupying lesions were identified under con- tinuous sonography. The intraoperative color Doppler sonography with preoperative enhanced MR in solid le- sions was compared to aneurysm with postoperative CTA examination before the end of operation. Pathologi- cal examination was performed in suspected tumor tissue. Results A total of 38 lesions were all shown and successfully located in the operation and 1 intramedullary oligodendrocytes was not found. Total removal of the lesion was applied in 26 cases of gliomas,3 cases of brain metastases, 1 case of cerebral abscess, 1 case of cerebral ischemic necrosis, subtotal removal in 2 gliomas, 2 cases of complete block aneurysm and 1 case of aneurysm ruptured organization. The recurrence in two tumors could not been explored due to no difference between tumor and stuffing. Conclusion The intraoperative uhrasonography could exactly explore first sur- gery lesion, which could provide prompt proposal, real-time detection during the operation, estimate the operation results and reduce cerebral tissue injury.

关 键 词：颅内病变 彩色多普勒超声检查 手术中监测 

分 类 号：R445.1[医药卫生—影像医学与核医学]