术中灰阶及彩色多普勒超声在颅内占位性病变切除术中的应用  

Application of Intraoperative Gray Scale Ultrasound and Color Doppler Sonography in Intracranial Mass Resection

作　　者：黄振超[1] 王辉[1] 李文胜[1] 蔡梅钦[1] 秦峰[1] 郭英[1] 

机构地区：[1]中山大学附属第三医院神经外科,广东广州510630

出　　处：《中国医学影像学杂志》2012年第8期622-625,共4页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金项目(30901542)

摘　　要：目的评价灰阶及彩色多普勒超声技术在颅内占位性病变手术中的应用价值。资料与方法回顾性分析经头颅CT、MRI证实的26例颅内占位性病变患者的临床资料,对比患者术前CT或MRI与术中实时超声显示的病变范围、病变周围组织变化的差异;对其中17例脑内实体性占位病灶的矢状位、冠状位和轴位径线进行测量并计算体积,与术前影像学结果进行对比;通过术中超声指导手术切除占位病变,与术后MRI对比,总结手术全切率。结果术中超声对26例患者的病灶范围、周围脑组织变化情况及病变的血流分布情况均能有效显示,并与术前CT或MRI结果一致;且术中超声对实体性占位体积的测量结果与术前影像学结果相一致(t=1.757,P>0.05),术后经超声探查未发现术腔残留,与术后头颅MRI复查对比证实术中超声引导下的占位全切除率为93%。结论术中超声对颅内病灶定位的准确性与CT、MRI相当,并且能实时便捷地在术中应用,指导神经外科微创手术治疗。Purpose To assess the value of the intraoperative gray scale ultrasound and color Doppler sonography in intracranial mass resection. Materials and Methods The intraoperative real-time ultrasound data of 26 patients with intracranial lesions were compared with preoperative CT or MRI results. The size of the lesions and change of the surrounding tissue were analyzed. The diameters were measured on the sagittal, coronal and axial view in 17 cases and the volume was calculated, which was compared with preoperative imaging results. Surgical resection was under the guide of real-time ultrasound, and total resection rate was calculated and compared with postoperative MRI images. Results The extension of the lesions, the change of the surrounding tissue and the blood supply the lesions in 26 patients were detected by intraoperative ultrasound, which was in agreement with preoperative CT or MRI images. The volumes of the masses calculated by intraoperative ultrasound were in agreement of preoperatvie imaging results （t = 1.757, P 〉 0.05）. Meanwhile, the surgical total resection rate was 93% based on the postoperative MRI. Conclusion lntraoperative ultrasound can accurately localized the intracranial masses, which is similar to CT or MRI. It is a convenient and real-time intraoperative imaging method for minimal invasive neurosurgery.

关 键 词：脑肿瘤 神经胶质瘤 颅内动静脉畸形 中枢神经系统静脉血管瘤 脑脓肿 神经外科手术 超声检查 多普勒 彩色 术中超声 

分 类 号：R739.41[医药卫生—肿瘤] R730.41[医药卫生—临床医学]