多普勒超声系统实时定位在颅内肿瘤手术中的应用72例  

Application of Doppler Ultrasound System for Real-time Intraoperative Localization in 72 Cases of Intracranial Tumor Surgery

作　　者：王维军 吕廷勇 周美春 王超 孙强 唐兴平 WANG Wei-jun;LV Ting-yong;ZHOU Mei-chun;WANG Chao;SUN Qiang;TANG Xing-ping(Qiannan Prefecture Traditional Chinese Medicine Hospital,Duyun,558000,Guizhou;Qiannan Prefecture People's Hospital,Duyun,558000,Guizhou)

机构地区：[1]黔南州中医医院,贵州都匀558000 [2]黔南州人民医院,贵州都匀558000

出　　处：《黔南民族医专学报》2024年第4期395-398,共4页Journal of Qiannan Medical College for Nationalities

基　　金：黔南州科技计划项目[黔南科合社字(2022)2号]。

摘　　要：目的:探讨多普勒超声系统对在颅内肿瘤术中精准定位的应用价值。方法:收集2022年01月01日至2023年06月30日在我院神经外科住院手术治疗的脑肿瘤患者,通过CT、MRI初步定位后,打开颅骨骨瓣后用使用多普勒超声系统确定肿瘤的深度、边界,确认肿瘤周围是否有大血管以及和周围血管的关系,根据彩超结果选择合适的硬脑膜切开范围,精准切除肿瘤并保护好血管。结果:共收集到72例脑肿瘤患者和数前CT、磁共振定位符合率100%,使用多普勒术中定位全切胶质瘤16例(76.19%,16/21)、脑膜瘤43例(100%,43/43)和脑转移瘤8例(100%,8/8),通过术中使用多普勒超声系统确定肿瘤的深度、边界,72例患者颅内肿瘤通过术中多普勒超声系统均被精准定位并顺利暴露并切除肿瘤;术中多普勒超声系统能有效探测肿瘤周围血管走行并引导术者有效保护过路血管25例(100%,25/25)。结论:术中使用多普勒超声系统对颅内肿瘤进行准确的实时定位,有利于术者在术中能快速精准的实施肿瘤的暴露和切除,减少了由于寻找肿瘤而进行的不必要的操作,缩短了手术时间,减少了手术的创伤;同时避免对肿瘤周围重要血管的误伤,操作简单有效。Objective:To explore the application value of Doppler ultrasound system in precise intraoperative localization of intracranial tumors.Methods:Brain tumor patients hospitalized for surgical treatment in our neurosurgery department from January 1,2022,to June 30,2023,were enrolled.After initial localization using CT and MRI,the cranial bone flap was opened,and the Doppler ultrasound system was used to determine the tumor's depth and boundaries,confirm the presence of major blood vessels around the tumor,and assess their relationship with surrounding vessels.Based on the color Doppler ultrasound results,the appropriate dural incision range was selected to precisely resect the tumor while protecting the vessels.Results:A total of 72 brain tumor patients were included,with a 100%concordance rate between preoperative CT/MRI localization and intraoperative findings.Using Doppler intraoperative localization,complete resection was achieved in 16 gliomas(76.19%,16/21),43 meningiomas(100%,43/43),and 8 brain metastases(100%,8/8).The Doppler ultrasound system intraoperatively determined the tumor's depth and boundaries,enabling precise localization,exposure,and resection of intracranial tumors in all 72 patients.Intraoperative Doppler ultrasound effectively detected the course of blood vessels around the tumor and guided the surgeon to effectively protect 25 transit vessels(100%,25/25).Conclusion:Intraoperative use of the Doppler ultrasound system for accurate real-time localization of intracranial tumors facilitates rapid and precise tumor exposure and resection,reducing unnecessary manipulations during tumor search,shortening surgical duration,and minimizing surgical trauma.It also avoids accidental injury to important vessels surrounding the tumor,with simple and effective operation.

关 键 词：多普勒超声系统 颅内肿瘤 手术 术中定位 

分 类 号：R445[医药卫生—影像医学与核医学]