术中实时超声在颅脑手术中的应用研究.pdfVIP

术中实时超声在颅脑手术中的应用研究 孙杰 聂晟 胡勤乐 冯楠 张作洪 费冰 蔺志清 宁波市第一医院神经外科 315010） 【摘要】目的 探讨术中实时超声在神经外科手术中的应用价值。 方法 收集 2007 年 1 月至 2010 年 4 月 69 例神经外科手术术中超声 影像资料。与术前 CT、MRI 结合，观察正常脑组织、脑室和中线结构 等的超声图像；记录颅内病变的大小、形态、深度和内部回声；在超声 实时引导下穿刺；利用多普勒技术探测病变周 大血管分布情况。并 将术后 CT 或 MRI 与术中超声图像对比，了解病变切除程度。结果 术中 69 例病变均在超声影像上清晰显示，其中位于脑内深部 36 例病 灶准确定位，33 例脑内肿瘤边界较清晰，6 例发现病灶残留，得以进 一步切除，8 例结合彩色多普勒技术探测病灶与周围脑血管的毗邻关 系及局部血流速度，区分动、静脉。结论 术中实时超声可清晰显示 颅脑正常结构和颅内病变部位、大小、形态，可对深部小病灶进行准 确定位，实时指导手术入路和手术进展，判断病变有无残留；能在超声 引导下进行穿刺手术，并观察有无出血等并发症；可以评价病变周 大血管的分布状况，避免损伤。 [关键词] 实时超声 神经外科手术 多普勒 Application of real-time ultrasound in neurosurgical operation Sun Jie, Nie Sheng, Hu Qin-le, Feng Nan, Zhang Zuo-hong, Fei Bing, Lin Zhi-qing Ningbo No.1 Hospital.315010. [Abstract] Objective to explore the value of real-time sonography applied in neurosurgery. Methods 69 cases of brain lesions from January, 2007 to April, 2010 were proceeded with real-time sonography (type B ultrasound ) during operation. we collected 69 cases of brain lesions using type B ultrasound imaging technology during the operation from Jan. 2007 to Apr.2010. From the ultrasonic images, normal structures and characteristic of the lesions were easily differentiated. Sonography was applied in three main ways: 1) Measure the size and depth of the lesion; 2) puncture Under b-sonography real-time guiding; 3) Use doppler technique to detect the distribution of the great vessels around the lesion using detection of regional blood flow velocity. Results All the lesions were clearly displayed in ultrasound images. 36 intracephalic lesions were accurately located, and 6 cases were guided with sonography to resect the residual tumor. The vessels adjacent to the tum