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中华脑科疾病与康复杂志(电子版) ›› 2020, Vol. 10 ›› Issue (06) : 331 -334. doi: 10.3877/cma.j.issn.2095-123X.2020.06.004

所属专题: 文献

神经损伤与修复

术中超声在侧脑室占位性病变的应用价值
尧小龙1, 王声播1, 陈迎春1, 别毕洲1, 李欢欢1, 盛柳青1, 汪志忠1, 叶建峰1, 游慧超1, 李俊1,()   
  1. 1. 430030 武汉,江汉大学附属湖北省第三人民医院神经外科
  • 收稿日期:2020-12-05 出版日期:2020-12-15
  • 通信作者: 李俊

Application value of intraoperative ultrasound in space-occupying lesions of lateral ventricle

Xiaolong Yao1, Shengbo Wang1, Yingchun Chen1, Bizhou Bie1, Huanhuan Li1, Liuqing Sheng1, Zhizhong Wang1, Jianfeng Ye1, Huichao You1, Jun Li1,()   

  1. 1. Department of Neurosurgery, Third People’s Hospital Affiliated to Wuhan Jianghan University, Wuhan 430030, China
  • Received:2020-12-05 Published:2020-12-15
  • Corresponding author: Jun Li
引用本文:

尧小龙, 王声播, 陈迎春, 别毕洲, 李欢欢, 盛柳青, 汪志忠, 叶建峰, 游慧超, 李俊. 术中超声在侧脑室占位性病变的应用价值[J/OL]. 中华脑科疾病与康复杂志(电子版), 2020, 10(06): 331-334.

Xiaolong Yao, Shengbo Wang, Yingchun Chen, Bizhou Bie, Huanhuan Li, Liuqing Sheng, Zhizhong Wang, Jianfeng Ye, Huichao You, Jun Li. Application value of intraoperative ultrasound in space-occupying lesions of lateral ventricle[J/OL]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(06): 331-334.

目的

探讨术中超声在侧脑室占位性病变的应用价值。

方法

选取江汉大学附属湖北省第三人民医院神经外科自2015年7月至2019年7月收治的28例侧脑室占位患者,手术切除前后及术中应用实时超声对病灶进行定位及定性诊断,指导临床医师选择合适手术路径,评价肿瘤切除程度。

结果

28例侧脑室占位病变患者中,边界不清晰10例(35.7%),病变周围存在水肿带12例(42.9%),病变内有血流信号14例(50%)。16例病理诊断WHO分级Ⅰ级肿瘤发现异常血流信号7例,12例病理诊断WHO分级Ⅰ级以上肿瘤发现异常血流信号10例,2组检出率比较差异有统计学意义(χ2=114.5,P=0.035)。术后1例死于早期术后再出血伴大面积脑梗死;27例患者术后半年随访,神经功能症状较术前均显著改善,无新发神经功能障碍。术后MRI复查显示病变全切25例,少量残留2例,术中超声定位引导下肿瘤全切率为92.59%。

结论

侧脑室占位切除术中,超声具有实时、便捷、图像直观、定位准确、可反复检查等独特优势,对于术中全切肿瘤,保护功能与血管具有重要帮助。

Objective

To explore the application value of intraoperative ultrasound in lateral ventricle space occupying.

Methods

Twenty-eight patients with lateral ventricular space occupying lesions in the Neurosurgery Department of Third People’s Hospital Affiliated to Wuhan Jianghan University were selected from July 2015 to July 2019. All patients underwent localization and qualitative diagnosis by intraoperative ultrasonography before and after surgical resection, which guided clinicians to select appropriate surgical pathways and evaluated the extent of tumor resection.

Results

In 28 patients with lateral ventricular space occupying, 10 cases (35.7%) had unclear boundary, 12 cases (42.9%) had edema zone around lesions and 14 cases (50%) had blood flow signals in lesions. Abnormal blood flow signals were found in 7 cases of 16 patients with WHO grade Ⅰ and 10 cases of 12 patients with WHO grade above Ⅰ, and there was a significant difference in the detection rate between the two groups (χ2=114.5, P=0.035). One patient died of early postoperative because of rebleeding with massive cerebral infarction; 27 patients were followed up for half a year, the neurological symptoms were significantly improved, and there was no new neurological dysfunction. Postoperative MRI reexamination showed total resection in 25 cases and minor residual in 2 cases. The overall complete resection rate guided by intraoperative ultrasound was 92.59%.

Conclusion

Intraoperative ultrasound has the advantages of real-time, convenience, visual image, accurate location and repeatable examination. It has unique advantages in lateral ventricle space-occupying surgery. It is helpful for full preoperative preparation, total resection of tumors, protection of function and blood vessels.

表1 28例患者侧脑室占位病变术中声像图特征比较
图1 术前MRI增强与术中超声的影像学资料
[1]
刘禧,段云友,王佳,等.超声在颅脑占位病变术中的应用[J].中华超声影像学杂志, 2006, 15(9): 685-688.
[2]
Ivanov M, Wilkins S, Poeata I, et al. Intraoperative ultrasound in neurosurgery-a practical guide[J]. Br J Neurosurg, 2010, 24(5): 510-517.
[3]
Albright AL, Sclabassi RJ. Use of the Cavitron ultrasonic surgical aspirator and evoked potentials for the treatment of thalamic and brain stem tumors in children[J]. Neurosurgery, 1985, 17(4): 564-568.
[4]
王颖鑫,韩伟,高军喜,等.术中超声对颅脑深部占位病变的应用价值[J].临床超声医学杂志, 2012, 14(7): 457-460.
[5]
杜伟,陈义兵,魏新亭. 2016版《WHO中枢神经系统肿瘤分类》更新解读[J].中华神经外科杂志, 2016, 32(11): 1095-1098.
[6]
Ram Z, Cohen ZR, Harnof S, et al. Magnetic resonance imaging-guided, high-intensity focused ultrasound for brain tumor therapy[J]. Neurosurgery, 2006, 59(5): 949-955; discussion 955-956.
[7]
孙瑾,艾文兵,冯定昆,等.实时超声在颅内占位性病变手术中的应用(附46例报告)[J].山东医药, 2009, 49(7): 85-86.
[8]
程令刚,何文,王立淑,等.术中超声辅助切除侧脑室中枢神经细胞瘤的应用研究[C]//中华医学会.中华医学会第十二次全国超声医学学术会议论文汇编,青岛, 2012.北京:中华医学会, 2012: 506.
[9]
胡飞,邵强,王焕明,等.术中超声引导下显微手术切除脑室内占位性病变[J].中华神经外科杂志, 2014, 30(6): 561-563.
[10]
Horbar JD, Leahy KA, Lucey JF. Ultrasound identification of lateral ventricular asymmetry in the human neonate[J]. J Clin Ultrasound, 2010, 11(2):67-69.
[11]
王红光,张述升,贾强,等.侧脑室脑膜瘤的显微手术治疗[J].中华神经外科杂志, 2015, 31(8): 788-791.
[12]
王鹏程,赵建农,李俊驹,等.侧脑室肿瘤的显微手术治疗[J].中国微创外科杂志, 2004, 4(3): 220-221.
[13]
冯松山,曾瑜,黄正,等.侧脑室肿瘤的显微手术治疗策略[J].国际神经病学神经外科学杂志, 2016, 43(4): 314-318.
[14]
Liu HL, Fan CH, Ting CY, et al. Combining microbubbles and ultrasound for drug delivery to brain tumors: current progress and overview[J]. Theranostics, 2014, 4(4): 432-444.
[15]
范振,杨春春,魏祥品,等.侧脑室肿瘤的临床分型及显微手术策略[J].中国临床神经外科杂志, 2011, 16(8): 452-455.
[16]
Winkler P, Helmke K. Ultrasonic diagnosis and follow-up of malignant brain tumors in childhood. A report of 4 cases and a review of the literature[J]. Pediatr Radiol, 1985, 15(4): 215-219.
[17]
张华,汤数,赵杰,等.术中超声联合神经导航辅助显微手术切除颅内肿瘤的临床研究[J].中国临床神经外科杂志, 2010, 15(7): 404-406.
[18]
李虎年,刘南平,孙海峰,等.术中实时超声在颅内肿瘤手术中的应用价值[J].中国临床神经外科杂志, 2010, 15(5): 307-308.
[19]
张华楸,陶安宇,刘胜文,等.术中彩超在神经外科手术中的应用[EB/OL].北京:中国科技论文在线, [2013-12-10].

URL    
[20]
吴明伟,吴京展,谢庆海,等.术中超声实时导航在大脑半球肿瘤切除术中的应用[J].临床神经外科杂志, 2013, 10(4): 216-218.
[21]
段英俊,窦长武.实时超声引导在神经外科手术中的应用[J].临床神经外科杂志, 2011, 8(2): 110-112.
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