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目的改进术中超声技术,评价超声在脑胶质瘤术中判断残余肿瘤价值。方法选择高频(12 MHz)专用术中探头,采用残腔腔内与残腔表面扫查结合的检查方法,在37例拟行肿瘤根治术脑胶质瘤患者常规显微手术结束时行超声检查。将超声影像与病理组织学检查结果对比,评价超声判断胶质瘤残余肿瘤的能力和价值。结果通过改进扫查方法,可获得高质量术中影像,降低了病理基础不确定的超声征象的出现率,避免了其对诊断的干扰。本组脑胶质瘤术中超声诊断残余肿瘤敏感性、特异性及准确性分别为65．71%(23/35)、98．34%(178/181)和93．06%(201/216)。假阴性诊断中的91．67%(11/12)发生于高分级胶质瘤,以胶质母细胞瘤明显。结论通过改进检查技术,获得高质量术中实时影像,超声可作为脑胶质瘤手术术中判断残余肿瘤安全可靠的影像手段。
Objective To improve the technique of intraoperative ultrasound and evaluate the value of ultrasound in judging residual tumor in gliomas. Methods The special high frequency (12 MHz) intraoperative probe was selected. In combination with the examination of the surface of the residual cavity in the residual cavity, 37 cases of patients undergoing radical resection of brain glioma underwent conventional microsurgery with ultrasonography an examination. Ultrasound imaging and histopathological examination results compared to evaluate the ability and value of ultrasound to determine glioma residual tumor. Results By improving the scanning method, high quality intraoperative images were obtained, the incidence of ultrasonographic signs with uncertain pathological basis was reduced, and the interference to the diagnosis was avoided. The sensitivity, specificity and accuracy of intraoperative ultrasound in the diagnosis of gliomas in this group were 65.71% (23/35), 98.34% (178/181) and 93.06% (201/216) respectively ). 91.67% (11/12) of false-negative diagnoses occurred in high-grade gliomas, which was marked by glioblastoma. Conclusion By improving the inspection technique and obtaining high quality intraoperative real-time images, ultrasound can be used as a safe and reliable means of imaging residual tumor in glioma surgery.