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Application of intraoperative ultrasound in neurological surgery.

OBJECTIVE
The aim of this study was to evaluate the value of intraoperative ultrasound (IOUS) in neurological operations.


PATIENTS AND METHODS
IOUS was applied in 110 operations, involving 68 gliomas, 7 meningiomas, 1 acoustic neuroma, 5 hemangioblastomas, 3 granulomas, 17 AVMs and 9 cavernous angiomas. A color Doppler model was used to display the blood flow. For 6 gliomas with unclear margins, IOUS was repeated after 2.5 mg Levovist had been given intravenously. Pre-operative and post-operative conditions of all patients were recorded and analyzed.


RESULTS
In all cases IOUS provided real-time information about the localization of lesions and the distribution of vasculature, which helped in choosing the proper approach and also in controlling the extent of the resection. In the color Doppler model, IOUS displayed the distribution of vasculature, as well as the size and structure of AVMs. Total or subtotal resection was achieved in all cases. Six gliomas which were visualized with Levovist showed obvious enhancement with margins becoming more clear.


CONCLUSION
IOUS was a valuable tool in localizing lesions, selecting the proper approach, controlling the extent of resection and displaying the distribution of vasculature. IOUS can provide more reliable safeguard for minimally invasive neurosurgery.