The application of volume navigation with ultrasound and MR fusion image in neurosurgical braintumor resection
10.3760/cma.j.issn.1004-4477.2018.12.006
- VernacularTitle:超声融合导航技术在脑肿瘤切除术中的初步应用
- Author:
Dongfang WU
1
;
Wen HE
;
Song LIN
;
Bo HAN
;
Xiaohui REN
;
Shiji WEI
;
Mengze LIU
Author Information
1. 100160,首都医科大学附属北京天坛医院超声科
- Keywords:
Ultrasonography;
Brain neoplasms;
Fusion imaging ultrasonography;
Neurosurgery navigation
- From:Chinese Journal of Ultrasonography
2018;27(12):1036-1041
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the feasibility in neurosurgical brain tumor resection using ultrasound fusion navigation technology . Methods Thirty patients undergoing brain tumor rescetion accepted fusion ultrasound ( US ) navigation with magnetic renounce/computed tomography ( MR/CT ) technique and cognitive fusion" by neurosurgeon based on the tumor′s localization of magnetic renounce imaging (MRI) separately to definite the position and size of the craniotomy window flaps . After removal cranial bone ,conventional B-mode ultrasound scanning was used to detect lesion firstly . Then ,fusion US/MR navigation was applied again after automatically registration;the images of tumors from B-mode ultrasound and contrast-enhanced ultrasound separately were compared to those from coplanar reconstructive MR/CT in a real time . Results Fusion US/MR navigation was useful to define the position and size of the craniotomy window flaps ,and tumors in all patients were fully exposed to the microscope field of view . In all of 30 cases ,26 cases of fusion imaging of volume navigation technology were successfully registrated . The tumors in 3 cases of glioma ( WHO Ⅰ - Ⅱ grade) and 1 patient with pathologically verified inflammatory couldn′t be localized by conventional B-mode ultrasound but could be accurately localized after fusion ( US/MR) imaging navigation . Compared to contrast-enhanced MR ,high-grade glioma with contrast-enhanced ultrasound (CEUS) showed enhancement in arterial phase and clear tumor boundary rapidly . The enhanced modality with CEUS and MR was functioned equal . Low-grade glioma with CEUS showed scattered point or linear enhancement in arterial phase and the tumor′s margin was blurred . The preoperative T1-weighted enhanced MRI demonstrated no enhancement in the low-grade glioma . Conclusions Fusion ultrasound navigation can be used to definite size of bone flap before craniotomy . It is more suitable for fusion with preoperative T 2 Flair phase to localize low grade glioma . High-grade glioma is suitable to preoperative T 1 weighted enhanced phase for discerning margin of tumor .
