CAJ | 학술논문

目的探讨术中超声造影技术在评价脑胶质瘤病理分级及区分肿瘤、瘤周水肿脑组织与正常脑组织范围中的价值.方法对80例脑胶质瘤患者的术中超声造影图像进行回顾性分析,观察肿瘤、瘤周水肿脑组织与正常脑组织的强化情况,定量分析不同部位造影参数.结果正常脑组织呈等增强,高级别胶质瘤瘤体组织与瘤周水肿脑组织呈高增强,瘤体组织增强强度高于瘤周水肿脑组织；低级别胶质瘤瘤体组织呈高增强,但瘤周水肿脑组织增强强度与正常脑组织相近.瘤体组织的绝对峰值强度高于瘤周水肿脑组织与正常脑组织,组间比较差异有统计学意义(P＜0.05)；高级别胶质瘤瘤体组织的造影达峰时间早于瘤周水肿脑组织与正常脑组织,组间比较差异有统计学意义(P＜0.05)；低级别胶质瘤瘤体组织造影达峰时间与瘤周水肿脑组织和正常脑组织比较,差异无统计学意义(P＞0.05).结论术中超声造影技术有助于切除肿瘤前判断胶质瘤病理级别及确定瘤周水肿脑组织的边界,有效指导临床手术.
목적 탐토술중초성조영기술재평개뇌효질류병리분급급구분종류、류주수종뇌조직여정상뇌조직범위중적개치.방법 대80례뇌효질류환자적술중초성조영도상진행회고성분석,관찰종류、류주수종뇌조직여정상뇌조직적강화정황,정량분석불동부위조영삼수.결과 정상뇌조직정등증강,고급별효질류류체조직여류주수종뇌조직정고증강,류체조직증강강도고우류주수종뇌조직；저급별효질류류체조직정고증강,단류주수종뇌조직증강강도여정상뇌조직상근.류체조직적절대봉치강도고우류주수종뇌조직여정상뇌조직,조간비교차이유통계학의의(P＜0.05)；고급별효질류류체조직적조영체봉시간조우류주수종뇌조직여정상뇌조직,조간비교차이유통계학의의(P＜0.05)；저급별효질류류체조직조영체봉시간여류주수종뇌조직화정상뇌조직비교,차이무통계학의의(P＞0.05).결론 술중초성조영기술유조우절제종류전판단효질류병리급별급학정류주수종뇌조직적변계,유효지도림상수술.
Objective To explore the value of intraoperative contrast-enhanced ultrasonography in distinguishing gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues,and grading cerebral gliomas.Methods Intraoperative contrast-enhanced ultrasonic imaging in 80 patients diagnosed cerebral gliomas were studied retrospectively.The blood perfusion patterns of gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues were observed closely after contrast and parameters were recorded.Results After contrast-enhanced ultrasound,peripheral normal cerebral tissues showed homogeneous enhancement,the tumor tissues and peritumorous cerebral edema of high-grade gliomas (HGG) showed high enhancement,but peritumorous cerebral edema of low-grade gliomas (LGG) showed nearly homogeneous enhancement.Absolute peak intensity(API) of the tumor tissues were higher than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜0.05).Time to peak (TTP) of the tumor tissues in HGG were shorter than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜ 0.05).TTP of the tumor tissues in LGG compared with those of peripheral normal cerebral tissues and peritumorous cerebral edema,two groups had no statistical significance ( P ＞ 0.05).Conclusions Intraoperative contrast-enhanced ultrasonography can reflect the boundary of the brain edema,which is useful to guide surgical resection effectively and helpful to grade cerebral gliomas.