CAJ | 학술논문

目的采用术中超声观察不同颅内血管性病变的显示情况,探讨术中超声实时定位病灶、指导手术切除的价值.方法对204例颅内血管性疾病患者行术中超声检查,对动静脉畸形患者寻找供血动脉和引流静脉.对海绵状血管瘤患者剪开硬脑膜切除病变前(术前)、经大脑皮层造瘘到达病灶时(术中)以及病灶切除术后(术后)均行术中导航及术中超声检查,并比较二者定位的准确性.结果 ①术中超声对颅内血管性疾病的显示率为98%,其中对颅内动静脉畸形和海绵状血管瘤的显示率均为100%,动脉瘤的显示率为81%,血管母细胞瘤的显示率为91%.②术中超声对颅内动静脉畸形患者供血动脉及引流静脉的显示率为71%.③术中超声与术中导航在海绵状血管瘤切除术前定位的准确率差异无统计学意义(100%对95%,P=0.244).术中超声在海绵状血管瘤切除术中、术后定位的准确率明显高于术中导航,差异有统计学意义(100%对74%,x2=19.513,P＜0.0001,100%对68%,x2=24.973,P＜0.0001).结论术中超声对颅内血管性疾病具有较高的显示率,并可准确定位病变,指导手术,缩短手术时间,减少损伤,提高手术的精确性.
목적 채용술중초성관찰불동로내혈관성병변적현시정황,탐토술중초성실시정위병조、지도수술절제적개치.방법 대204례로내혈관성질병환자행술중초성검사,대동정맥기형환자심조공혈동맥화인류정맥.대해면상혈관류환자전개경뇌막절제병변전(술전)、경대뇌피층조루도체병조시(술중)이급병조절제술후(술후)균행술중도항급술중초성검사,병비교이자정위적준학성.결과 ①술중초성대로내혈관성질병적현시솔위98%,기중대로내동정맥기형화해면상혈관류적현시솔균위100%,동맥류적현시솔위81%,혈관모세포류적현시솔위91%.②술중초성대로내동정맥기형환자공혈동맥급인류정맥적현시솔위71%.③술중초성여술중도항재해면상혈관류절제술전정위적준학솔차이무통계학의의(100%대95%,P=0.244).술중초성재해면상혈관류절제술중、술후정위적준학솔명현고우술중도항,차이유통계학의의(100%대74%,x2=19.513,P＜0.0001,100%대68%,x2=24.973,P＜0.0001).결론 술중초성대로내혈관성질병구유교고적현시솔,병가준학정위병변,지도수술,축단수술시간,감소손상,제고수술적정학성.
Objective To explore the significance of ultrasound in localization tumors and directing operation.Methods Intraoperative ultrasound findings in 204 patients with cerebral vascular disease were analyzed retrospectively.Feeding arteries and draining veins need to be distinguished from normal vessels in patients with arteriovenous malformation(AVM).The findings of cavernous of intraoperative neuronavigator and intraoperative ultrasound before,during and after the resection were respectively compared.Results ①98% cerebral vascular disease can be displayed by intraoperative ultrasound.All of the AVM and cavernous hemangiomas were localized accurately,while 81% of aneurysms and 91% hemangioblastomas were displayed.②Feeding arteries and draining veins and be detected in 71% of AVMs.③The localization accuracy of intraoperative ultrasound tended to be higher than superior intraoperative neuronavigator before resection,but the difference were not significant(100% vs 95%,P=0.244).The localization accuracy of during and after the resection were significantly different between them(100% vs 74%,x2=19.513,P＜0.0001;100% vs 68%,x2=24.973,P＜0.0001).Conclusions Intraoperative ultrasound can display and localize cerebral vascular disease,reduce injury,shorten operation time,and improve the accuracy of operation.