Application Of Intraoperative Real-time Ultrasound During Neuronavigation In Resection Of Iintracranial Deep Lesions

Objective To evaluate the intraoperative real-time ultrasound during neuronavigation system for resection of intracranial deep lesions. Summarized the experience that we employed the intraoperative real-time ultrasound solved the brain shift and instructed resection of intracranial deep lesions.Methods 15 cases with intracranial deep lesions were surgically treated with guidance of Brain-Lab neuronavigation. Totel cases included 11 male and 4 female,age 12-65 yeas old. Neuronavigation-MRI were three-dimensionally reconstructed, and lesions were outlined to design surgical planning preoperatively. We registrated the patients by the way of Softtouch during intraoperative. The position will be shown in the form of virtual probe at the same time by using tracking equipment, the three-dimensional position, important nerve and the vessel structure can also be shown exactly. According to the position, the size ,the nature and the adjacent structural of lesions, we designed removal range and the skin margin. The principle of the surgery was avoids the important nerve and the vessel structure. We was acquired the datasets of real-time ultrasound after craniotomy. Tumor as well as tumor remnants and normal brain structures can be visualized during a surgical.. Intraoperative real-time ultrasound discovered tumor remnants and assisted resection. Intraoperative real-time ultrasound was beneficial for aiding the detection of brain shift and correction.Results The lesion and it′s surrounding structure were located accurately. Through intraoperative real-time ultrasound we discovered the varying degree brian shift and corrected the shift by aiding of ultrasound. The length of the scalp incision and the size of bone flap were both smaller than those of the ordinary syrgery. In 15 cases of lesionectomy operations, total lesion resmovel was achieved in 10 cases, subtotal resmovel in 4 cases, inflammatory lesion was confirmed chronic granuloma through inspection of living tissue.Total cases′neurological symptoms improved in postoperative.Conclusion Intraoperative real-time ultrasound during neuronavigation system can provide a accurate localization for intracranial deep lesions operation, and help to design surgical approach well. A combination of preoperative MRI with intraoperative real-time ultrasound may enhance the convenience of neuronavigation by adding intraoperative information. Intraoperative imaging is beneficial for intraoperative orientation, reducing the extent of craniotomy, aiding the detection of brain shift and for resection control, avoiding the important nerve and the vessel structure. Intraoperative real-time ultrasound is accurate, safe, mini-invasive and reliable.The application of this technique can dramatically improve surgical effect and decrease surgical complication.