The Application Value Of Contrast Enhanced Ultrasound In Intracranial Tumor Resection

Intracranial tumors are the most common diseases in nervous system, withgreat harm to nervous system function of human beings. Operative resection ofthe tumor is the main treatment method to the disease. The basic principle ofoperative resection is to protect the preservation of nerve function under themaximum resection of tumor. The application of intra-operative ultrasound inintracranial tumor resection contributes to lesion location and boundary,increase the resection rate, reduce the postoperative recurrence of tumor. Butthe conventional ultrasound has obvious limitations in the contrast of the imageon the inadequacy in its clinical application. Contrast enhanced ultrasound canuse the perfusion differences between lesion tissue and normal tissue toincrease the image contrast, in order to provide more accurate and clear images,which helping the surgeon to determine tumor boundary more accurately, tounderstand the blood perfusion of tumor, to improve the accuracy of diagnosisand operation resection rate.Objective:To discuss the application value of contrast enhancedultrasound in Intracranial tumor resection．Method:21patients in our hospital from2011June to2012who weredoubted intracranial tumor by computed tomography(CT) or magneticresonance(MR) were involved in the study. They are all through microscopeneurosurgical operation to resect the tumor. The application of intra-operativeultrasound scanning to display of neoplastic lesions, observe the position,morphology, boundary, internal conditions, the surrounding brain tissue edema,measure the lesion size and the distance of the lesions to the brain surface.Color Doppler mode showed the tumor and their surrounding important vesselsadjacent relations. Spectral Doppler displays the hemodynamic. Observing the tumor perfusion and enhanced features after the injection of a contrast agent,further identification of the boundary. After resection of the tumor undergoingcontrast enhanced ultrasound, observing the residual cavity enhanced case,judging the extent of resection operation. Postoperative combined withpathological diagnosis, comparative analysis of the different nature of thetumor by ultrasound imaging features.Results:All lesions were good display under Intra-operative ultrasoundguidance, precise positioning. The process of operation become more smoothlywithout complication. Total tumor resection in15cases, subtotal resection in6cases. Different tumor has different ultrasound performance in lesionmorphology, boundary, internal echo, peripheral edema, internal flow and otheraspects. Normal brain tissue was consistently low enhancement, and all tumorsafter injection of a contrast agent appear different level enhancement. Thetumor boundary is clearer. Different tumor has different intensifying time,intensity, and distribution. Tumor resection again after ultrasound contrast toaccurately determine the tumor residual, improve tumor resection rate.Conclusion:1. Through the enhancement of tumor tissue echogenicity, intra-operativecontrast-enhanced ultrasound can make the operation of intracranial tumor inaccurate positioning. Compared with conventional ultrasound, ultrasoundcontrast imaging display the tumor internal vascular structures and closerelationship between vascular more clearly, thereby determine tumor boundarymore accurately.2. According to the focal image enhancement features, intra-operativecontrast-enhanced ultrasound can analysis the tumor perfusion, contribute tothe judgement of tumor pathological grade, improve the differential diagnosisof malignant and benign tumors, guide the operation excision.3. According to the tumor residual cavity locally with or without contrast agent perfusion aggrandizement, intra-operative contrast-enhanced ultrasoundcan help determine whether there is residual tumor. Compared with theconventional ultrasound, it has more application value to guide the operation ofthe greatest degree of resection of the tumor, to reduce the postoperativerecurrence of tumor opportunity.