Application Of Intraoperative Contrast-enhanced Ultrasound In Glioma Resection

Objctive:To explore the application of intra-operative contrast-enhanced ultrasonography in cerebral gliomas resection. Methods:66patients who were doubted cerebral gliomas by CT or MRI (Eventually61casea confirmed) were in informed of advantages and risks about contrast-enhanced ultrasound and all the participants in the program were voluntary.The patients were divided into intra-operative contrast-enhanced ultrasound group (experimental group) and conventional ultrasound group(control group). All the cases with glioma underwent microsurery, who were examined by conventional ultrasound during operation. And31cases conducted intra-operative contrast-enhanced ultrasound. All the patients accepted MRI and performed comparisons about retention rate and recurrence rate according to the grade of gliomas. The value of intra-operative contrast-enhanced ultrasound in glioma resection could be explored. Results:(1)The boundary, shape and necrosis of low grade glioma (LGG) and high grade glioma (HGG) in two-dimensional ultrasound had statistical significance (P<0.05). The peripheral cerebral edema of LGG and HGG in two-dimensional ultrasound had no statistical significance (P>0.05);on the contrary, there was statistically significant difference between of them in contrast-enhanced ultrasound (P>0.05). Time to peak (TTP) of HGG were shorter than LGG,two groups had statistical significance (P<0.05).(2)The boundary, shape and necrosis of low grade glioma (LGG) and high grade glioma (HGG) in two-dimensional ultrasound had statistical significance (P<0.05). The peripheral cerebral edema of LGG and HGG in two-dimensional ultrasound had no statistical significance (P>0.05);on the contrary, there was statistically significant difference between of them in contrast-enhanced ultrasound (P>0.05). Time to peak (TTP) of HGG were shorter than LGG,two groups had statistical significance (P<0.05). Conclusion:(1)Intra-operative conventional ultrasound can identify the location of tumors exactly. When intra-operative conventional ultrasound combined with contrast-enhanced ultrasound, different grade gliomas had different ultrasonogram, so they can provide preliminary judgment during the process of operations.(2)Intraoperative contrast-enhanced ultrasound can clearly show the border of gliomas and accurately judgment postoperative residual, especially for high grade gliomas; it can reduce tumor residue and recurrence rate and significantly improve the treatment effect. Intra-operative contrast-enhanced ultrasound compared with the conventional ultrasound in glioma surgery has great superiority and application value.