Intraoperative Ultrasound Combined With Others Muti-modality In The Surgical Treatment Of Gliomas

Objective:deep brain glioma is adjacent to the important nerve nucleus, blood vessel and functional bundle.The prognosis of patients is closely related to the degree of tumor resection.The application of navigation improves the degree of resection of deep brain tumors.The existence of brain shift effect of the tumor resection, intraoperative imaging technology has helped to correct navigation of the shift, this paper compared intraoperative ultrasound and intraoperative magnetic resonance assisted surgery resection of brain deep tumor curative effect, and to explore intraoperative ultrasonography and intraoperative magnetic resonance imaging (MRI) to judge the value of the residual tumor.Methods:a total of 118 patients with deep brain tumors were screened from the General Hospital of PLA,Single factor analysis of patients with K-M analysis of survival curves and COX regression analysis, analyzing the different impact factors affecting survival and influence. Comparison of magnetic resonance, navigation group, experimental group (ultrasound combined with intraoperative navigation system) of deep brain tumor resection degree, operation time, postoperative fever, postoperative infection and functional status. In order to intraoperative magnetic resonance imaging studies as the gold standard, on magnetic resonance group (44 cases) intraoperative ultrasound signal is high slug residual cavity thickness for statistical diagnostic tests and preliminary study of intraoperative ultrasound signal is high residual cavity thickness for residual tumor decision rules.Results:age, gender, tumor location, clinical symptoms, preoperative KPS score and prognosis were of no statistical significance; surgery, pathologic grade of tumor and extent of resection is the influence factors of deep brain tumor; intraoperative ultrasound combined with navigation application can increase the tumor total resection degree; the application of ultrasound did not increase postoperative fever and infection; ultrasound did not increase the operation time. The survival rate of 1 year was 69.6% in high grade gliomas, survival rate of 2 yearwas 27.1%. the median survival time was 18 month The survival rate of 1 year of low grade gliomas was 88%, survival rate of 2 years was 74%, and the median progression free survival and median overall survival time were not yet reached.To preoperative planning as the standard, use of intraoperative magnetic resonance imaging as a means of verification, by intraoperative ultrasonic residual cavity under high signal residual cavity, the residual of tumor thickness diagnosis of ROC curve showed that optimum ultrasonic diagnosis of residual cavity thickness 2.8mm, the sensitivity was 79.3%, specificity was 52.9%,The accuracy of the diagnostic test medium:area under the curve 0.737, (95% confidence interval 0.583-0.890).Conclusion:intraoperative ultrasound combined navigation is safe and feasible for deep brain tumors. Intraoperative ultrasound combined with navigation in the application of deep brain tumors does not increase the complications of surgery. Intraoperative ultrasound combined with navigation in the application of deep brain tumors did not increase the operation time. The intraoperative ultrasound combined with intraoperative navigation can better correct the brain shift. The intraoperative ultrasound combined with intraoperative MRI can better correct the brain shift.By improving the technology of ultrasonic diagnosis, ultrasound is an effective examination and diagnosis of tumor residue.The value of intraoperative ultrasonography in the diagnosis of low grade gliomas may be higher than that of the high grade gliomas.Intraoperative ultrasound can be used in real time to understand the intraoperative resection, to correct the brain displacement, and the use of magnetic resonance in the operation, it can be better to complete the resection of glioma.