Application Of Intraoperative Ultrasound In Resection Of Glioma Located In Cerebral Functional Areas

Objective To explore the clinical value of intraoperative ultrasound(IOUS)in the removal of gliomas in functional areas of the brain,focusing on the analysis of the role of precise positioning and total resection rate of gliomas in functional areas,as well as the significance of neurological protection in patients.Methods Retrospective analysis.From December 2018 to June 2020,62 patients with glioma in the brain function area of the Department of Neurosurgery of the First Affiliated Hospital of Bengbu Medical College were enrolled,including 26 males and 36 females,aged 28-68 years;glioma WHO classification Ⅰ There were 13 cases of grade Ⅱ,22 cases of grade Ⅱ,21 cases of grade Ⅲ,and 6 cases of grade Ⅳ.All patients underwent tumor craniotomy and were divided into two groups according to whether or not ultrasound was used during the operation: 31 cases who used intraoperative ultrasound were included in the ultrasound group,and 31 cases who did not use intraoperative ultrasound were included in the traditional group.To compare and observe the clinical baseline data of the two groups of patients,the sonographic performance of IOUs on different grades of glioma,and the time taken to expose the tumor during the operation,the time taken for the operation,the degree of tumor resection,and the degree of brain edema on the 5th day after the operation.The Karnofsky score(KPS)evaluated the recovery of neurological function in the two groups at 3 months after surgery.Results There was no statistically significant difference between the two groups of patients in gender,age,tumor size,location,grade,the vertical distance from the tumor center to the dura mater(cm),the degree of brain edema and the neurological KPS score of the patients before the operation,and there were no statistically significant differences(P >0.05).The exposure time of the ultrasound group was(23.07±3.72)min shorter than the time of the traditional group(37.32±4.32)min.The degree of tumor resection was higher than that of the traditional group.The degree of brain edema on the 5th postoperative day was less than that of the traditional group.The 3-month KPS score(78.32±4.32)was higher than the traditional group’s 3-month KPS score(74.22±2.38),and the differences between the groups were statistically significant(P<0.05);in terms of operation time,the ultrasound group compared with(187.36±17.84)min and the traditional group(194.84±15.78)min,there was no statistically significant difference between the groups(P>0.05).IOUS has different sonograms of different grades of glioma.IOUS echo of low-grade glioma is higher than that of brain tissue,and the interior is slightly uniform,with regular edges,and strong echoes with calcification can be seen inside;high-grade glioma IUS has better echo than brain The tissue is high,the edges are blurred mixed echo shadows,and the internal non-uniform echo or non-echoic necrotic cystic area.Conclusion Intraoperative ultrasound is used in microsurgery for functional area glioma craniotomy.It has the advantages of accurate real-time positioning,which can increase the tumor total resection rate,reduce postoperative cerebral edema,protect and improve postoperative neurological function,and is worthy of clinical application.