Becker G, Perez J, Krone A, Demuth K, Lindner A, Hofmann E, Winkler J, Bogdahn U
Neurologische Universitätskliniken, Julius-Maximilians-Universität Würzburg, Germany.
Neurosurgery. 1992 Sep;31(3):420-8. doi: 10.1227/00006123-199209000-00006.
Transcranial color-coded real-time sonography (TCCS) was performed in 57 patients with primary intracranial brain tumors (n = 49) or arteriovenous malformations (n = 8) to evaluate its diagnostic potential. In 46 patients (81%), lesions could be identified employing this technique. In 7 patients, transcranial ultrasound examination was not feasible because of bone thickness; in the remaining 4 patients, the tumor was indistinguishable from adjacent brain tissue despite sufficient insonation, suggesting that these neoplasms are isoechogenic. The sonographic features of brain tumors were very similar: a hyperechogenic matrix of the lesion was interspersed by hypoechogenic pixels. Larger hypoechogenic areas (0.5-1 cm) gave evidence of tumor necrosis. Differences between the findings of TCCS and computed tomography concerning tumor size were found in 7 patients, in whom TCCS revealed an area of smaller extension within the corresponding hypodense area on the computed tomographic scan. Perifocal brain edema could not be detected by ultrasound examination. In 13 patients, a thin, hypoechogenic peritumoral halo was disclosed that did not correlate with perifocal brain edema identified by computed tomography and that may have been due to compression of adjacent parenchyma. In patients with arteriovenous malformations, TCCS permitted the identification of the main feeders, the nidus, and the draining venous system by color-coded depiction of intravascular blood flow. In conclusion, TCCS is an additional method for initial diagnosis and highly suitable for follow-up in tumor patients and provides valuable information about tissue characteristics and blood flow.
对57例原发性颅内脑肿瘤患者（n = 49）或动静脉畸形患者（n = 8）进行经颅彩色编码实时超声检查（TCCS），以评估其诊断潜力。46例患者（81%）采用该技术可识别病变。7例患者因骨厚度原因无法进行经颅超声检查；其余4例患者，尽管进行了充分的超声探测，但肿瘤与相邻脑组织难以区分，提示这些肿瘤为等回声。脑肿瘤的超声特征非常相似：病变的高回声基质中散布着低回声像素。较大的低回声区域（0.5 - 1厘米）提示肿瘤坏死。7例患者的TCCS与计算机断层扫描在肿瘤大小的检查结果上存在差异，TCCS显示在计算机断层扫描相应的低密度区域内有较小范围的病变。超声检查无法检测到瘤周脑水肿。13例患者中，发现了一个薄的、低回声的瘤周晕，其与计算机断层扫描确定的瘤周脑水肿无关，可能是由于相邻实质受压所致。对于动静脉畸形患者，TCCS可通过对血管内血流进行彩色编码描绘来识别主要供血动脉、畸形血管团和引流静脉系统。总之，TCCS是一种用于初步诊断的辅助方法，非常适合肿瘤患者的随访，并能提供有关组织特征和血流的有价值信息。
