Department of Neurosurgery, Freiburg University Medical Center, Breisacherstrasse 64, Freiburg, Germany.
Neurosurgery. 2011 Jun;68(2 Suppl Operative):267-75; discussion 274-5. doi: 10.1227/NEU.0b013e3182124677.
Central nervous system (CNS) hemangioblastomas are a benign condition, which can be permanently cured by complete surgical removal. However, the vascular nature of these lesions and difficulties in localizing the tumors account for operative morbidity and recurrence. Power Doppler flow sonography has been proven useful during surgical removal of other vascular lesions.
To evaluate the usefulness of Power Doppler flow sonography for hemangioblastoma.
We used the SonoWand Invite (Sonowand AS, Trondheim, Norway) intraoperative navigation system in a consecutive series of hemangioblastomas operated on at our institution. Patients with von Hippel-Lindau (VHL) disease as well as sporadic hemangioblastomas were included.
The system was used on n = 64 consecutive hemangioblastomas operated on at our institution from 2007 to 2009. The tumors were localized in the cerebellum (n = 26), spinal cord (n = 27), brainstem (n = 10), and supratentorial (n = 1). In VHL disease was diagnosed 53 patients, and germline mutations of the VHL tumor suppressor gene were identified in 98%. Average tumor size was 1782 mm and 45% of the tumors were cystic. Forty-two of 64 tumors could be localized by grayscale sonography. All tumors were visible on power Doppler flow sonography. However, in 40 cases, only the pathological vessels and not the solid tumor itself enhanced on power Doppler. Postoperative MRI follow-up revealed remnant/recurrent tumors in 2 cases.
Power Doppler flow sonography is a sensitive intraoperative tool to guide the surgical approach and resection and provides reliable resection control in surgery of CNS hemangioblastoma.
中枢神经系统（CNS）血管母细胞瘤是一种良性疾病，可以通过完全手术切除来治愈。然而，这些病变的血管性质以及肿瘤定位的困难导致了手术的发病率和复发率。功率多普勒血流超声已被证明在其他血管病变的手术切除中有用。
评估功率多普勒血流超声对血管母细胞瘤的应用价值。
我们在我院连续系列手术切除的血管母细胞瘤中使用 SonoWand Invite（Sonowand AS，特隆赫姆，挪威）术中导航系统。纳入患有 von Hippel-Lindau（VHL）病和散发性血管母细胞瘤的患者。
该系统于 2007 年至 2009 年在我院用于 n = 64 例连续的血管母细胞瘤手术。肿瘤定位于小脑（n = 26）、脊髓（n = 27）、脑干（n = 10）和幕上（n = 1）。诊断出 53 例 VHL 病，98%的患者发现 VHL 肿瘤抑制基因突变。平均肿瘤大小为 1782mm，45%的肿瘤为囊性。42/64 个肿瘤可通过灰阶超声定位。所有肿瘤在功率多普勒血流超声上均可见。然而，在 40 例中，只有病理性血管而不是实体肿瘤本身在功率多普勒上增强。术后 MRI 随访显示 2 例残留/复发肿瘤。
功率多普勒血流超声是一种敏感的术中工具，可指导手术入路和切除，并为 CNS 血管母细胞瘤的手术提供可靠的切除控制。
