Shamov Todor, Eftimov Tihomir, Kaprelyan Ara, Enchev Yavor
Military Medical Academy, Department of Neurosurgery, Sofia, Bulgaria.
Turk Neurosurg. 2013;23(3):329-35. doi: 10.5137/1019-5149.JTN.6639-12.2.
The study aimed to examine the position of three-dimensional (3D) neurosonography and the advantages and disadvantages of ultrasound-based neuronavigation in spinal cord tumour surgery.
During the period July, 2007- February 2011, 28 patients with spinal cord tumours were operated in our neurosurgical clinic. All patients underwent intraoperative 3D neurosonography by means of SonoWandTM and SonoWand InviteTM ultrasound-based neuronavigation systems.
Intraoperative 3D neurosonography was used for 6 intramedullary tumours (5 ependymomas and 1 astrocytoma) and 22 extramedullary tumours (8 neurinomas, 10 meningiomas and 4 filum terminale ependymomas). During the performed spinal tumour surgery, snapshots of the 3D images of the surgical situation were obtained. Post-operative results, based on the control MRI findings and the patients' score on Karnofsky Performance Scale, were evaluated during the third month after the surgery.
Ultrasound-based neuronavigation is a promising tool in extramedullary tumour surgery, especially of meningiomas and neurinomas, ensuring better control on the extent of tumour excision. In patients with intramedullary tumours, however, the use of 3D neurosonography for more precise control on the extent of radical tumour excision is not possible. In general, ultrasound-based neuronavigation has not added much to the surgical management of spinal cord tumors.
本研究旨在探讨三维（3D）神经超声检查在脊髓肿瘤手术中的地位以及基于超声的神经导航的优缺点。
2007年7月至2011年2月期间，28例脊髓肿瘤患者在我们的神经外科门诊接受手术。所有患者均通过SonoWandTM和SonoWand InviteTM基于超声的神经导航系统进行术中3D神经超声检查。
术中3D神经超声检查用于6例髓内肿瘤（5例室管膜瘤和1例星形细胞瘤）和22例髓外肿瘤（8例神经鞘瘤、10例脑膜瘤和4例终丝室管膜瘤）。在进行脊髓肿瘤手术期间，获取了手术情况的3D图像快照。根据术后3个月的对照MRI检查结果和患者的卡氏功能状态评分评估术后结果。
基于超声的神经导航在髓外肿瘤手术中是一种有前景的工具，尤其是对于脑膜瘤和神经鞘瘤，可确保更好地控制肿瘤切除范围。然而，对于髓内肿瘤患者，使用3D神经超声检查无法更精确地控制肿瘤根治切除范围。总体而言，基于超声的神经导航在脊髓肿瘤的手术治疗中并未带来太多帮助。
