Moiyadi Aliasgar V, Shetty Prakash, Degaonkar Amol
Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
J Pediatr Neurosci. 2017 Jan-Mar;12(1):19-23. doi: 10.4103/jpn.JPN_141_16.
Extent of resection is a very important prognostic marker in most pediatric brain tumors. Intraoperative imaging facilitates resection control. Intraoperative ultrasound (IOUS) is a cost-effective alternative to intraoperative magnetic resonance, but scant literature addresses its utility in this context.
We retrospectively reviewed all pediatric brain tumors operated at our center using navigated three-dimensional ultrasound (US). The utility of the US in resection control was recorded and extent of resection evaluated.
IOUS was used in 20 cases (3 for frameless biopsy and 17 for tumor resection control). It was 100% accurate in localizing all tumors and yielded 100% diagnosis in the biopsy cases. Technical limitations precluded its use in 2 of the 17 cases of tumor resection. In the remaining 15, it correctly predicted the residual tumor status in 13 cases (87%). A gross total resection was achieved overall in 12 cases (80%) with postoperative morbidity in only one case.
IOUS is a useful tool to localize intracranial tumors and guide the resection reliably. Widespread use can improve its applicability and make it an effective intraoperative imaging tool in pediatric brain tumors.
在大多数小儿脑肿瘤中，切除范围是一个非常重要的预后指标。术中成像有助于控制切除范围。术中超声（IOUS）是术中磁共振成像的一种经济有效的替代方法，但在这方面的应用文献较少。
我们回顾性分析了在我们中心使用导航三维超声（US）进行手术的所有小儿脑肿瘤病例。记录超声在控制切除范围方面的应用情况，并评估切除范围。
IOUS用于20例（3例用于无框架活检，17例用于肿瘤切除控制）。在定位所有肿瘤方面准确率为100%，在活检病例中诊断率为100%。技术限制导致在17例肿瘤切除病例中有2例无法使用。在其余15例中，它正确预测了13例（87%）的残留肿瘤状态。总体上12例（80%）实现了全切，仅1例有术后并发症。
IOUS是定位颅内肿瘤并可靠指导切除的有用工具。广泛应用可提高其适用性，使其成为小儿脑肿瘤有效的术中成像工具。
