Isu T, Iwasaki Y, Imamura H, Akino M, Abe H
Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan.
No Shinkei Geka. 1987 Sep;15(9):947-54.
Recently, operative results of intramedullary spinal cord tumors have been greatly improved since the introduction of microsurgery. It is very important to know the precise size and location of the tumor prior to the operation so that we can approach the tumor with a minimum of damage to the spinal cord. However, it is not always possible to demonstrate the precise localization of the tumor preoperatively. In this report, we emphasize that intraoperative spinal sonography is very useful in determining the extent of the tumor and differentiating solid component from cystic component of the tumor. Methods and Materials We performed intraoperative spinal sonography on ten patients with intramedullary spinal cord tumor. This series included three cases of hemangioblastoma, three cases of astrocytoma, two cases of ependymoma, one case of subependymoma, and one case of mixed glioma. Eight out of ten cases were associated with cysts. The intraoperative spinal sonographic examinations were performed after laminectomy. The linear scanning probe of 5 or 7.5 MHz transducer was used. Results 1) Solid components The acoustic pattern of the solid tumor was either hyperechoic or iso-echoic. Six cases (three hemangioblastomas, two ependymomas, and one astrocytoma) were hyperechoic. Other four cases (two astrocytomas, one subependymoma, and one mixed glioma) were iso-echoic. 2) Cystic components The cysts associated with the tumor were anechoic in six out of eight cases, which were confirmed at surgery, and multiple cysts were identified.(ABSTRACT TRUNCATED AT 250 WORDS)
近年来,自从显微外科技术应用以来,脊髓髓内肿瘤的手术效果有了显著改善。术前了解肿瘤的确切大小和位置非常重要,这样我们在手术时就能以对脊髓最小的损伤来接近肿瘤。然而,术前并非总能精确显示肿瘤的定位。在本报告中,我们强调术中脊髓超声在确定肿瘤范围以及区分肿瘤实性成分和囊性成分方面非常有用。方法与材料 我们对10例脊髓髓内肿瘤患者进行了术中脊髓超声检查。该系列包括3例血管母细胞瘤、3例星形细胞瘤、2例室管膜瘤、1例室管膜下瘤和1例混合性胶质瘤。10例中有8例伴有囊肿。术中脊髓超声检查在椎板切除术后进行。使用5或7.5MHz换能器的线阵扫描探头。结果 1)实性成分 实性肿瘤的声学模式为高回声或等回声。6例(3例血管母细胞瘤、2例室管膜瘤和1例星形细胞瘤)为高回声。其他4例(2例星形细胞瘤、1例室管膜下瘤和1例混合性胶质瘤)为等回声。2)囊性成分 8例中有6例与肿瘤相关的囊肿为无回声,手术中得到证实,且发现了多个囊肿。(摘要截断于250字)