Department of Neurosurgery, Cancer Hospital of China Medical University, Shenyang 110042, China.
Department of Anesthesia, Cancer Hospital of China Medical University, Shenyang 110042, China.
Biomed Res Int. 2021 Apr 16;2021:6651726. doi: 10.1155/2021/6651726. eCollection 2021.
Gliomas are the most invasive and fatal primary malignancy of the central nervous system that have poor prognosis, with maximal safe resection representing the gold standard for surgical treatment. To achieve gross total resection (GTR), neurosurgery relies heavily on generating continuous, real-time, intraoperative glioma descriptions based on image guidance. Given the limitations of currently available equipment, developing a real-time image-guided resection technique that provides reliable functional and anatomical information during intraoperative settings is imperative. Nowadays, the application of intraoperative ultrasound (IOUS) has been shown to improve resection rates and maximize brain function preservation. IOUS, which presents an attractive option due to its low cost, minimal operational flow interruptions, and lack of radiation exposure, is able to provide real-time localization and accurate tumor size and shape descriptions while helping distinguish residual tumors and addressing brain shift. Moreover, the application of new advancements in ultrasound technology, such as contrast-enhanced ultrasound, three-dimensional ultrasound, navigable ultrasound, ultrasound elastography, and functional ultrasound, could help to achieve GTR during glioma surgery. The current review describes current advancements in ultrasound technology and evaluates the role and limitation of IOUS in glioma surgery.
神经胶质瘤是中枢神经系统中最具侵袭性和致命性的原发性恶性肿瘤，预后不良，最大限度地安全切除是手术治疗的金标准。为了实现全切除（GTR），神经外科手术严重依赖于在图像引导下生成连续、实时的术中神经胶质瘤描述。鉴于目前可用设备的局限性，开发一种能够在术中环境中提供可靠功能和解剖信息的实时图像引导切除技术至关重要。如今，术中超声（IOUS）的应用已被证明可以提高切除率并最大限度地保留脑功能。IOUS 由于其成本低、手术流程中断少且无辐射暴露，因此成为一种有吸引力的选择，能够实时定位并准确描述肿瘤的大小和形状，帮助区分残留肿瘤并解决脑移位问题。此外，超声技术的新进展，如对比增强超声、三维超声、导航超声、超声弹性成像和功能超声的应用，有助于在神经胶质瘤手术中实现 GTR。本综述描述了超声技术的最新进展，并评估了 IOUS 在神经胶质瘤手术中的作用和局限性。
