McGahan J P, Ellis W G, Budenz R W, Walter J P, Boggan J
Radiology. 1986 May;159(2):485-92. doi: 10.1148/radiology.159.2.3515424.
To determine the ability of ultrasound (US) to help characterize brain lesions and determine the best site for biopsy, intraoperative sonographic examination of nine intracerebral gliomas was performed and correlated with the preoperative computed tomographic (CT), gross intraoperative, and histopathologic findings. Real-time US provided a precise and rapid method for intraoperative localization of intracerebral neoplasms in all cases. While the sonographic appearance of gliomas is nonspecific, US added information on tumor characterization to that provided by CT. All gliomas were sonographically echogenic compared with surrounding brain. US permitted good characterization of the cystic components of tumors; portions of the operation therefore involved surgical drainage rather than resection. Autopsy specimens from five anaplastic cerebral gliomas were examined with US and found to be echogenic. The central portions of all five tumors were echogenic and corresponded to areas of tumor necrosis; thus they were poor sites for biopsy. Alternatively, the best site for biopsy was the inner portion of the echogenic margin of the mass, which usually represented areas of active tumor growth. The information obtained from both preoperative CT and intraoperative US is beneficial in characterizing lesions and predicting the best site for biopsy.
为确定超声（US）辅助鉴别脑病变及确定最佳活检部位的能力，对9例脑内胶质瘤进行了术中超声检查，并与术前计算机断层扫描（CT）、术中大体及组织病理学检查结果进行了对比。实时超声在所有病例中均为脑内肿瘤的术中定位提供了一种精确且快速的方法。虽然胶质瘤的超声表现不具有特异性，但超声为CT所提供的信息增添了有关肿瘤特征的内容。与周围脑组织相比，所有胶质瘤在超声检查中均表现为回声增强。超声能够很好地鉴别肿瘤的囊性成分；因此部分手术涉及的是外科引流而非切除。对5例间变性脑胶质瘤的尸检标本进行超声检查，发现均为回声增强。所有5例肿瘤的中央部分均为回声增强，且对应于肿瘤坏死区域；因此这些部位并非活检的理想部位。另外，活检的最佳部位是肿块回声边缘的内部，这通常代表肿瘤活跃生长的区域。术前CT及术中超声所获得的信息均有助于鉴别病变并预测最佳活检部位。
