Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2024 Apr;44(2):399-405. doi: 10.1007/s11596-024-2840-z. Epub 2024 Apr 18.
Complete resection of malignant gliomas is often challenging. Our previous study indicated that intraoperative contrast-enhanced ultrasound (ICEUS) could aid in the detection of residual tumor remnants and the total removal of brain lesions. This study aimed to investigate the survival rates of patients undergoing resection with or without the use of ICEUS and to assess the impact of ICEUS on the prognosis of patients with malignant glioma.
A total of 64 patients diagnosed with malignant glioma (WHO grade HI and IV) who underwent surgery between 2012 and 2018 were included. Among them, 29 patients received ICEUS. The effects of ICEUS on overall survival (OS) and progression-free survival (PFS) of patients were evaluated. A quantitative analysis was performed to compare ICEUS parameters between gliomas and the surrounding tissues.
The ICEUS group showed better survival rates both in OS and PFS than the control group. The univariate analysis revealed that age, pathology and ICEUS were significant prognostic factors for PFS, with only age being a significant prognostic factor for OS. In multivariate analysis, age and ICEUS were significant prognostic factors for both OS and PFS. The quantitative analysis showed that the intensity and transit time of microbubbles reaching the tumors were significantly different from those of microbubbles reaching the surrounding tissue.
ICEUS facilitates the identification of residual tumors. Age and ICEUS are prognostic factors for malignant glioma surgery, and use of ICEUS offers a better prognosis for patients with malignant glioma.
恶性脑胶质瘤的完全切除常常具有挑战性。我们之前的研究表明，术中对比增强超声（ICEUS）有助于检测残余肿瘤残留和脑病变的完全切除。本研究旨在探讨接受切除手术的患者是否使用 ICEUS 及其对恶性脑胶质瘤患者预后的影响。
纳入 2012 年至 2018 年间接受手术治疗的 64 例恶性脑胶质瘤（WHO 分级 HI 和 IV）患者。其中 29 例患者接受了 ICEUS。评估 ICEUS 对患者总生存率（OS）和无进展生存率（PFS）的影响。进行定量分析以比较 ICEUS 参数在脑肿瘤和周围组织之间的差异。
ICEUS 组的 OS 和 PFS 生存率均优于对照组。单因素分析显示，年龄、病理和 ICEUS 是 PFS 的显著预后因素，只有年龄是 OS 的显著预后因素。多因素分析显示，年龄和 ICEUS 是 OS 和 PFS 的显著预后因素。定量分析显示，到达肿瘤的微泡强度和达峰时间与到达周围组织的微泡明显不同。
ICEUS 有助于识别残留肿瘤。年龄和 ICEUS 是恶性脑胶质瘤手术的预后因素，ICEUS 的应用可为恶性脑胶质瘤患者带来更好的预后。
