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床旁超声在截瘫孕妇手术中的应用:一个“不伤害”的案例

Point-of-care ultrasound (POCUS) in the surgery of a paraplegic pregnant female: A case of "do no harm".

作者信息

Mokbul Mobin Ibne, Biswas Shahnawas, Beniwal Shreya Singh, Sharma Srishti, Cummings Kareema Rebekah Sofia, Karim Robiul, Rana Md Sumon

机构信息

Dhaka Medical College Hospital, Dhaka, Bangladesh.

Department of Neurosurgery, BRB Hospital, Dhaka, Bangladesh.

出版信息

Radiol Case Rep. 2024 Jun 18;19(9):3782-3787. doi: 10.1016/j.radcr.2024.04.087. eCollection 2024 Sep.

Abstract

We present here a case of multidisciplinary management of a 20-year-old pregnant woman who presented with sudden paraplegia attributed to a large paraspinal tumor. Magnetic resonance imaging (MRI) revealed compressive dorsal myelopathy due to an extramedullary tumor. Given the urgency of her symptoms and pregnancy status, a multidisciplinary team decided to proceed with surgery while avoiding radiation exposure (eg, O/C-arm). Intraoperative point-of-care ultrasound (POCUS) was utilized for tumor localization and surgical guidance, facilitating successful gross total excision with minimal risk to the fetus. Postoperative recovery was uneventful, with improvement in muscle strength and preservation of the pregnancy. Beyond tumor localization, POCUS offers additional benefits in assessing maternal hemodynamics and detecting potential complications. This case highlights the utility of POCUS as a radiation-free theranostic imaging modality in pregnant patients with spinal tumors, enhancing safety in surgery and optimizing outcomes for both mother and fetus.

摘要

我们在此介绍一例20岁孕妇的多学科管理病例,该孕妇因巨大的椎旁肿瘤出现突发截瘫。磁共振成像(MRI)显示因髓外肿瘤导致压迫性脊髓病。鉴于其症状的紧迫性和妊娠状态,多学科团队决定在避免辐射暴露(如使用O型/C型臂)的情况下进行手术。术中使用床旁即时超声(POCUS)进行肿瘤定位和手术引导,以最小的胎儿风险成功实现肿瘤全切。术后恢复顺利,肌肉力量有所改善,且妊娠得以维持。除了肿瘤定位外,POCUS在评估孕妇血流动力学和检测潜在并发症方面还有其他益处。该病例突出了POCUS作为一种无辐射的诊疗成像方式在患有脊柱肿瘤的孕妇中的实用性,提高了手术安全性并优化了母婴结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2220/11238703/1bc3fd969bd2/gr1a.jpg

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