Caro-Osorio Enrique, Perez-Ruano Luis Alejandro, Figueroa Sanchez Jose Antonio
Neurosurgery, Tecnologico de Monterrey, Monterrey, MEX.
Cureus. 2024 Nov 20;16(11):e74101. doi: 10.7759/cureus.74101. eCollection 2024 Nov.
Objective Evaluate the utility of intraoperative ultrasound (IOUS) in brain and spinal tumor resections and the concordance of the extent of resection between IOUS and postoperative magnetic resonance imaging (MRI). Methods A retrospective analysis of prospectively collected data was performed. Thirty-nine lesions (36 patients) in the brain and spine were operated on for resection using IOUS between May 2020 and December 2022. All patients who underwent brain or spinal tumor resection were included, and who underwent IOUS during tumor resection and postoperative MRI was done within 48 hours of surgery. The Cohen's kappa coefficient was performed to the concordance of resection by IOUS and postoperative MRI. Results Forty-one patients underwent surgery, of which 36 met the inclusion criteria and five were excluded due to incomplete clinical records. Of the 36 patients included, two presented lesions in different locations, one with frontal and parietal metastases and the other with extradural and intradural spinal lesions, and one patient had a recurrence of glioblastoma, for which 39 procedures were included. Of the 36 patients, 36% were women, and the average age was 51.4 years with an age range of one year and two months to 94 years. The concordance of the degree of resection by ultrasound and the degree of resection by postoperative magnetic resonance is high. Conclusions The higher degree of concordance between IOUS and postoperative MRI would suggest that IOUS is a reliable tool for assessing the extent of tumor resection during surgery and provides real-time information to make decisions to adjust surgery plans based on the benefit/risk ratio.
目的 评估术中超声（IOUS）在脑和脊髓肿瘤切除术中的效用，以及IOUS与术后磁共振成像（MRI）之间切除范围的一致性。方法 对前瞻性收集的数据进行回顾性分析。2020年5月至2022年12月期间，对39个脑和脊柱病变（36例患者）进行了IOUS引导下的切除手术。纳入所有接受脑或脊髓肿瘤切除的患者，这些患者在肿瘤切除术中接受了IOUS检查，且术后MRI在手术48小时内完成。采用Cohen's kappa系数评估IOUS与术后MRI切除的一致性。结果 41例患者接受了手术，其中36例符合纳入标准，5例因临床记录不完整被排除。在纳入的36例患者中，2例病变位于不同部位，1例为额叶和顶叶转移瘤，另1例为硬膜外和硬膜内脊髓病变，1例患者为胶质母细胞瘤复发，共纳入39例手术。36例患者中，36%为女性，平均年龄51.4岁，年龄范围为1岁2个月至94岁。超声检查的切除程度与术后磁共振成像的切除程度一致性较高。结论 IOUS与术后MRI之间较高的一致性表明，IOUS是评估手术中肿瘤切除范围的可靠工具，并能提供实时信息，以便根据获益/风险比做出调整手术计划的决策。
