Lunardi P, Acqui M
Department of Neurological Sciences, University of Rome La Sapienza, Italy.
Acta Neurochir (Wien). 1993;123(3-4):113-7. doi: 10.1007/BF01401865.
Twenty cavernous angiomas were surgically removed after being localised by intra-operative echography. 10 patients were males and 10 females, with an average age of 34 years. Four patients had had intracerebral haemorrhage; all the remaining patients presented with headaches or seizures. The size of the lesion ranged from a minimum of 2.5 to a maximum of 4.0 cm. Its localisation was subcortical in 14 cases, paraventricular in 4 and in another 2 originated from the floor of the IV ventricle. Echography showed a blackberry-like cavernous angioma, hyperechogenous with respect to the surrounding parenchyma; the lesion was well-defined in all cases due to the absence of perilesional oedema with a clear demarcation from healthy tissue. After operation, pre-operative cranial nerve deficits (brought on by haemorrhage) only persisted in the two cases where the cavernoma involved the floor of the IV ventricle. In all cases post-operative radiological investigation recorded the complete removal of the cavernous angioma, the diagnosis of which was invariably confirmed by histological analysis. The authors draw the conclusion that intra-operative echography is capable of localising cavernous angiomas, providing the surgeon with real-time guidance during microsurgical removal. It is also useful for establishing as to whether complete removal has been accomplished.
20例海绵状血管瘤在术中超声定位后接受了手术切除。患者中男性10例，女性10例，平均年龄34岁。4例曾发生脑出血；其余所有患者均表现为头痛或癫痫发作。病变大小范围为最小2.5 cm至最大4.0 cm。其位置在14例位于皮质下，4例位于脑室旁，另外2例起源于第四脑室底部。超声显示为黑莓样海绵状血管瘤，相对于周围实质呈高回声；由于病灶周围无水肿，与健康组织界限清晰，所有病例中的病变均边界清楚。术后，术前因出血导致的脑神经功能缺损仅在海绵状血管瘤累及第四脑室底部的2例中持续存在。在所有病例中，术后影像学检查记录显示海绵状血管瘤已完全切除，其诊断均经组织学分析得以证实。作者得出结论，术中超声能够定位海绵状血管瘤，在显微手术切除过程中为外科医生提供实时指导。它对于确定是否已实现完全切除也很有用。
