摘要
目的探讨术中常规超声与超声造影在判断肿瘤切除后术腔周围残留肿瘤中的临床应用价值。方法对38例脑胶质瘤患者于脑胶质瘤切除术中行常规超声及超声造影检查,实时观察脑肿瘤切除范围,判断肿瘤切除后术腔周围有无残留肿瘤。同时在术腔四壁及底部取脑组织行病理检查。将术中常规超声及超声造影诊断结果与术后病理诊断结果进行对照分析。结果术中常规超声及超声造影引导下对38例脑胶质瘤患者行手术切除并引导术者在术腔取组织标本205处,病理结果证实术腔及周围组织有肿瘤残留10例(10/38),无肿瘤残留28例(28/38)。与病理诊断结果对照,术中常规超声诊断术腔及周围组织有无肿瘤残留与病理诊断结果符合29例(76.3%,29/38),漏误诊9例,诊断符合率为76.3%(29/38);术中超声造影诊断术腔及周围组织有无肿瘤残留与病理诊断结果符合34例,漏误诊4例,诊断符合率为89.5%(34/38),高于术中常规超声,差异有统计学意义(χ2=0.835,P<0.01)。结论术中超声造影能有效地检出术腔及周围组织中的残留肿瘤,有助于提高脑胶质瘤手术全切率。
Objective To explore the value of conventional ultrasound and contrast-enhanced ultrasonography in intraoperative detection of residual gliomas.Methods Conventional ultrasonography and contrast-enhanced ultrasonography were performed in 38 patients with gliomas intraoperatively,and with real-time observation of tumor resection.The samples resected from the tumor-brain interface which were reported as tumor or normal tissue on intraoperative contrast-enhanced ultrasonography were submitted to pathology.The diagnosis were compared with pathological findings.Results Two hundred and five samples were taken from 38 gliomas cases who were operated with the guidance of intraoperative conventional ultrasonography and contrast-enhanced ultrasonography.Pathological findings showed complete tumor resection in 28 cases（28/38）and residual tumors in 10 cases（10/38）.There were 29 true and 9 false diagnosis by intraoperative conventional ultrasonography,coincidence rate between pathology and intraoperative conventional ultrasound diagnosis was 76.3%（29/38）.There were 34 true and 4 false diagnosis by intraoperative contrast-enhanced ultrasonography,coincidence rate between pathology and intraoperative contrast-enhanced ultrasound diagnosis was 89.5%（34/38）.Coincidence rate of intraoperative contrast-enhanced ultrasound diagnosis of residual tumor was higher than that of conventional ultrasound,with a statistically significant difference（χ2=0.835,P0.01）.Conclusion Intraoperative contrast-enhanced ultrasonography can detect the residual tumor effectively,which is beneficial for improving the precision of total resection.
出处
《中华医学超声杂志（电子版）》
2012年第1期31-33,共3页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
首都医学发展基金重点资助项目(2005-2025)
关键词
超声检查
造影剂
监测
手术中
脑胶质瘤
Ultrasonography Contrast media Monitoring intraoperative Cerebral glioma
