2003 年 16 巻 2 号 p. 78-82
Object. We intended to evaluate the usefulness of intraoperative ultrasound imaging for assistance during neurosurgical operations.
Methods. Thirty-four consecutive patients (19 with brain tumor, 9 with subarachnoid hemorrhage, 4 with intracerebral hemorrhage, 2 with hydrocephalus) underwent neurosurgical operations with the assistance of intraoperative ultrasound imaging. A total of 46 operations (removal of tumor in 18 patients, biopsy in one, removal of intracerebral hematoma in 4, ventricular drainage in 16, and ventriculo-peritoneal (VP) shunt in 7) were performed. Two different types of ultrasound machines (General Electric, RT4600 and LOGIQ 500) were used in this series, and their probes were the sector (3.3 and 3.5 MHz) linear (6.7 MHz), and pencil (5 MHz) types.
Results. Ventricular drainage and placement of the ventricular tube were easily accomplished under real-time visualization of the ventricles by B-mode imaging. Tumors were clearly demonstrated over the dura mater and then the shortest approach to the tumor could be determined. Arteries and veins around the tumors were detected by color Doppler imaging. Intracerebral hematoma was easily detected and the appropriate site for evacuation could be determined.
Conclusion. Intraoperative ultrasound imaging can contribute to the safety and precision of ventricular drainage and VP shunt, and removal of brain tumor and intracerebral hemorrhage.