脳神経外科手術における術中超音波画像診断の有用性 [in Japanese] Usefulness of Intraoperative Ultrasound in Neurosurgery [in Japanese]
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Despite its advantages, ultrasound imaging is not widely used in neurosurgery. We present our experience with intraoperative ultrasound (IOUS), focusing on its usefulness and pitfalls. Cases: Between October 2003 and September 2004, we used IOUS in 40 patients; 21 underwent ventriculostomy, 9 aspiration of intracerebral hemorrhage, 5 brain tumor surgery, 2 aspiration of brain abscess, 1 aspiration of acute subdural hematoma, and 2 anterior fusion for cervical spondylosis. Results: IOUS facilitated appropriate placement of the ventricular drainage tube. It was particularly useful in patients undergoing ventriculostomy for subarachnoid hemorrhage where the lateral ventricle was not enlarged. In patients with intracerebral or acute subdural hematoma, IOUS facilitated visual monitoring of the aspiration procedure and we were able to remove a sufficient amount of the hematoma. In tumor removal procedures, IOUS helped to determine the location of the tumor and to identify residual tumor tissue. We were able to center the drainage tube in the tumor cyst or brain abscess. In anterior fusion for cervical spondylosis, IOUS was helpful for confirming decompression of the nerve root. Discussion: Although IOUS has some pitfalls, it is a convenient, less expensive method of real-time monitoring and is useful in neurosurgery.
Neurosonalogy 18(2), 63-68, 2005-12-30
The Japan Academy of Neurosonology