脳動脈瘤手術における術中超音波検査の有用性について : 三次元超音波検査(3DCPA)とAdaptive Filter Imaging法(XRES)から(<特集>脳卒中の外科における合併症の予防と対策)  [in Japanese] Intraoperative Sonographic Findings with 3 Dimensional Color Power Angio (3DCPA) and Adaptive Filter Imaging Method(XRES)(<Topics>Intraoperative Management to Avoid the Complications)  [in Japanese]

US (Ultrasound) has become the most valuable intraoperative navigation and monitoring method. It has wide applications: monitoring blood flow, 3-dimensional angiography, tissue perfusion study by contrast sonographic imaging with PIHI, analysis of time intensity curves by (HDI lab software) and examination of their parameters. US is also simple, repeatable and harmless. We studied the use of US as an intraoperative monitoring method on 64 patients with aneurysm. The US instrument was an HDI 5000. The linear probe was an L12-5 broad-banded type and the sector probes were a P7-4 and P4-2, respectively. The patients were examined with conventional B-mode, 3-dimensional color power angio (3DCPA) and tissue perfusion was studied by contrast sonographic imaging with PIHI. The 3DCPA images are more effective than conventional continuous Doppler method to evaluate vascular components after aneurysmal clipping and can clearly detect vascular structures and the differences of their theories. Perfusion examination can confirm brain tumor, venous infarction and brain damage and can detect hemorrhage at the early stage before CT and MRI diagnosis. Hereinafter, parameters of their TIC can evaluate the functional images objectively in what is called parametric imaging. The clinical application of US is becoming increasingly common.