Abstract: Objective To assess diagnostic performance of the intraoperative ultrasonography in neuro-oncology practice based on the clinical features of patients with deep-seated brain tumors.Methods A retrospective review of 24 patients who were treated for deeply seated brain tumors has been performed.Among these cases,13 patients underwent tumor resection via dissection of the non-eloquent cortex or trans-sulcal approach depending on the intraoperative ultrasonic findings (ultrasound-guided group),while 11 patients experienced trans-sulcal approach without intraoperative ultrasonography (control group).Data regarding clinical findings and technical considerations were analyzed.Results No statistically significant difference was observed in the age,tumor diameter,depth of the lesions,and preoperative Karnofsky Performance Scale (KPS) of these 2 groups.However,shorter exposure time,less microscopic or endoscopic procedure time,reduced duration of hospitalization,a fewer extent of focal encephalomalacia,and higherKPS 3 months after surgery were all achieved statistical significance in patients in the ultrasound-guided group when compared with the control group (P＜0.05).Moreover,the ultrasound-guided surgery provided higher rate of gross total resection,fewer complications,and less degree of postoperative brain edema.Conclusion Intraoperative ultrasonography can accurately identify deeply seated brain tumors,andmay compensate for craniotomy-induced brain-shift.Shortening operation duration,complete tumor resection with minimal invasion,and improved recovery time can be obtained via the ultrasonic-guided surgery,resulting insurvival benefits.

Key words: Intraoperative ultrasonography, Deep-seated brain tumors, Surgical approach

摘要： 目的 总结分析术中超声引导下脑深部肿瘤切除的临床经验,以期提高手术疗效,改善疾病预后。方法 回顾24例接受手术治疗的脑深部肿瘤患者临床资料,术中应用超声引导13例(超声组),未使用超声11例(对照组)。个体化选择经非功能区皮层和经脑沟入路显露并切除肿瘤,分析比较两组病例围手术期各项指标。结果 两组患者在年龄、肿瘤大小、病灶深度、术前功能状态评分上均无统计学差异。超声组在显露肿瘤时间、镜下操作时长、术后住院时长、术后三月脑软化灶体积、术后三月患者功能状态评分上均显著优于对照组(P<0.05),且肿瘤全切率较高,术后并发症发生率和术后脑水肿程度较低。结论 术中超声可精准定位脑深部肿瘤,有效弥补了神经导航的不足。超声引导下个体化手术入路有利于节省手术时间、全切肿瘤、保护神经功能、促进康复、改善疾病预后。

关键词: 术中超声, 脑深部肿瘤, 手术入路