Romanian Neurosurgery (Nov 2024)
ULTRASOUND GUIDED MAXIMAL SAFE RESECTION OF MALIGNANT BRAIN TUMORS
Abstract
Introduction Intraoperative ultrasound (IOUS) is a non-invasive technique that is increasingly used in neurosurgery, especially in oncological pathology. The main advantage consists of offering a real time image and can help localize the lesion and guide the extent of resection. Material and Methods We describe our experience at Bagdasar-Arseni Clinical Emergency Hospital from a prospectively maintained database of malignant CNS tumors where IOUS was used over the past three years. Results Intraoperative ultrasound (IOUS) was routinely employed in the resection of brain tumors, proving helpful not only in localizing the lesion but also in determining the extent of resection. This was particularly useful for diffuse infiltrative lesions such as gliomas. Moreover, in patients with multiple metastases, where the neuronavigation system was limited due to brain shift following the resection of one lesion, IOUS was very efficient in determining the location. Conclusion Intraoperative ultrasound is a widely adopted technique in neurosurgery, aiding neurosurgeons achieve maximal safe resection of brain and spinal tumors. Its main advantages include quick, real-time image acquisition, compensation for brain shift, and integration with neuronavigation systems. The most significant limitation, however, is the relatively long learning curve associated with mastering the technique.
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