神经外科术中超声扫描七步法.ppt

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1、7StepsofNeurosurgeryUltrasoundScanningAlexFanAsiaclinicalapplication&KOLmanagerGeneraladvicePrevioussurgeryandradiotherapycancausedifficultiesusingultrasoundinthebrainorspine.Theboneopeningmustbelargeenoughtoaccommodatetheprobe.Goodacousticcontactrequirestheuseofsterileultrasoun

2、dgelorsalinebetweentheprobeandbrain/dura.Ifavailable,connectiontoBrainlabnavigationwillallowfasterandmoreintuitiveorientation.7stepsofNeurosurgeryUSScanningEnterpatientIDRecognizepatient’spositionSelectprobe&presetSetfrequencyIdentifyleftsideofprobeRecognizeultrasoundimagesThree

3、planesofbrainPatient’spositioniscrucialTypicalCT/MRscanIdealpositionforUSscanningSelectprobe&presetCraniotomyprobe:8862Burr-holeprobe:8863“Hockeystick”probe:8809SetfrequencyDefaultsettingis8MHz5MHz6.5MHz8MHz10MHzDeepPeripheralIdentifyleftsideofprobeRecognizeultrasoundimagesEchog

4、enicityHyper-echoicIso-echoicHypo-echoicHomogenicity/UniformityHomogenous/UniformHeterogenous/NonuniformShapeRegularIrregularBorderClear/SharpUnclearRecognizeultrasoundimagesEchogenicityHyper-echoicIso-echoicHypo-echoicRecognizeultrasoundimagesHomogenicity/UniformityHomogenous/U

5、niformHeterogenous/NonuniformRecognizeultrasoundimagesShapeRegularIrregularRecognizeultrasoundimagesBorderEchogenicityHomogenicityHypoechoicIsoechoicHyperechoicHomogenousHeterogenousWhitematerXXGreyMaterXXXVentricleXXSulciXXChoroidPlexusXXBrainstemXXNormalBrainGreymatterWhitemat

6、terSulciFalxNormalBrainGyrusSulciChoroidPlexusventricleThreeplanesofbrainHorizontalCoronalsaggitalThreeplanesofbrainMostcommonlyusedindailywork.Horizontallyputtheprobeonthesurfaceofbraintissueafterremovepartofskull,thenyoucanhavetypicalhorizontalplane.Differentimagesondifferentl

7、evels。HorizontalplaneAnteriorhorizontalplaneAnteriorlateralventricleTemporalwindowhorizontalplaneOccipitalhorizontalplaneLevelsofhorizontalplaneCortexlevelLateralventriclelevel4thventriclelevelBrainstemlevelCortexlevel1:CerebralFalx2:Sulci3:Gyrus112233Lateralventriclelevel11221、

8、CerebralFalx2、LateralVentricle4thventriclelevel