术中超声造影评价脑胶质瘤病理分级及瘤周水肿.pdf

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1、术中超声造影评价脑胶质瘤病理分级及瘤周水肿贺焱何文杜丽娟黄文燕于书卿王集生李慧展[摘要]目的探讨术中超声造影技术在评价脑胶质瘤病理分级及区分肿瘤、瘤周水肿脑组织与正常脑组织范围中的价值。方法对80例脑胶质瘤患者的术中超声造影图像进行回顾性分析，观察肿瘤、瘤周水肿脑组织与正常脑组织的强化情况，定量分析不同部位造影参数。结果正常脑组织呈等增强，高级别胶质瘤瘤体组织与瘤周水肿脑组织呈高增强，瘤体组织增强强度高于瘤周水肿脑组织；低级别胶质瘤瘤体组织呈高增强，但瘤周水肿脑组织增强强度与正常脑组织相近。瘤体组织的绝对峰值强度高于瘤周水肿脑组织与正常脑组织，组间比较差异有统计学意义(P＜0.

2、05)；高级别胶质瘤瘤体组织的造影达峰时间早于瘤周水肿脑组织与正常脑组织，组间比较差异有统计学意义(P＜0.05)；低级别胶质瘤瘤体组织造影达峰时间与瘤周水肿脑组织和正常脑组织比较，差异无统计学意义(P＞0.05)。结论术中超声造影技术有助于切除肿瘤前判断胶质瘤病理级别及确定瘤周水肿脑组织的边界，有效指导临床手术。超声检查；微气泡；神经胶质瘤Intraoperativecontrast-enhancedultrasonicimagingintheevaluationofpathologicgradesofcerebralgliomasandperitumoralcerebral

3、edemaHEYanHEWenDULi-juanHUANGWen-yanYUShu-qingWANGJi-shengLIHui-zhanDepartmentofUltrasound,BeijingTiantanHospital,CapitalUniversityofMedicalSciences,Beijing100050,China[Abstract]ObjectiveToexplorethevalueofintraoperativecontrast-enhancedultrasonographyindistinguishinggliomas,peritumorouscere

4、braledemaandperipheralnormalcerebraltissues,andgradingcerebralgliomas.MethodsIntraoperativecontrast-enhancedultrasonicimagingin80patientsdiagnosedcerebralgliomaswerestudiedretrospectively.Thebloodperfusionpatternsofgliomas,peritumorouscerebraledemaandperipheralnormalcerebraltissueswereobserv

5、edcloselyaftercontrastandparameterswererecorded.ResultsAftercontrast-enhancedultrasound,peripheralnormalcerebraltissuesshowedhomogeneousenhancement,thetumortissuesandperitumorouscerebraledemaofhigh-gradegliomas(HGG)showedhighenhancement,butperitumorouscerebraledemaoflow-gradegliomas(LGG)show

6、ednearlyhomogeneousenhancement.Absolutepeakintensity(API)ofthetumortissueswerehigherthanthoseofperipheralnormalcerebraltissuesandperitumorouscerebraledema(P＜0.05).Timetopeak(TTP)ofthetumortissuesinHGGwereshorterthanthoseofperipheralnormalcerebraltissuesandperitumorouscerebraledema(P＜0.05).TT

7、PofthetumortissuesinLGGcomparedwiththoseofperipheralnormalcerebraltissuesandperitumorouscerebraledema,twogroupshadnostatisticalsignificance(P＞0.05).ConclusionsIntraoperativecontrast-enhancedultrasonographycanreflecttheboundaryofthebrainedema,whichi