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Neurosurgical intraoperative ultrasonography using contrast enhanced superb microvascular imaging -vessel density and appearance time of the contrast agent-.

Authors :
Ishikawa, Mami
Masamoto, Kazuto
Hachiya, Ryota
Kagami, Hiroshi
Inaba, Makoto
Naritaka, Heiji
Katoh, Shojiro
Source :
British Journal of Neurosurgery. Jun2023, Vol. 37 Issue 3, p485-494. 10p. 1 Color Photograph, 1 Diagram, 1 Chart, 2 Graphs.
Publication Year :
2023

Abstract

Ultrasonography (US) provides real-time information on structures within the skull during neurosurgical operations. Superb microvascular imaging (SMI) is the latest imaging technique for detecting very low-velocity flow with minimal motion artifacts, and we have reported on this technique for intraoperative US monitoring. We combined SMI with administration of contrast agent to obtain detailed information during neurosurgical operations. Twenty patients diagnosed with brain tumor (10 meningiomas, 5 glioblastomas, 2 hemangioblastomas, 1 schwannoma, 1 malignant lymphoma, 1 brain abscess) underwent neurosurgery under US with SMI and contrast agent techniques. Vessel density and appearance time following contrast administration were analyzed. Flow in numerous vessels was not visualized by SMI alone, but appeared following injection of contrast agent in all cases. Flow in tumors was drastically enhanced by contrast agent in schwannoma, hemangioblastoma and meningioma, compared to normal brain tissue. Flows in the dilated and bent vessels of glioblastoma were also enhanced, although flow in hypoechoic lymphoma remained inconspicuous. The characteristics of tumor vessels were clearly visualized and tumor borders were demonstrated by the difference between tumor flow and brain flow, by the increased tumor vessel density and decreased appearance time of contrast agent compared to normal brain vessels. The combination of SMI and contrast agent techniques for intraoperative US monitoring could provide innovative flow images of tumor and normal brain. The neurosurgeon obtains information about tumor flow and tumor borderline before tumor resection. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
02688697
Volume :
37
Issue :
3
Database :
Academic Search Index
Journal :
British Journal of Neurosurgery
Publication Type :
Academic Journal
Accession number :
164366261
Full Text :
https://doi.org/10.1080/02688697.2020.1772958