摘要
目的评估超声造影在脑胶质瘤切除术术中的应用价值。方法选取2020年9月至2021年7月于哈尔滨医科大学附属第一医院神经外科行脑胶质瘤切除术的27例患者(术前MRI诊断为脑胶质瘤),所有患者术中均行二维超声及超声造影检查,以术后病理作为诊断金标准,明确脑胶质瘤病理类型。采用随机区组设计方差分析比较高级别脑胶质瘤的肿瘤组织、正常脑组织和供血动脉超声造影参数[开始强化时间(TTS)、达峰时间(TTP)、峰值强度(API)]的差异,组间多重比较采用Tukey HSD检验;采用配对t检验比较低级别脑胶质瘤的肿瘤组织和正常脑组织超声造影参数的差异。结果27例脑胶质瘤患者中,根据术后病理回报,其中高级别脑胶质瘤16例,低级别脑胶质瘤11例。在高级别脑胶质瘤中,肿瘤组织的TTS为(30.94±2.11)s、TTP为(45.04±2.74)s、API为(79.56±7.35)dB;主要供血动脉的TTS为(28.88±1.54)s、TTP为(43.04±2.85)s、API为(134.27±14.57)dB;正常脑组织的TTS为(35.88±2.16)s、TTP为(46.41±2.75)s、API为(48.02±4.79)dB;高级别脑胶质瘤肿瘤组织的TTS、TTP低于正常脑组织、高于主要供血动脉,API高于正常脑组织、低于主要供血动脉,差异均具有统计学意义(P均<0.001)。在低级别脑胶质瘤中,肿瘤组织的TTS为(23.62±1.90)s、TTP为(35.66±2.38)s、API为(103.67±7.32)dB;正常脑组织的TTS为(27.97±2.23)s、TTP为(44.11±4.68)s、API为(67.27±11.59)dB;低级别脑胶质瘤肿瘤组织的TTS、TTP低于正常脑组织,API高于正常脑组织,差异均具有统计学意义(t=-14.80、-7.41、8.67,P均<0.001)。结论术中超声造影可为脑胶质瘤定位及切除范围的确定提供帮助,可最大限度提高肿瘤切除范围。
Objective To investigate the application value of intraoperative contrast-enhanced ultrasound(CEUS)in surgical resection of glioma.Methods A total of 27 patients who underwent glioma resection at Neurosurgery Department of the First Affiliated Hospital of Harbin Medical University from September 2020 to July 2021(diagnosed as having glioma by MRI before surgery)were selected.All patients underwent intraoperative two-dimensional ultrasound and CEUS.Postoperative pathology was used as the diagnostic gold standard to define the pathological type of glioma.Random block design analysis of variance was used to compare CEUS parameters between tumor tissue,normal brain tissue,and the blood supplying arteries of high-grade glioma.Tukey HSD test was used for multiple comparisons among groups.Paired t test was used for comparison of CEUS parameters between the normal brain tissue and tumor tissue of low-grade glioma.Results Among the 27 patients with glioma,16 had high-grade glioma and 11 had low-grade glioma according to postoperative pathology.In high-grade glioma,the time to start(TTS),time to peak(TTP),and absolute peak intensity(API)were(30.94±2.11)s,(45.04±2.74)s,and(79.56±7.35)dB,respectively.The TTS,TTP,and API of the main supplying arteries were(28.88±1.54)s,(43.04±2.85)s,and(134.27±14.57)dB,respectively.The TTS,TTP,and API of normal brain tissue were(35.88±2.16)s,(46.41±2.75)s,and(48.02±4.79)dB,respectively.The TTS and TTP of high-grade glioma tumor tissue were significantly lower than those of normal brain tissue and higher than those of the main supplying arteries,and the API was significantly higher than that of normal brain tissue and lower than that of the main supplying arteries(P<0.001).In low-grade glioma,the TTS,TTP,and API were(23.62±1.90)s,(35.66±2.38)s,and(103.67±7.32)dB,respectively.The TTS,TTP,and API of normal brain tissue were(27.97±2.23)s,(44.11±4.68)s,and(67.27±11.59)dB,respectively.The TTS and TTP of low-grade glioma tumor tissue were significantly lower than those of normal brain
作者
王晗宇
张司可
张羽
万欣
贺秋霞
李明明
杨秀华
Wang Hanyu;Zhang Sike;Zhang Yu;Wan Xin;He Qiuxia;Li Mingming;Yang Xiuhua(Department of Ultrasonography,Qunli Hospital of the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2023年第7期755-760,共6页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
脑胶质瘤
超声
超声造影
时间-强度曲线
Brain glioma
Ultrasound
Contrast-enhanced ultrasound
Time-intensity curve
