摘要
目的观察术中超声用于辅助胚胎发育不良性神经上皮瘤(DNET)切除术的价值。方法纳入32例接受术中超声辅助下脑肿瘤切除术并经术后病理证实的DNET患者,依照术前MRI所见将病灶分为Ⅰ型(n=12)、Ⅱ型(n=11)及Ⅲ型(n=9);比较各型病灶术中超声表现,观察以之判断DNET病灶MRI类型及术中超声辅助切除DNET的价值。结果不同MRI类型DNET病灶之间,术中超声呈“脑沟样”回声、后方回声增强及边界清晰占比差异均有统计学意义(P均<0.05)。根据病灶后方回声增强判断MRIⅠ型DNET的敏感度和特异度分别为75.00%和95.00%,以病灶内“脑沟样”回声判断MRIⅢ型DNET的敏感度和特异度分别为77.78%和78.26%,以病灶边界不清判断MRIⅢ型DNET的敏感度和特异度分别为66.67%和91.30%。32例均在术中超声辅助下准确定位DNET,30例(30/32,93.75%)完全切除病灶。结论术中超声可清晰显示DNET并辅助术者判断其类型,进而选择切除方式及范围。
Objective To observe the value of intraoperative ultrasound for assisting resection of dysembryoplastic neuroepithelial tumor(DNET).Methods Data of 32 patients with single DNET proved by postoperative pathology and underwent intraoperative ultrasound-assisted brain tumor resection were retrospectively analyzed.Based on preoperative MRI,the lesions were classified into MRI typeⅠ(n=12),Ⅱ(n=11)orⅢ(n=9).The intraoperative ultrasonic manifestations were compared among different types of lesions,and the value of ultrasonic findings for judging MRI type and assisting resection of DNET were explored.Results Significant differences of the proportions of sulcus-like echoes,posterior echo enhancement and clear boundaries were found among DNET lesions of different MRI types(all P<0.05).The sensitivity and specificity of judging MRI typeⅠDNET according to posterior echo enhancement was 75.00%and 95.00%,respectively,of evaluating MRI typeⅢDNET according to sulcus-like echoes was 77.78%and 78.26%,respectively,while of evaluating MRI typeⅢDNET according to clear boundaries was 66.67%and 91.30%,respectively.All 32 DNET lesions were accurately localized with the assistance of intraoperative ultrasound,among which 30 lesions(30/32,93.75%)were wholly resected.Conclusion Intraoperative ultrasound could clearly show and assist typing DNET,hence being helpful to the choice of procedure and scope of resection.
作者
张文恺
张巍
程令刚
陈治光
李睿
何文
ZHANG Wenkai;ZHANG Wei;CHENG Linggang;CHEN Zhiguang;LI Rui;HE Wen(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中国医学影像技术》
CSCD
北大核心
2023年第10期1488-1491,共4页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金(82271995)。
关键词
肿瘤
神经上皮
外科手术
超声检查
neoplasms,neuroepithelial
surgical procedures,operative
ultrasonography
