Year 2012 Vol. 20 No 3

NEUROSURGERY

E.L. TSITKO 1, A.F. SMEYANOVICH 2

COMPARATIVE ANALYSIS OF DIAGNOSTIC VALUE OF NEUROSONOGRAPHY MODERN METHODS AT EXTENSIONAL BRAIN TUMORS

ME Gomel Regional Clinical Hospital 1, Gomel,
SE Republican Scientific Clinical Center of Neurology and Neurosurgery 2, Minsk,
The Republic of Belarus

Objectives. To evaluate predictors of quality of intraoperative ultrasound scanning at the focal brain pathology and to perform the comparative analysis with modern methods of neuroimaging.
Methods. 116 patients with the extensional lesions of the brain (tumors, intracerebral hematomas, abscesses) were included in the research. All patients were subjected to the intraoperative ultrasound scanning through the post-trepanation defect. In the preoperative period computer tomography (CT) of the brain was performed in 79 cases (68,1%), magnetic resonance imaging (MRI) in 23 (19,8%) patients. In 10 (8,6%) cases, CT and MRI were carried out for the differential diagnosis of focal pathology. In order to determine the cause of the intracranial hypertension, in 4 (3,5%) patients diagnostic trepanation was done, followed by brain parenchyma neurosonography (NSG).
In order to determine the diagnostic value of MRI, CT and NSG, the data of the pathomorphological changes obtained during the surgery and, in cases of the brain tumors, the histopathological examination of the material obtained at the removal were used as a "gold standard".
Results. Studying of the neurosonography operative characteristics proves high informational content of the given method in the diagnostics of the brain focal pathology (validity 98%). The comparative estimation of the diagnostic value of three alternative methods of neuroimaging has shown that intraoperative ultrasound scanning has high prognostic qualities (all AUROC values exceed 0,9) and can be compared with MRI in its significance (>0,050 no matter what nosological form it is) and CT at intracerebral hematomas (=0,389). What concerns CT at tumors and brain abscesses, the importance of the intraoperative ultrasound scanning is significantly superior to native CT <0,001 and =0,001, correspondently).
Conclusions. Predictive value of intraoperative ultrasound scanning in the diagnosis of pathological extensive tumors of the brain is comparable with MRI and CT at intracerebral hematomas, but surpasses CT in cases of the brain tumors and abscesses.

Keywords: brain tumors, intracerebral hematomas, brain abscesses, predictive value, neurosonography
p. 65 73 of the original issue
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Address for correspondence:
246029, Respublika Belarus', g. Gomel', ul. Brat'ev Liziukovykh, d. 5, U Gomel'skaia oblastnaia klinicheskaia bol'nitsa, neirokhirurgicheskoe otdelenie,
e-mail: fedor30@tut.by,
Tsitko Evgeniy Leonidovich
Information about the authors:
Tsitko E.L., Neurosurgeon, "Gomel Regional Clinical Hospital."
Smeyanovich A.F., an Academician of the National Academy of Sciences of Belarus, Doctor of Medical Sciences, Professor of SE "The Republican Scientific and Clinical Center of Neurology and Neurosurgery", Minsk.
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