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Year 2012 Vol. 20 No 3
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 (ð>0,050 no matter what nosological form it is) and CT at intracerebral hematomas (ð=0,389). What concerns CT at tumors and brain abscesses, the importance of the intraoperative ultrasound scanning is significantly superior to native CT ð<0,001 and ð=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.
1. Vasil'ev SA, Zuev AA. Ul'trazvukovaia navigatsiia v khirurgii opukholei golovnogo mozga [Ultrasonograpy-based navigation in surgical treatment of brain tumors]. Neirokhirurgiia. 2010;(4 Ch. 2.):16–23.
2. Shipai AP, Smeianovich AF, Sidorovich RR. Neirokhirurgicheskaia navigatsionnaia sistema v lechenii ob"emnykh obrazovanii golovnogo mozga [Neurosurgical navigation system in the treatment of space-occupying lesions of the brain]. Nevrologiia i neirokhirurgiia v Belarusi. 2009;(3):138–42.
3.Savello AV. Mul'timodal'naia neironavigatsiia i intraoperatsionnaia ul'trazvukovaia vizualizatsiia v khirurgii vnutricherepnykh novoobrazovanii [Multimodal neuronavigation and intraoperative ultrasound visualization in surgery of intracranial tumors]. Vopr Obshchei i Chastnoi Khirurgii. 2007;166(5):11–18.
4. Jain D, Sharma MC, Sarkar C, Gupta D, Singh M, Mahapatra AK. Comparative analysis of diagnostic accuracy of different brain biopsy procedures. Neurol India. 2006 Dec;54(4):394–98.
5.Wadley J, Dorward N, Kitchen N, Thomas D. Pre-operative planning and intra-operative guidance in modern neurosurgery: a review of 300 cases. Ann R Coll Surg Engl. 1999;(81): 217–25.
6.Rubin JM, Quint DJ. Intraoperative US versus intraoperative MR imaging for guidance intracranial neurosurgery. Radiology. 2000;215:917–19.
7. Dreval' ON, Rynkov IP, Zubarev AR, Kim IuE. Znachenie intraoperatsionnogo ul'trazvukovogo navedeniia v neirokhirurgicheskoi praktike pri ob"emnykh obrazovaniiakh golovnogo mozga [The role of intraoperative ultrasound guidance in neurosurgical practice in the space-occupying lesions of the brain]. Ul'trazvuk i Funkts Diagnostika. 2004;(4): 92–97.
8. Behnke S, Becker G. Sonographic imaging of the brain parenchyma. Eur J Ultrasound. 2002;16:73–80.
9.Huisman TAG. Intracranial hemorrhage: ultrasound, CT and MRI findings. Eur Radiol. 2005;(15):434–40.
10. Woydt M, Vince GH, Krauss J, Krone A, Soerensen N, Roosen K. New ultrasound techniques and their application in neurosurgical intraoperative sonography. Neurol Res. 2001 Oct;23(7):697–705.
11. Fletcher R, Fletcher S, Vagner E. Klinicheskaia epidemiologiia: osnovy dokazatel'noi meditsiny [Clinical epidemiology: basics of evidence-based medicine]. Moscow, RF: Media Sfera, 1998. 350 p.
246029, Respublika Belarus', g. Gomel', ul. Brat'ev Liziukovykh, d. 5, U “Gomel'skaia oblastnaia klinicheskaia bol'nitsa“, neirokhirurgicheskoe otdelenie,
Tsitko Evgeniy Leonidovich
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.