TY - JOUR
T1 - Intraoperative navigated angiosonography for skull base tumor surgery
AU - Prada, Francesco
AU - Bene, Massimiliano Del
AU - Casali, Cecilia
AU - Saladino, Andrea
AU - Legnani, Federico Giuseppe
AU - Perin, Alessandro
AU - Moiraghi, Alessandro
AU - Richetta, Carla
AU - Rampini, Angela
AU - Mattei, Luca
AU - Vetrano, Ignazio Gaspare
AU - Fornaro, Riccardo
AU - Saini, Marco
AU - Martegani, Alberto
AU - DiMeco, Francesco
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background One of the main challenges during skull base tumor surgery is identifying the relationships between the lesion and the principal intracranial vessels. To this end, neuronavigation systems based on preoperative imaging lack accuracy because of brain shift and brain deformation. Intraoperative navigated B-mode ultrasonography is useful in defining the extent of brain tumor. Doppler imaging adds information regarding flow entity in neighboring vessels. Second-generation ultrasound contrast agents improve the signal-to-noise ratio of B-mode imaging and permit the study of the vessel's course, blood flow, and perfusion characteristics of focal lesions. We report our experience using intraoperative navigated contrast-enhanced ultrasound to perform a navigated angiosonography (N-ASG) for the visualization of vessels in a series of 18 skull base tumors. Methods We performed N-ASG in a series of 18 skull base tumors (10 meningiomas, 3 craniopharyngiomas, 2 giant pituitary adenomas, 1 posterior fossa epidermoid, 2 dermoid cysts). N-ASG was obtained after craniotomy before resecting each lesion and during tumor removal, after intravenous injection of ultrasound contrast agent. Results In all 18 cases, major vessels and their branches were simultaneously identified (both high and low flow) using N-ASG, which allowed to visualize the whole length of each vessels. N-ASG was also useful in highlighting the lesion, compared with standard B-mode imaging, and showing its perfusion patterns. Conclusions N-ASG can be applied to skull base tumor surgery, providing helpful information about the relationship between principal intracranial vessels and tumors. This technique could be of assistance in approaching the tumor and avoiding vascular damages.
AB - Background One of the main challenges during skull base tumor surgery is identifying the relationships between the lesion and the principal intracranial vessels. To this end, neuronavigation systems based on preoperative imaging lack accuracy because of brain shift and brain deformation. Intraoperative navigated B-mode ultrasonography is useful in defining the extent of brain tumor. Doppler imaging adds information regarding flow entity in neighboring vessels. Second-generation ultrasound contrast agents improve the signal-to-noise ratio of B-mode imaging and permit the study of the vessel's course, blood flow, and perfusion characteristics of focal lesions. We report our experience using intraoperative navigated contrast-enhanced ultrasound to perform a navigated angiosonography (N-ASG) for the visualization of vessels in a series of 18 skull base tumors. Methods We performed N-ASG in a series of 18 skull base tumors (10 meningiomas, 3 craniopharyngiomas, 2 giant pituitary adenomas, 1 posterior fossa epidermoid, 2 dermoid cysts). N-ASG was obtained after craniotomy before resecting each lesion and during tumor removal, after intravenous injection of ultrasound contrast agent. Results In all 18 cases, major vessels and their branches were simultaneously identified (both high and low flow) using N-ASG, which allowed to visualize the whole length of each vessels. N-ASG was also useful in highlighting the lesion, compared with standard B-mode imaging, and showing its perfusion patterns. Conclusions N-ASG can be applied to skull base tumor surgery, providing helpful information about the relationship between principal intracranial vessels and tumors. This technique could be of assistance in approaching the tumor and avoiding vascular damages.
KW - Angiosonography
KW - Brain tumor
KW - Contrast-enhanced ultrasound
KW - Intraoperative imaging
KW - Intraoperative ultrasound
KW - Skull base surgery
KW - Vascular surgery
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U2 - 10.1016/j.wneu.2015.07.025
DO - 10.1016/j.wneu.2015.07.025
M3 - Article
C2 - 26193670
AN - SCOPUS:84952637128
VL - 84
SP - 1699
EP - 1707
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
IS - 6
ER -