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Intraoperative neurosonography revisited: effective neuronavigation in pediatric neurosurgery.

Cheon JE - Ultrasonography (2015)

Bottom Line: The advantages of IOUS include realtime depiction of neuroanatomy, accurate localization and characterization of a lesion, reduced surgical exploration and surgical time, and presumably decreased patient morbidity.IOUS is useful in the intraoperative monitoring of lesion resection as well as intraoperative localization and characterization of focal parenchymal lesions.This review aims to provide an overview of the clinical application of IOUS in pediatric intracranial neurosurgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.

ABSTRACT
Intraoperative ultrasonography (IOUS) is a widely used noninvasive method to evaluate the morphology, vasculature, and pathologies of the brain. The advantages of IOUS include realtime depiction of neuroanatomy, accurate localization and characterization of a lesion, reduced surgical exploration and surgical time, and presumably decreased patient morbidity. IOUS is useful in the intraoperative monitoring of lesion resection as well as intraoperative localization and characterization of focal parenchymal lesions. This review aims to provide an overview of the clinical application of IOUS in pediatric intracranial neurosurgery.

No MeSH data available.


Related in: MedlinePlus

Intraoperative ultrasonography procedure.A 10-year-old girl presented with cerebellar pilocytic astrocytoma. The transducer is applied directly to the exposed cerebellum through craniostomy. Sterile saline solution filled the craniostomy defect to improve the acoustic coupling.
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f1-usg-14054: Intraoperative ultrasonography procedure.A 10-year-old girl presented with cerebellar pilocytic astrocytoma. The transducer is applied directly to the exposed cerebellum through craniostomy. Sterile saline solution filled the craniostomy defect to improve the acoustic coupling.

Mentions: IOUS requires a high-end ultrasound machine, combined with a 5-7-MHz sector transducer and a 7-12-MHz linear transducer, for optimal lesion detection and depiction. The transducer should be wrapped in a sterile sheath and applied directly to the intact dura or the exposed brain through craniostomy. The use of sterile saline before the application of the transducer improved the acoustic coupling (Fig. 1). An overview of the cerebral structures is easily obtained using a sector transducer with deep penetration to identify reliable anatomic landmarks. Both the anechoic CSF in the lateral ventricle and the echogenic falx cerebri are useful landmarks for lesion orientation. During the examination, the insonation depth can be sequentially reduced to provide more detailed observations [8-10]. With a relatively high-frequency linear transducer, the low-echoic cortical ribbon can be differentiated from the brighter echogenicity of the subcortical white matter (Fig. 2).


Intraoperative neurosonography revisited: effective neuronavigation in pediatric neurosurgery.

Cheon JE - Ultrasonography (2015)

Intraoperative ultrasonography procedure.A 10-year-old girl presented with cerebellar pilocytic astrocytoma. The transducer is applied directly to the exposed cerebellum through craniostomy. Sterile saline solution filled the craniostomy defect to improve the acoustic coupling.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4372713&req=5

f1-usg-14054: Intraoperative ultrasonography procedure.A 10-year-old girl presented with cerebellar pilocytic astrocytoma. The transducer is applied directly to the exposed cerebellum through craniostomy. Sterile saline solution filled the craniostomy defect to improve the acoustic coupling.
Mentions: IOUS requires a high-end ultrasound machine, combined with a 5-7-MHz sector transducer and a 7-12-MHz linear transducer, for optimal lesion detection and depiction. The transducer should be wrapped in a sterile sheath and applied directly to the intact dura or the exposed brain through craniostomy. The use of sterile saline before the application of the transducer improved the acoustic coupling (Fig. 1). An overview of the cerebral structures is easily obtained using a sector transducer with deep penetration to identify reliable anatomic landmarks. Both the anechoic CSF in the lateral ventricle and the echogenic falx cerebri are useful landmarks for lesion orientation. During the examination, the insonation depth can be sequentially reduced to provide more detailed observations [8-10]. With a relatively high-frequency linear transducer, the low-echoic cortical ribbon can be differentiated from the brighter echogenicity of the subcortical white matter (Fig. 2).

Bottom Line: The advantages of IOUS include realtime depiction of neuroanatomy, accurate localization and characterization of a lesion, reduced surgical exploration and surgical time, and presumably decreased patient morbidity.IOUS is useful in the intraoperative monitoring of lesion resection as well as intraoperative localization and characterization of focal parenchymal lesions.This review aims to provide an overview of the clinical application of IOUS in pediatric intracranial neurosurgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.

ABSTRACT
Intraoperative ultrasonography (IOUS) is a widely used noninvasive method to evaluate the morphology, vasculature, and pathologies of the brain. The advantages of IOUS include realtime depiction of neuroanatomy, accurate localization and characterization of a lesion, reduced surgical exploration and surgical time, and presumably decreased patient morbidity. IOUS is useful in the intraoperative monitoring of lesion resection as well as intraoperative localization and characterization of focal parenchymal lesions. This review aims to provide an overview of the clinical application of IOUS in pediatric intracranial neurosurgery.

No MeSH data available.


Related in: MedlinePlus