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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

A 10-year-old boy with intractable left temporal lobe epilepsy.A, B. Preoperative axial (A) and coronal (B) T2-weighted images show localized cortical thickening with subcortical hyperintensity in the left temporal lobe (arrows). C. Intraoperative ultrasonography through left temporal craniostomy reveals gyriform hyperechogenicity in the left superior temporal gyrus (arrows). Pathologic diagnosis was a ganglioglioma.
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f4-usg-14054: A 10-year-old boy with intractable left temporal lobe epilepsy.A, B. Preoperative axial (A) and coronal (B) T2-weighted images show localized cortical thickening with subcortical hyperintensity in the left temporal lobe (arrows). C. Intraoperative ultrasonography through left temporal craniostomy reveals gyriform hyperechogenicity in the left superior temporal gyrus (arrows). Pathologic diagnosis was a ganglioglioma.

Mentions: The goal of cerebral glioma surgery is not only maximal but also safe tumor resection; that is, the maximum neurologically permissible tumor volume should be resected, but eloquent areas must be spared and neurological damage minimized. These two antagonistic goals can be achieved through accurate localization of the extent of tumors, and intraoperative mapping of eloquent areas required for functions such as language, sensation, or movement. The main advantage of IOUS in brain tumor surgery lies in its realtime property. It can generate a complete overview of the tumor and the surrounding structures within seconds (Fig. 4). In deepseated lesions, IOUS can be used to find a suitable cleavage plane for resection. It also allows sonographic guidance of a tumor biopsy or puncture of the cystic tumor components. IOUS can repeatedly evaluate the extent and location of residual tumorous tissue at any stage of the operation. This greatly facilitates both resection control and the goal of safe but maximum volume reduction. In diffuse infiltrating gliomas, the extent of resection is associated with survival and ultrasonography has the potential to increase the extent of resection and thereby increase survival [11-14].


Intraoperative neurosonography revisited: effective neuronavigation in pediatric neurosurgery.

Cheon JE - Ultrasonography (2015)

A 10-year-old boy with intractable left temporal lobe epilepsy.A, B. Preoperative axial (A) and coronal (B) T2-weighted images show localized cortical thickening with subcortical hyperintensity in the left temporal lobe (arrows). C. Intraoperative ultrasonography through left temporal craniostomy reveals gyriform hyperechogenicity in the left superior temporal gyrus (arrows). Pathologic diagnosis was a ganglioglioma.
© Copyright Policy
Related In: Results  -  Collection

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

f4-usg-14054: A 10-year-old boy with intractable left temporal lobe epilepsy.A, B. Preoperative axial (A) and coronal (B) T2-weighted images show localized cortical thickening with subcortical hyperintensity in the left temporal lobe (arrows). C. Intraoperative ultrasonography through left temporal craniostomy reveals gyriform hyperechogenicity in the left superior temporal gyrus (arrows). Pathologic diagnosis was a ganglioglioma.
Mentions: The goal of cerebral glioma surgery is not only maximal but also safe tumor resection; that is, the maximum neurologically permissible tumor volume should be resected, but eloquent areas must be spared and neurological damage minimized. These two antagonistic goals can be achieved through accurate localization of the extent of tumors, and intraoperative mapping of eloquent areas required for functions such as language, sensation, or movement. The main advantage of IOUS in brain tumor surgery lies in its realtime property. It can generate a complete overview of the tumor and the surrounding structures within seconds (Fig. 4). In deepseated lesions, IOUS can be used to find a suitable cleavage plane for resection. It also allows sonographic guidance of a tumor biopsy or puncture of the cystic tumor components. IOUS can repeatedly evaluate the extent and location of residual tumorous tissue at any stage of the operation. This greatly facilitates both resection control and the goal of safe but maximum volume reduction. In diffuse infiltrating gliomas, the extent of resection is associated with survival and ultrasonography has the potential to increase the extent of resection and thereby increase survival [11-14].

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