By Francesco Prada, Luigi Solbiati, Alberto Martegani, Francesco DiMeco
This booklet is meant as a realistic guide at the use of intraoperative ultrasound (IOUS) as a device for imaging tips in the course of cranial and spinal neurosurgical tactics. complete account is taken of the emergence of novel medical functions and up to date technical advances, with large assurance of the influence of advancements similar to more suitable probe expertise, fusion imaging and digital navigation, 3D ultrasound imaging, contrast-enhanced ultrasound, and elastosonography. uncomplicated rules of ultrasound are elucidated with a purpose to help in the optimum use of IOUS and transparent counsel is equipped at the interpretation of imaging findings in a variety of pathologies. Informative comparisons also are made from using recommendations akin to fusion imaging and contrast-enhanced ultrasound generally radiology and neurosurgery. the purpose of the authors is to reinforce the overall wisdom concerning intra-operative ultrasound mind imaging, standardizing its use and exploring new thoughts, top in a roundabout way towards compensating the inability of particular education within the software of ultrasound one of the neurosurgical group. IOUS is a delicate software that may increase surgical precision and aid to lessen morbidity.
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Additional info for Intraoperative Ultrasound (IOUS) in Neurosurgery: From Standard B-mode to Elastosonography
Del Bene • A. Moiraghi Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. it F. DiMeco Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, via Celoria 11, Milan 20133, Italy Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, USA Intraoperative ultrasound (IOUS) provides real-time direct visualization of the explored area. Its use in neurosurgery has been first described in 1978 by Reid . Over the years a lot of neurosurgical procedures were reported to be guided by IOUS: lesion localization in the brain and spine, guidance of surgical resection, catheter placement, aspiration of abscess, decompression control in Chiari I malformation, and others [9–15].
With the pterional approach, no sagittal view is possible. Furthermore in small pterional approaches, it is sometimes difficult to evaluate the axial plane. (a, b) US and MR semi-coronal view. (c) Three-dimensional model with probe positioning Fig. 9 Parietal approach. A case of a parasagittal meningioma, which appears on IOUS as an iso-hypoechoic homogenous lesion surrounded by a hyperechoic capsule. With the parietal approach no coronal view is possible. (a, b) US and MR sagittal view, (d, e) US and MR axial view.
C–f) Three-dimensional model with probe positioning 38 Fig. 10 Coronal approach. A case of a frontal-mesial lung metastasis is showed, which appears on IOUS as an hypoechoic cystic lesion with a nodular component surrounded by a bright hyperechoic rim. With the coronal References 1. Dorward NL, Alberti O, Velani B, Gerritsen FA, Harkness WF, Kitchen ND, Thomas DG (1998) Postimaging brain distortion: magnitude, correlates, and impact on neuronavigation. J Neurosurg 88(4):656–662. 0656 2. Nimsky C, Ganslandt O, Cerny S, Hastreiter P, Greiner G, Fahlbusch R (2000) Quantification of, visualization of, and compensation for brain shift using intraoperative magnetic resonance imaging.