INTRAOPERATIVE ULTRASOUND FOR INTRACRANIAL SURGERY

摘要

Intraoperative imaging guidance is a rapidly advancing modality for veterinary intracranial surgery. We have utilized intraoperative ultrasound as our guidance modality in 25 patients over the course of four years. The purpose of this study was to present our initial experiences using intraoperative ultrasound imaging for intraaxial and extraaxial intracranial masses. This presentation includes details on the technique, instrumentation, intraoperative imaging characteristics, and its correlation withpostoperative CT or MR imaging.Twenty-five canine patients were presented to either the Mississippi State University Veterinary Neurology and Imaging (MSU-VNI) service or the Auburn University Small Animal Clinic (AUSAC) for neurologic disorders that were ultimately diagnosed as intracranial masses. Each of the 25 patients underwent a pre-operative evaluation consisting of routine blood and urine analyses and thoracic radiography. Some patients were evaluated with cardiac or abdominal radiography or both. Results of the pre-operativeevaluations revealed no evidence of co-existing or metastatic neoplasia. Each of the patients underwent craniotomy or craniectomy procedures for removal / debulking of the intracranial mass using intraoperative ultrasound guided visualization of the mass. Mass removable was accomplished using an ultrasonic aspirator (CUSA Excel - MSU-VNI; CUSA NS200 - AUSAC). Twenty-four of the 25 patients survived surgery and 17 were eventually discharged to the owners' care. All 25 intracranial masses were characterized by microscopic evaluation, demonstrating the following distribution of tissue types: meningioma (13), glioma (10), nasal adenocarcinoma (1), cerebellar cyst (1). Twenty-two lesions were supratentorial and 3 were infratentorial.