ABSTRACT
Objective To investigated the value of intraoperative ultrasonography in guiding the surgical approach,improving the total resection rate of the tumor,and the survival time of patients who underwent resection of cerebral gliomas.Methods One hundred and ninteen patients with cerebral gliomas (pathologically confirmed) comprised the study groups.Patients who underwent intraoperative ultrasoundguided surgery were followed up for 6-60 months.In addition,randomly selected low and high grade cerebral glioma patients (all 30 cases of which were without intraoperative ultrasonography guidance) served as the control groups.Follow up included survival time,and the differences in survival time between the study groups and control groups were statistically analyzed.Results Complete follow-up data were obtained for 101 of 119 cases (84.9％) for a follow-up time of 6 60 months.Total removal of the lesion was achieved in 68 cases (67.3％) and subtotal removal in 33 cases (32.7 ％).Sixty-five cases had partial recurrence (64.4％) and 60 patients died due to tumor recurrence.Survival in patients with low grade gliomas (LGG) was significantly higher than that in patients with high grade gliomas (HGG).Patients with total tumor resection had a longer survival time than patients who had subtotal tumor resection.In the control LGG group,6-month survival was 96.7％,1-year survival was 73.3％,2-year survival was 53.3％,4-year survival was 36.7％ and 5-year survival was 26.7％.In the control HGG group,survival at 6 months,1 year,2 years,4 year and 5 years was 83.3％,36.7％,13.3％,3％,0 respectively.When comparing survival between the control groups and study groups,there was no significant difference at 6 months (P ＞0.05),but survival at 1 year,2 years,4 year and 5 years was different (P ＜0.05).Conclusions Intraoperative ultrasonography-guided resection of cerebral gliomas helps the surgeon to understand the relationship between the lesion and the surrounding structures,helps to protect normal brain tissue and increase the safety of surgery.It is of value in improving the total resection rate of tumors and the patient's survival time.
ABSTRACT
Objective To investigate the value of intraoperative contrast-enhanced ultrasound(CEUS) in evaluating pathological grades of cerebral gliomas. Methods Intraoperative CEUS was performed in 33 patients of cerebral gliomas of different pathological grades. Real-time blood perfusion and enhance characteristics of these tumors were observed,quantitative parameters from the automatically derived time-intensity curve (TIC) were obtained, and compared with the tumor microvessel density (MVD) by immunostaining with anti-CD34. Results The time to peak was significantly shorter and the MVD was significantly higher in the high grade cerebral gliomas compared with the low grade ones ( P <0. 05). The time to peak was negatively correlated with the MVD by immunostaining (r = -0.79, P < 0. 05). Conclusions Intraoperative CEUS could be used to observe microvascular perfusion in real-time, and could indirectly reflect the information of MVD in cerebral gliomas, which is of help to grade cerebral gliomas and guide surgical resections.
ABSTRACT
Objective To analyse the cost-effectiveness analysis of the focal injection treatment under the guidance of contrast enhanced ultrasound(CEUS) for the severe abdominal parenchymal organs trauma.Methods One hundred and twelve patients with severe abdominal parenchymal organs trauma,including 42 hepatic injuries,52 splenic injuries and 33 renal injuries,were rolled in this study. The cost-effectiveness of this group was compared with that of surgery group. Results Treatment duration of single organ trauma under the guidance of CEUS was 20 - 30 minutes. During the first 72 hours after the focal injection, blood pressure and heart rate were improved ( P ＜0.05). Free intraperitoneal liquid did not increase on immediate US image of post-therapy and then it disappeared gradually. Heart rate returned to normal level after injection treatment ( P ＜0. 001 ). Lengths of stay in hospital was 3 - 11 (5.4 ± 2.4)days, which was not different with 3 - 9(5.1± 1.9) of surgery group( P ＞0.05). Treatment cost was 0.32 - 0.43 (0.36 ±0. 14) ten thousand RMB, which was obviously less than 3. 1 - 4. 2 (3.6 ± 10.8) ten thousand RMB of surgery group ( P ＜ 0.01 ). Conclusions The efficacy of the focal injection treatment of the severe abdominal parenchymal organs trauma under the guidance of CEUS was consistent with that of the operative treatment, but its cost was less. Especially it benefited for reserving organs and less pain.