Türk Nöroşirürji Dergisi 2016 , Vol 26 , Num 3
The Use of Ultrasound as a Neuronavigation Tool in the Surgical Management of Supratentorial Brain Lesions
Murat GEYİK1, Serhat PUSAT2, Kadir ÇINAR3, İbrahim ERKUTLU1, Mehmet ALPTEKİN1, Abdülvahap GÖK1
1Gaziantep Üniversitesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Gaziantep, Türkiye
2Haydarpaşa Sultan Abdülhamid Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, İstanbul, Türkiye
3Sanko Üniversitesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Gaziantep, Türkiye
AIM: Computer-based navigation systems are used to reduce the risk of injury onto the normal brain structure during the neurosurgical procedures. In this study, we aimed to evaluate the resection success of the brain lesions in different nature using ultrasonography (USG) and to analyze the effects of ultrasonography.

MATERIAL and METHODS: Ultrasonography-assisted surgical resection was performed in 38 patients between 2010 and 2014 who had supratentorial lesions. The resection borders and residual tumor tissue were checked intraoperatively by ultrasonography and postoperatively by magnetic resonance imaging (MRI) in all patients.

RESULTS: The borders, cavities and locations of the gliomas (including low grade tumors), meningiomas, vascular and inflmmatory lesions were determined with 94% (36/38 cases) accuracy. Difficulty to determine the exact border of the tumor was experienced only in tumors with large edema and diffuse nature. The lesions were 31 glial tumor (13 grade 4, 4 grade 3, 10 grade 2 and 4 grade 1), 2 cavernomas, one thrombozed aneurysm, one chronic granulomatous lesion, two encephalitis and one atypical meningioma. Gross total excision was achieved in all cases and no additional neurological deficit was observed in any patient.

CONCLUSION: Color doppler ultrasonography shows the relationship between the brain lesions and vascular structures and this increases the success of surgery. Another advantage of the ultrasonography is the real time intraoperative determination of the resection degree. Ultrasonography is a good and reliable guide for the detection of deep and superficial cortical projection of brain tumors. Anahtar Kelimeler : Brain tumor, Neuronavigation, Ultrasonography