Background: Over the past decade, the use of intraoperative image guidance in neurosurgery has
gradually gained in importance. Apart from some sophisticated and very expensive techniques,
intraoperative ultrasound (IOUS) is a simple and economical technique that allows
the surgeon to localize deep-seated lesions under a real-time ultrasonic image display
without dissection. The purpose of this study was to present our own preliminary experiences
in various (n=1250) neurosurgical procedures carried out at our tertiary care centre
in a developing country. Materials and Methods: A Prospective study was carried out in our department of neurosurgery at Grant Medical
College and Sir J J Group of hospitals from January 2010 to May 2019. IOUS was used
during various elective neurosurgical procedures done during this period as given
in table no below. A total of 1250 patients, 850 supratentorial lesion, 290 infratentorial
lesion and 110 spinal lesion, were included in this study. All studies were performed
using an ultrasound machine with variable 3.5~7.5 MHz sector transducers. The echogenicity
and pathomorphology between IOUS and computed tomography/magnetic resonance imaging
(CT/MRI) of various disease entities were compared. Results: Intracranial structures could be well demonstrated by ultrasound once the skull was
opened. Most of the intracranial lesions were hyperechoic, except those with a cystic
component. IOUS was more sensitive in demonstrating non-enhanced solid lesions and
lesions with a cystic component than was preoperative CT/MRI. The border between the
tumor and healthy brain was better delineated on IOUS in all cases aiding in tumor
resection. Conclusions: High-resolution real-time IOUS is a convenient and user-friendly method for identifying,
localizing, and characterizing the pathological focus during an operation. Such information
is very important and can enhance surgical results.
Key-words:
Economical - intraoperative - neurosurgery - ultrasound
