[Efficacy of the newest ultrasonographic techniques in intraoperative neurosurgical diagnosis]

The contemporary neurosurgery requires efficient methods of intraoperative image guidance. Among some expensive techniques the rather cheap intraoperative ultrasound has been widely accepted in the last decade. The aim of the study is to estimate the efficacy of this technique in the intraoperative evaluation of the different kinds of brain lesions. The authors illustrate it with some ultrasonic images presented in comparison to the images obtained from the preoperative CT or angiography. B-mode ultrasound has proven to be extremely useful for localizing subcortical rather than deep-seated brain tumours, cysts, abscesses as well as intraparenchymal haematomas. The advantages were particularly evident when searching for tumours that were not visible on brain surface. Its use for guidance in cyst or abscess aspiration, as well as usefulness in tumor vascularization estimations (using Power Doppler mode) is outlined. Ultrasound B-mode Color or Power Doppler sonography with high resolution probes offers new possibilities of intraoperative control of neurovascular procedures--either in the localization of small arterio-venous malformations (AVMs) and feeders estimation or for the evaluation of proper clip application in the aneurysm surgery.