Intraoperative ultrasound imaging: practical applicability as a real-time navigation system

Area of Science:

• Neurosurgery
• Medical Imaging

Background:

• Intraoperative Ultrasound (US) has been utilized since 1987 for diverse neurosurgical pathologies.
• Real-time navigation systems are crucial for enhancing surgical precision and outcomes.

Purpose of the Study:

• To define and discuss useful intraoperative applications of US imaging in neurosurgery.
• To evaluate the efficacy of US for lesion delineation and guidance during surgical procedures.

Main Methods:

• Routine intraoperative US imaging performed since 1987 for intracerebral and intramedullary pathologies.
• Utilized varying US frequencies (5 MHz and 10 MHz probes) to assess different lesion types and anatomical structures.
• Evaluated US guidance for procedures like catheter, needle, and endoscope insertion.

Main Results:

• Accurate definition and delineation of deep-seated lesions using 5 MHz US frequency.
• Visualization of small subcortical lesions with high-frequency probes.
• Differentiation between solid tumors, cysts, and necrosis was achievable.
• Identification of residual tumors proved difficult.
• 10 MHz probes visualized dural sinuses and invading tumors.
• US guidance facilitated puncturing procedures.
• Postoperative percutaneous US imaging through a burr hole was not effective.

Conclusions:

• Intraoperative US imaging is a reliable method for determining lesion size, shape, and localization.
• US serves as a practical, cost-effective, and time-saving real-time navigation system in neurosurgery.
• While effective for guidance and delineation, residual tumor identification requires further investigation.