Intraoperative Navigated Angiosonography for Skull Base Tumor Surgery

Area of Science:

• Neurosurgery
• Medical Imaging
• Vascular Surgery

Background:

• Skull base tumor surgery presents challenges in identifying lesion-vessel relationships.
• Preoperative imaging-based neuronavigation accuracy is limited by brain shift and deformation.
• Intraoperative ultrasound, especially contrast-enhanced, offers improved visualization of tumors and vessels.

Purpose of the Study:

• To evaluate the utility of intraoperative navigated contrast-enhanced ultrasound (N-ASG) for visualizing intracranial vessels in skull base tumor surgery.

Main Methods:

• N-ASG was performed on 18 patients with various skull base tumors (meningiomas, craniopharyngiomas, adenomas, cysts).
• The procedure involved intravenous injection of an ultrasound contrast agent after craniotomy and during tumor resection.
• N-ASG aimed to visualize vessel course, flow, and lesion perfusion.

Main Results:

• N-ASG successfully identified major intracranial vessels and their branches in all 18 cases.
• The technique visualized the entire course of vessels and highlighted tumor perfusion patterns.
• N-ASG provided superior lesion highlighting compared to standard B-mode ultrasound.

Conclusions:

• N-ASG is a valuable tool in skull base tumor surgery.
• It enhances understanding of the relationship between tumors and critical blood vessels.
• This technique can assist in tumor approach and help prevent vascular injury.