Intraoperative spinal sonography in the evaluation of intramedullary tumors

Seventeen intraoperative spinal sonographic examinations were performed in 14 patients with intramedullary spinal cord neoplasms. Results of the ultrasound exams were correlated with preoperative imaging studies, surgical findings, and histopathologic analysis of the tumors. Intraoperative spinal sonography accurately localized the intramedullary tumors, often revealing the need for extension of the initial laminectomy. The neoplasms appeared as expansile echogenic masses, with cystic components in over half. Ultrasound was as accurate as preoperative imaging in the evaluation of solid neoplasms, and was superior to computed tomography (CT) and magnetic resonance imaging (MRI) for delineating the cystic components of neoplasms. Intraoperative sonography should be used routinely in all surgical cases of intramedullary spinal cord neoplasms.