Abstract:
Introduction: Reliable intraoperative orientation in neurosurgery is essential. Anatomical
topographic landmarks, frame based and frameless neuronavigation, iUS allow the neurosurgeon to
localize the lesion and surrounding structures, to aid in optimizing the approach and achieve safe
maximal resection. In recent years there has been a significant improvement in the quality of ultrasound
imaging. Intraoperative ultrasound provides low cost real time imaging that is simple and rapid to use.
Objectives: Ultrasound integrated neuronavigation can be used to optimize the approach and
achieving safe maximal resection, thereby improving outcomes for patients with different localization
and histology of brain tumors, vascular patology and spontaneous intracerebral hemorrhage.
Material and methods: Since 2007 till 2010, in the Institute of Neurology and Neurosurgery,
130 operations with application of 2D iUS have been performed. Starting from March till May
2012, 17 patients went under surgical treatment using the intraoperative ultrasound integrated
neuronavigation system.
Results: We applied ultrasound neuronavigation system in 17 cases on patients with diverse
pathologies, including brain tumors (craniopharyngeoma, corpus callosum glioblastoma and high
grade intracerebral glioma), vascular patology (arteriovenous malformations, aneurysms), spontaneous intracerebral hemorrhage. Application of ultrasound neuronavigation system aids in
improving postoperative outcomes for these patients.
Conclusion: The integration of 3D US with neuronavigation technology created an efficient
and inexpensive tool for intraoperative imaging in neurosurgery. The technology has been applied
to optimize surgery of brain tumors, but it has also been found to be useful in other procedures such
as operations for aneurysms or arteriovenous malformations. iUS is easy to use and has a rapid
learning curve which makes it a useful tool to the neurosurgeons intraoperative armamentarium.
Description:
State Medical and Pharmaceutical
University “Nicolae Testemitanu”, Department of Neurosurgery, Institute of Neurology and
Neurosurgery, Chisinau, Republic of Moldova