Application of Intraoperative Ultrasonography in the Resection of Intracranial Arteriovenous Malformation_West China Medical Journal

Authors：

YAO Wenhua ¹ , ZHANG Deming ¹ , ZHU Chengming ¹ , WANG Guifu ² , LIU Qi ¹

1. Department of Ultrasound, Ya’an People’s Hospital,Ya’an, Sichuan 563000, P. R. China; 2. Zunyi Medical College, Zunyi, Guizhou 563003, P. R. China;

Corresponding author：

Keywords：

颅内动静脉畸形; 外科手术; 术中超声; 预后

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【摘要】　目的　探讨颅内动静脉畸形切除术中彩色多普勒超声检查的应用价值与预后的关系。　方法　在显微外科手术的基础上，将65例动脑静脉畸形患者随机分为A、B两组， A组34例动静脉畸形患者在术中接受术中超声检查，确定其畸形血管团的数目、位置、深度、大小、范围及其与周边组织结构的关系，探查供血动脉及引流静脉的数目及走行，以确定动、静脉畸形的位置、手术切除范围及切除术后是否有畸形血管残留；B组31例行常规手术，比较两组之间的差异。　结果　术中彩色多普勒超声能清晰的显示动静脉畸形的情况，两组经手术完整切除动静脉畸形率、再出血率、术后7 d Glasgow昏迷评分及预后差异均有统计学意义（P lt;0.05）。　结论　术中实时彩色多普勒超声能对脑动静脉畸形准确定位，并可判定脑动静脉畸形的血供模式及残余情况，减少脑组织损伤及降低手术并发症的发生，提高了手术安全性及治疗效果。
【Abstract】　Objective　 To explore the application of the colored Doppler ultrasonography in the excision of intracranial arteriovenous malformation (AVM) to determine the location of the lesion and the completeness of the resection, and to evaluate the clinical value of intraoperative ultrasonography in the diagnosis, treatment and the relation to the prognosis of patients.　Methods　 A total of 65 patients with brain AVM were randomly divided into group A and B. The microsurgery was perfromed on the patients. Intraoperative ultrasound was performed on the 34 patients in group A to the numbers, location, depth,size of different malformation vascular clumps relationship of the arteriovenous malformation with surrounding tissues. While the pateints in group B underwent the routine surgery. The difference between the two groups were compared.　Results　 The condition of the AVM were clearly revealed by intraoperative ultrasonography. All of the intracranial AVM in group A were completely removed. The difference in rehaemorrhagia and postoperative Glasgow coma scale score of seven day between the two groups were statistically significant (P lt;0.05).　Conclusions　 Intraoperative color Doppler ultrasounography in the resection of intracranial AVM could accurate localize the lesions, identify vascular anatomy of the AVM vascular balls and the completeness of resection. The parameters including resistance index of the vessels may identify the abnormal vessels and reduce the operative complications and brain tissue damage, which improve the safety and efficacy of the therapeutic effect.

Citation： YAO Wenhua,ZHANG Deming,ZHU Chengming,WANG Guifu,LIU Qi. Application of Intraoperative Ultrasonography in the Resection of Intracranial Arteriovenous Malformation. West China Medical Journal, 2011, 26(6): 896-899. doi: Copy

1.	中华神经科学会, 中华神经外科学会. 全国第四届脑血管病学术会议: 脑卒中临床疗效评定标准[J]. 中华神经科杂志, 1996, 29(6): 381 - 383.
2.	姜笑千, 何文, 赵继宗, 等. 颅内动静脉畸形的术中超声应用研究[J/CD]. 中华医学超声杂志(电子版), 2006, 3(4): 213-215.
3.	Cokluk C, Lyigun O, Senel A, et al. The guidance of intraoperativeUltrasonography in the surgical treatment of arteriovenous malformation[J]. Minim Invasive Neurosurg, 2003, 46(3): 169-172.
4.	王立淑, 何文, 刘会晤, 等. 颅内血管网织细胞瘤的术中超声应用研究[J/CD]. 中华医学超声杂志(电子版), 2008, 5(2): 255-260.
5.	Dempsey RJ, Moftakhar R, Pozniak M. Intraoperative Doppler to measure cerebrovascular resistance as a guide to complete resection of arteriovenous malformations[J]. Neurosurgery, 2004, 55(1): 155-160.
6.	Griffith S, Pozniak MA, Mitchell CC, et al. Intraoperative sonography of intracranial arteriovenous malformations, how we do it[J]. J Ultra sound Med, 2004, 23(8): 1065-1072.
7.	周大彪, 赵继宗, 王硕, 等. 术中实时超声在脑动静脉畸形外科治疗中的应用[J]. 中华医学杂志, 2005, 85(24): 1688-1691.
8.	刘承基. 脑血管外科学[M]. 南京: 江苏科学技术出版社, 2000: 10-26.
9.	王忠诚. 王忠诚神经外科学[M]. 湖北科学技术出版社, 2004: 867-874.
10.	Erdogan N, Tucer B, Mavili E, et al. Ultrasound guidance inintracranial tumor resection: correlation with postoperative magnetic resonance findings[J]. Acta Radiol,2005, 46(7): 743-749.
11.	王怡, 王涌, 杨永明. 术中超声在神经外科手术中的应用价值[J]. 中国医学影像技术, 2004, 20(2): 227-229.

1. 　中华神经科学会, 中华神经外科学会. 全国第四届脑血管病学术会议: 脑卒中临床疗效评定标准[J]. 中华神经科杂志, 1996, 29(6): 381 - 383.
2. 　姜笑千, 何文, 赵继宗, 等. 颅内动静脉畸形的术中超声应用研究[J/CD]. 中华医学超声杂志(电子版), 2006, 3(4): 213-215.
3. 　Cokluk C, Lyigun O, Senel A, et al. The guidance of intraoperativeUltrasonography in the surgical treatment of arteriovenous malformation[J]. Minim Invasive Neurosurg, 2003, 46(3): 169-172.
4. 　王立淑, 何文, 刘会晤, 等. 颅内血管网织细胞瘤的术中超声应用研究[J/CD]. 中华医学超声杂志(电子版), 2008, 5(2): 255-260.
5. 　Dempsey RJ, Moftakhar R, Pozniak M. Intraoperative Doppler to measure cerebrovascular resistance as a guide to complete resection of arteriovenous malformations[J]. Neurosurgery, 2004, 55(1): 155-160.
6. 　Griffith S, Pozniak MA, Mitchell CC, et al. Intraoperative sonography of intracranial arteriovenous malformations, how we do it[J]. J Ultra sound Med, 2004, 23(8): 1065-1072.
7. 　周大彪, 赵继宗, 王硕, 等. 术中实时超声在脑动静脉畸形外科治疗中的应用[J]. 中华医学杂志, 2005, 85(24): 1688-1691.
8. 　刘承基. 脑血管外科学[M]. 南京: 江苏科学技术出版社, 2000: 10-26.
9. 　王忠诚. 王忠诚神经外科学[M]. 湖北科学技术出版社, 2004: 867-874.
10. 　Erdogan N, Tucer B, Mavili E, et al. Ultrasound guidance inintracranial tumor resection: correlation with postoperative magnetic resonance findings[J]. Acta Radiol,2005, 46(7): 743-749.
11. 　王怡, 王涌, 杨永明. 术中超声在神经外科手术中的应用价值[J]. 中国医学影像技术, 2004, 20(2): 227-229.

West China Medical Journal

Application of Intraoperative Ultrasonography in the Resection of Intracranial Arteriovenous Malformation

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