engleski

Correlation of intraoperative ultrasound, computed tomography, magnetic resonance imaging and histopathological findings

In the last five years intraoperative US was carried out in more than a thousand operations, mostly in tumours. We try to determine whether this method provides additional information about the extent of a solid tumour, its differentiation from surrounding oedema, its tissue components and defining borders. All gliomas were echogenic compared to surrounding brain. The centre of the tumours may consist of necrosis or cyst wich is not always visible in CT or MRI scans. Comparison of US, CT images and histological findings revealed that the vast majority of contrast enhancing areas on CT were hyperechogenic and contained tumour tissue. Hyperechogenic areas always represented solid tumour even when the CT showed low density, histology consistently revealed necrotic tumour. US improved intraoperative delineation of tumour margins, as depicted by CT and MRI, thus maximising the extent of resection. However, with recurrent tumours, US tends to overestimate the tumour volume. Gliosis may account for this difference. Despite the high specificity of US in the differentiation of tumour components, its sensitivity to tumour was inferior to that of CT and MRI, but allows identification of tumour tissue and its extent.

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