Association between features of intraoperative ultrasound and magnetic resonance imaging in the diagnosis of dysembryoplastic neuroepithelial tumor.

Abstract

To analyze the characteristics of images from intraoperative ultrasound (IoUS) and preoperative magnetic resonance imaging (MRI) and their relationship with pathological components of dysembryoplastic neuroepithelial tumor (DNT) and to discuss the role of IoUS in detecting tumor residues. The clinical and image data of 24 patients with postoperative pathology-confirmed DNT were analyzed retrospectively. Baseline characteristics, imaging features, and intraoperative residues were recorded for further analysis. Cohen's kappa consistency evaluation was performed on the echo and signal characteristics of the lesions. Cohen's kappa coefficient between the echo and signal of the lesion was 0.832. The characteristics of IoUS were gyrus or mass hyperechoic solid nodules located under the cortex, insufficient blood flow signals, and clear boundaries, in addition to mixed cystic and solid echo nodules. The solid part of the lesion consisted of pathologically nodular specific glioneuronal element (SGE) or was combined with glial nodules and focal cortical dysplasia (FCD), which was characterized by a high echo or long T1 long T2 signal and uniform or uneven distribution. The cystic part consisted of a mucinous matrix, showing echoless or long T1 long T2 on fluid attenuated inversion recovery (FLAIR), which was higher than that in cerebrospinal fluid but lower than that in the cerebral cortex. The residual lesion discovered using IoUS was confirmed with postoperative MRI. The IoUS characteristics of DNT are strongly consistent with MRI, and its imaging features are related to pathological components. IoUS can assist the operator to judge the mode and scope of tumor resection, detect residual tumor, and improve the rate of total tumor resection.