Intraoperative Contrast Enhanced Ultrasound Evaluates the Grade of Glioma.

Ling-Gang Cheng,Bin Ning,Hong-Xia Zhang,Yan He,Song Lin,Wen He,Qian Song,Hui-Zhan Li

doi:10.1155/2016/2643862

Abstract

Objective. The aim of our study was to investigate the value of intraoperative contrast enhanced ultrasound (CEUS) for evaluating the grade of glioma and the correlation between microvessel density (MVD) and vascular endothelial growth factor (VEGF). Methods. We performed intraoperative conventional ultrasound (CUS) and CEUS on 88 patients with gliomas. All of the patients have undergone surgery and obtained the results of pathology. All patients have undergone intraoperative CUS and CEUS to compare the characteristics of different grade gliomas and the results of CUS and CEUS were compared with pathological results. Results. The time to start (TTS) and time to peak (TTP) of low grade glioma (LGG) were similar to those of edema and normal brain surrounding glioma. The enhanced extent of LGG was higher than that of the normal brain and edema. The TTS and TTP of high grade glioma were earlier than those of the edema and normal brain surrounding glioma. The enhancement of HGG was higher than that of LGG. The absolute peak intensity (API) was correlated with MVD and VEGF. Conclusion. Intraoperative CEUS could help in determining boundary of peritumoral brain edema of glioma. Intraoperative CEUS parameters in cerebral gliomas could indirectly reflect the information of MVD and VEGF.

Highlights

Glioma is the most common primary neuroepithelial tumors, which accounts for 50% of intracranial tumors [1]
Low grade gliomas (LGG) included levels I and II, and high grade glioma (HGG) mainly included levels III and IV referring to the WHO classification of glioma in 2000
The area of edema appeared in 7 cases in low grade glioma and 22 cases in high grade glioma

Summary

Introduction

Glioma is the most common primary neuroepithelial tumors, which accounts for 50% of intracranial tumors [1]. The grade of glioma is closely related to the prognosis. The growth, invasion, and metastasis of tumor depended on angiogenesis, and the degree of tumor angiogenesis is closely related to malignancy and prognosis of tumor. CT can accurately determine the location of the lesion and clearly show the glioma calcification, but the accuracy is not good. MRI could diagnose the glioma more accurately than CT preoperatively. The assessment of gliomas by MRI was more accurate than CT, but it has limited application in surgery [2,3,4]. It is difficult to distinguish the grade of glioma by CT or MRI preoperatively [5]

Methods

Results

Conclusion