Role of Real-Time Ultrasonography in Glioma Surgery

Abstract

Glioma cases operated on since 1980 were analyzed in regard to the role of intraoperative ultrasonography (IOUS) . Perioperative MRI's and/or CT scans, and stained specimens and pathological reports were also reviewed. 3 cases of low-grade astrocytoma, 1 case of metastatic malignancy (for comparison), 2 cases of gemistocytic astrocytoma or astrocytoma with gemistocytic proliferation, and 1 case of glioblastoma multiforme were presented. Low-grade astrocytomas were generally hyperechoic with indistinct margins. IOUS was mostly helpful for guiding open biopsy maneuvers, but less so for needle biopsy. When located deep in the thalamus, however, IOUS was helpful in guiding needle biopsy. Gemistocytic astrocytomas were rather hyperechoic and proved good candidates for either echo-guided needle biopsy or open biopsy. Malignant gliomas were well visualized and good candidates both for needle biopsy and extensive excision under ultrasound guidance.