Intraoperative color-coded duplex sonography of the superior sagittal sinus in parasagittal meningiomas

Perspectives in Medicine Pub Date : 2012-09-01 DOI:10.1016/j.permed.2012.04.011

Vladimir B. Semenyutin, Dmitriy A. Pechiborsch, Viktor E. Olyushin, Vugar A. Aliev, Vladislav Y. Chirkin, Alexander V. Kozlov, G.K. Panuntsev

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Abstract

Background

Patency of the superior sagittal sinus (SSS) is a key factor in surgery of parasagittal meningiomas (PSM). The main and least invasive method of evaluation of the SSS is magnetic resonance venography (MR venography). However the efficacy of this method is limited in some cases especially in slow flow velocities.

Objective

Determine potentials of intraoperative color-coded duplex sonography (CCDS) for evaluation of the SSS in PSM comparing them with MR venography.

Methods

CCDS was conducted in 30 adult patients with PSM using linear ultrasound probe i12L-RS (Vivid E, GE) placed on the superior wall of the SSS after craniotomy. Intraoperative CCDS findings were compared with 2D time-of-flight MR venography.

Results

False-positive results of complete occlusion of the SSS by MR venography in our series were obtained in 7 out of 16 cases (for the anterior third of the SSS – 5 out of 6; middle third – 1 out of 8; posterior third – 1 out of 2). CCDS determined the degree of SSS invasion and differentiated invasion from compression or thrombosis of the SSS, which MR venography could not.

Conclusion

Intraoperative CCDS is safe and allows evaluation of SSS patency as well as venous lacunae, bridging veins and inferior sagittal sinus, classification according to degree of SSS invasion, and being more precise than MR venography it can be used to determine surgical strategy.

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矢状旁脑膜瘤上矢状窦的术中彩色双超

背景:上矢状窦(SSS)的通畅是手术治疗旁矢状脑膜瘤(PSM)的关键因素。评估SSS的主要和微创方法是磁共振静脉造影(MR venography)。然而，这种方法的有效性在某些情况下是有限的，特别是在慢流速。目的探讨术中彩色双工超声(CCDS)与MR静脉造影对PSM中SSS的评价价值。方法采用线性超声探头i12L-RS (Vivid E, GE)对30例成年PSM患者开颅后置于SSS上壁进行sccds检查。将术中CCDS结果与2D飞行时间MR静脉造影结果进行比较。结果在我们的研究中，16例中有7例通过MR静脉造影获得SSS完全闭塞的假阳性结果(SSS前三分之一- 6例中的5例;中间三分之一——八分之一;后三分之一- 1 / 2)。CCDS确定SSS侵犯程度，并区分SSS压迫或血栓形成的侵犯，这是MR静脉造影无法做到的。结论术中CCDS是安全的，可以评估SSS的通畅程度以及静脉腔隙、桥静脉和下矢状窦，根据SSS侵犯程度进行分类，比MR静脉造影更精确，可用于确定手术策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Perspectives in Medicine

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