Contrast-enchanced ultrasound navigation in glioma surgery

Introduction. In the surgery of gliomas, various techniques are currently being applied that allow the maximum resection of the tumor while maintaining a good or satisfactory functional status of the patients. A rare method is intraoperative contrast‑enhanced ultrasound imaging (CEUI) of the brain substance.Aim. To present the first experience of using contrast‑enhanced ultrasound imaging CEUI in surgery of brain tumors (large hemispheres and cerebellum), as well as an assessment of the prospects of the technique in routine use in a neurosurgical hospital.Materials and methods. The features of the application of the technique CEUI, its advantages over routine ultrasound studies and the limitations identified during testing of the technique in 5 patients with various brain tumors.Results. In some cases, the CEUI allows for the intraoperative detection of a tumor, which is similar in sensitivity to magnetic resonance imaging. This greatly facilitates both the search for the neoplasm, and the formation of the optimal trajectory of surgery. In the case of benign brain tumors, ultrasound contrasting of the tumor is not always observed, but it often helps to determine the boards of the tumor with greater accuracy than the routine ultrasound search.Conclusion. The use of CEUI in the surgery of brain tumors seems to be a promising direction. A pilot study has confirmed its effectiveness, but more cases are needed to fully study the problem.