title: Application of intraoperative ultrasonography for guiding microneurosurgical resection of small subcortical lesions.
abstract: OBJECTIVE
  We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions.
  
  
  METHODS
  Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation.
  
  
  RESULTS
  All the lesions were located in the cortex and their mean size was 1.3 ± 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated.
  
  
  CONCLUSIONS
  Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.
authors.affiliation: Department of Ultrasound, Tangdu Hospital of the Fourth Military Medicine University, Xi an 710038, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.forename: Yun You
authors.initials: YY
authors.lastname: Duan
authors.forename: Xi
authors.initials: X
authors.lastname: Liu
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Guo Dong
authors.initials: GD
authors.lastname: Gao
authors.forename: Huai Zhou
authors.initials: HZ
authors.lastname: Qin
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000601:surgery; D020786:Hemangioma, Cavernous, Central Nervous System / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018084:Ultrasonography, Interventional; D055815:Young Adult