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首页> 外文期刊>Neurosurgical focus >Modern intraoperative imaging modalities for the vascular neurosurgeon treating intracerebral hemorrhage
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Modern intraoperative imaging modalities for the vascular neurosurgeon treating intracerebral hemorrhage

机译：血管神经外科治疗脑内出血的现代术中成像方式

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This paper reviews the current intraoperative imaging tools that are available to assist neurosurgeons in the treatment of intracerebral hemorrhage (ICH). This review shares the authors' experience with each modality and discusses the advantages, potential limitations, and disadvantages of each. Surgery for ICH is directed at blood clot removal, reduction of intracranial pressure, and minimization of secondary damage associated with hematoma breakdown products. For effective occlusion and safe obliteration of vascular anomalies associated with ICH, vascular neurosurgeons today require a thorough understanding of the various intraoperative imaging modalities available for obtaining real-time information. Use of one or more of these modalities may improve the surgeon's confidence during the procedure, the patient's safety during surgery, and surgical outcome. The modern techniques discussed include 1) indocyanine green-based video angiography, which provides realtime information based on high-quality images showing the residual filling of vascular pathological entities and the patency of blood vessels of any size in the surgical field; and 2) intraoperative angiography, which remains the gold standard intraoperative diagnostic test in the surgical management of cerebral aneurysms and arteriovenous malformations. Hybrid procedures, providing multimodality image-guided surgeries and combining endovascular with microsurgical strategies within the same surgical session, have become feasible and safe. Microdoppler is a safe, noninvasive, and reliable technique for evaluation of hemodynamics of vessels in the surgical field, with the advantage of ease of use. Intraoperative MRI provides an effective navigation tool for cavernoma surgery, in addition to assessing the extent of resection during the procedure. Intraoperative CT scanning has the advantage of very high sensitivity to acute bleeding, thereby assisting in the confirmation of the extent of hematoma evacuation and the extent of vascular anomaly resection. Intraoperative ultrasound aids navigation and evacuation assessment during intracerebral hematoma evacuation surgeries. It supports the concept of minimally invasive surgery and has undergone extensive development in recent years, with the quality of ultrasound imaging having improved considerably. Image-guided therapy, combined with modern intraoperative imaging modalities, has changed the fundamentals of conventional vascular neurosurgery by presenting real-time visualization of both normal tissue and pathological entities. These imaging techniques are important adjuncts to the surgeon's standard surgical armamentarium. Familiarity with these imaging modalities may help the surgeon complete procedures with improved safety, efficiency, and clinical outcome.
机译：本文综述了目前可用于辅助神经外部的术中成像工具治疗脑出血（ICH）。该审查分享了作者对每种方式的作者的经验，并讨论了每个态度的优缺点和缺点。对ICH的手术涉及血凝凝块去除，减少颅内压力，以及最小化与血肿分解产品相关的二次损害。对于与ICH相关的血管异常的有效闭塞和安全爆发，血管神经外科医生需要彻底了解可用于获得实时信息的各种术中成像方式。使用一种或多种这些方式可以改善外科医生在手术过程中的信心，患者在手术期间的安全性以及手术结果。讨论的现代技术包括1）基于吲哚菁绿基的视频血管造影，其基于高质量图像提供了实时信息，显示血管病理实体的残余填充和外科手术场中任何尺寸的血管的通畅; 2）术中血管造影，其仍然是脑动脉瘤和动脉畸形的手术管理中的金标准术诊断试验。混合程序，提供多层性图像引导的手术，并将血管内与同一外科会话中的显微外科策略组合，变得可行和安全。 Microdoppler是一种安全，非侵入性和可靠的技术，用于评估手术领域的血管血流动力学，具有易用性的优点。术中MRI还提供了一种有效的导航工具，用于气囊瘤外科，以及评估程序期间切除程度。术中CT扫描具有对急性出血的敏感性非常高的优点，从而有助于确认血肿疏散程度和血管异常切除程度。术中超声波艾滋病导航和疏忽评估脑血肿疏散手术。它支持微创手术的概念，近年来经历了广泛的发展，具有显着提高的超声成像的质量。通过呈现正常组织和病理实体的实时可视化，改变了图像引导疗法，改变了常规血管神经外科的基础知识。这些成像技术是外科医生标准外科手术arium的重要辅助。熟悉这些成像方式可以帮助外科医生完整的程序，提高安全性，效率和临床结果。

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