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  • Title: Intraoperative sonography of intra- and extramedullary tumors.
    Author: Regelsberger J, Fritzsche E, Langer N, Westphal M.
    Journal: Ultrasound Med Biol; 2005 May; 31(5):593-8. PubMed ID: 15866408.
    Abstract:
    Intraoperative ultrasound (IOUS) was used in planning the operative resection of intradural spinal tumors, to define its diagnostic potential and limitations. Since 1997, 78 patients diagnosed with an ependymoma (n = 24), astrocytoma (n = 7), hemangioblastoma (n = 7), neurinoma (n = 15), meningioma (n = 17) and filum terminale ependymoma (n = 8) were examined using intraoperative transdural sonography. Intramedullary tumors turned out to show a heterogeneous image with occasional cystic alterations and an indistinct demarcation to the myelon of comparable echogenicity. Intramedullary tumors are easily distinguishable from their extramedullary counterparts, which display a homogeneous signal intensity and sharp demarcation on IOUS. In conclusion, IOUS allows a reliable diagnosis of intraspinal tumors, allowing the distinction between intra- and extramedullary tumors through their respective signal characteristics. Using IOUS, the extension of the neurosurgical approach can be adopted to the true extent of the tumor; thus, avoiding further bone work while the dura is already opened and the frequently edematous spinal cord protrudes through the opening. Our experiences have shown that IOUS may reduce the procedure-related morbidity and should, therefore, be used as a standard intraoperative tool in these high-risk surgical entities. (E-mail: ).
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