Clinical Application of intraoperative ultrasound Superb Microvascular Imaging in brain Tumors resections：Contribute to the achievement Total Tumoral Resection

Abstract

Abstract Background: To investigate whether intraoperative superb microvascular imaging technique is helpful in evaluating lesion boundaries compared with conventional gray-scale ultrasound in brain tumor surgery, and to explore factors that may be associated with complete radiographic resection. Methods: A total of 57 consecutive brain tumor patients undergoing surgery were enrolled in this study. The boundaries of brain tumors were evaluated by B-mode and SMI ultrasound during the operation. MRI before and within 48 hours after surgery was used as the gold standard to evaluate GTR. The ultrasound findings and GTR results were analyzed to find out the imaging factors related to GTR. Results: A total of 57 patients were enrolled in the study, including 32 males and 25 females with an average age of 53.4±14.1 years old(range, 19~80). According to the assessment criteria of MRI before and within 48 hours after operation, 37(63.9%) cases were classified as GTR, 20(35.1%) cases were classified as nGTR. In the comparison of tumor interface definition between B-mode and SMI mode, SMI improved HGG boundary recognition in 5 cases(P=0.033). The results showed that the tumor size≥5cm and unclear ultrasonic boundary were independent risk factors for nGTR (OR＞1, P＜0.05). Conclusions: As an innovative intraoperative doppler technique in neurosurgery, SMI can make a good demarcation on the boundary of the tumor and help achieve GTR as much as possible.