Background: Intraoperative ultrasound (IOUS) provides real-time imaging during brain tumor surgery but remains underused in brain metastasis resection. This study evaluates the effectiveness of 2D IOUS in improving the extent of resection compared to standard neuronavigation.Methods: We retrospectively analyzed 55 adult patients with brain metastases treated surgically at a single center. Patients were divided into two groups: IOUS-guided surgery (n = 20) and standard neuronavigation (n = 35). Gross total resection (GTR) was defined as the extent of resection > 96%, assessed volumetrically. Statistical analyses included chi-square tests, logistic regression, and ROC curve analysis.Results: GTR > 96% was achieved in 80% of IOUS-guided cases compared to 42.86% in the control group (p= 0.008). IOUS significantly increased the odds of achieving GTR (OR = 5.33,p= 0.011). Larger tumor volume reduced the likelihood of GTR (OR = 0.469,p= 0.025), but this effect was mitigated by IOUS use (interaction OR = 1.986,p= 0.044). The regression model showed excellent discrimination (AUC = 0.930,p< 0.001). Functional outcomes improved postoperatively in both groups.Conclusions: 2D IOUS significantly enhances the extent of resection in brain metastasis surgery, including that for larger tumors. Its accessibility, real-time feedback, and low cost support its wider adoption in neurosurgical practice, especially in settings with limited resources.
背景：术中超声（IOUS）可在脑肿瘤手术中提供实时成像，但在脑转移瘤切除术中仍未得到充分利用。本研究评估了二维IOUS与标准神经导航相比在提高切除范围方面的有效性。 方法：我们回顾性分析了55例在单一中心接受手术治疗的脑转移瘤成年患者。患者被分为两组：IOUS引导手术组（n=20）和标准神经导航组（n=35）。大体全切除（GTR）定义为体积评估切除范围>96%。统计分析包括卡方检验、逻辑回归和ROC曲线分析。 结果：IOUS引导组中80%的病例实现了>96%的GTR，而对照组为42.86%（p=0.008）。IOUS显著提高了实现GTR的几率（OR=5.33，p=0.011）。较大的肿瘤体积降低了实现GTR的可能性（OR=0.469，p=0.025），但使用IOUS可减轻这种影响（交互作用OR=1.986，p=0.044）。回归模型显示出极佳的区分度（AUC=0.930，p<0.001）。两组患者术后功能结局均有所改善。 结论：二维IOUS显著提高了脑转移瘤手术的切除范围，包括较大肿瘤的手术。其易用性、实时反馈和低成本支持其在神经外科实践中更广泛的应用，特别是在资源有限的环境中。
肿瘤(癌症)患者之家