Intraoperative ultrasound (IOUS) is an increasingly adopted adjunctive intraoperative visualization method in spinal tumor surgery, offering real-time imaging that improves lesion localization, exposure planning, and resection control. This paper focuses on IOUS findings in rare intradural entities (neuroenteric/respiratory cysts, chronic spinal subdural hematoma, tethered cord/scarring, intradural extramedullary hemangioblastomas, and arachnoid cysts) where evidence remains limited. Across these lesions, IOUS typically depicts cysts as anechoic or hypoechoic cavities with definable walls and occasional septations; CSSDH is also delimited by hypoechoic subdural collections bounded by echogenic membranes; hemangioblastomas, as well as circumscribed, homogeneous nodules often with cystic components; and arachnoid webs/cysts with their boundaries and subtle subarachnoid communications. Doppler and micro-Doppler can delineate feeding and draining vessels in highly vascular tumors, while shear wave elastography provides quantitative stiffness changes that support effective detethering. IOUS complements preoperative MRI, shortens exposure, helps tailor bone and dural openings, and allows immediate assessment of residual disease. Taken together, current data and our experience support IOUS as a safe, cost-effective, and versatile intraoperative tool for rare intradural spinal pathology, while underscoring the need for prospective studies to refine sonographic criteria and validate outcome benefits.
术中超声（IOUS）作为一种辅助性术中可视化技术，在脊柱肿瘤手术中的应用日益广泛，其提供的实时成像有助于改善病灶定位、暴露规划及切除控制。本文聚焦于罕见椎管内病变（神经肠源性/呼吸性囊肿、慢性脊髓硬膜下血肿、脊髓栓系/瘢痕形成、椎管内髓外血管母细胞瘤及蛛网膜囊肿）的术中超声表现，目前相关证据仍较为有限。在这些病变中，术中超声通常将囊肿显示为无回声或低回声腔隙，囊壁清晰可见，偶见分隔；慢性脊髓硬膜下血肿则表现为由高回声膜包绕的低回声硬膜下积液；血管母细胞瘤多呈现边界清晰、回声均匀的结节，常伴有囊性成分；蛛网膜束带/囊肿则可显示其边界及细微的蛛网膜下腔交通。多普勒及微多普勒技术可清晰勾勒富血管性肿瘤的供血与引流血管，而剪切波弹性成像能提供定量硬度变化，有助于实现有效的脊髓栓系松解。术中超声可作为术前磁共振成像的有效补充，缩短手术暴露时间，优化骨性与硬膜切开范围，并能即时评估残留病灶。综合现有数据及我们的经验，术中超声是一种安全、经济且多功能的术中工具，适用于罕见椎管内病变的手术处理，同时需开展前瞻性研究以进一步完善超声诊断标准并验证其临床获益。
肿瘤(癌症)患者之家