A new ultrasound-guided brain biopsy technique through a burr hole

Tsutsumi, Yutaka; Andoh, Yukihiko; Sakaguchi, Jun

doi:10.1007/bf01403497

Cited by 20 publications

(5 citation statements)

References 7 publications

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“…The experimental basis was given by Enzmann et al who clearly demonstrated that ultrasound imaging is able to detect abscesses in all stages of evolution [13]. Miniaturized ultrasound probes were developed in the late 1980s and used for biopsy of tumors and evacuation of cerebral hematomas [15,22]. Moringlane et al used a similar probe like ours to survey frame-based stereotactic procedures and clearly demonstrated sufficient quality of imaging although image resolution tended to be relatively poor at distances longer than 60 mm due to the limited acoustic aperture of the probe.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, this consecutive technique did not allow real-time imaging of the procedure. This was achieved by Tsutsumi et al in 1989 with a round ultrasound probe of 12 mm [15] and finally Moringlane et al demonstrated real-time ultrasound imaging of frame-based stereotactic procedures using a probe with tip dimensions of 8 8 mm [16]. The question of this study is whether it is possible to safely localize and aspirate brain abscesses under ultrasound guidance alone using a probe that is small enough to allow a single standard burr hole approach.…”

Section: Introductionmentioning

confidence: 88%

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Ultrasound-Guided Aspiration of Brain Abscesses Through a Single Burr Hole

Strowitzkí¹,

Schwerdtfeger²,

Steudel³

2001

Minim Invasive Neurosurg

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Surgical aspiration and/or drainage of brain abscesses is considered to be the first-line treatment for abscesses larger than 25 mm. This is ususally performed with the aid of CT-guided stereotaxy. A method of ultrasound guidance is presented that allows a single burr hole approach with real-time imaging of the whole procedure. A bayonet-like shaped ultrasound probe with tip dimension of 8 x 8 mm only (EUP-NS 32, Hitachi/Ecoscan) with frequencies of 3.5 and 5 MHz is used. After placement of a burr hole the target is identified by transdural insonation, a guideline is adjusted and a mounted puncture-adapter guides the cannula towards the lesion under real-time imaging control. Up to now 12 abscesses in 10 patients were treated. Visualization was always excellent. A second aspiration had to be performed twice. One abscess did not contain enough pus to be cured by aspiration and was removed by open surgery, another could not be tapped by the blunt cannula and was aspirated under stereotactic control using a sharp trocar. Outcome was excellent in 6 patients and fair in 2 patients but this was due to the pre-existing disease. Two patients admitted in deep coma died despite an emergency operation. The presented method has proven to be a very powerful guiding tool in the surgical treatment of brain abscesses through a single burr hole approach.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

Ultrasound-Guided Aspiration of Brain Abscesses Through a Single Burr Hole

Strowitzkí¹,

Schwerdtfeger²,

Steudel³

2001

Minim Invasive Neurosurg

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“…Initially they were fixed to the bone. With current fixers fastened to the operation table, this shortcoming is excluded [9].…”

Section: Discussionmentioning

confidence: 99%

The Difference Between Ultrasound-Guided and Stereotactic-Guided Neurosurgical Procedures

Melada¹,

Heinrich²,

Chudy³

et al. 2000

Minim Invasive Neurosurg

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We evaluate two different methods, ultrasound (US) guidance and stereotactic guidance, routinely used in our Department for navigation in various neurosurgical procedures. We have performed 53 US-guided and 101 stereotactic-guided procedures. These procedures were intracranial lesion biopsies, intracranial cysts and abscesses puncture and evacuations, ventricular punctures for hydrocephalus shunt operations, stereotactic-guided microneurosurgical resections, and stereotactic-guided endoscopic operations. Advantages of the US-guided operations are the shortness of the procedure, simplicity (no need for moving patient for additional CT scanning), no irradiation and the possibility of real-time imaging. The disadvantages of the US-guided procedures are worse resolution of the images in deep-seated and small lesions as well as the need for a bigger trepanation because of the transducer's dimensions. Stereotactic procedures are time-consuming but more precise and usually done in local anaesthesia because only a small trepanation is required. Main disadvantage of the stereotactic-guided procedures when compared with the US-guided procedures is a lack of real-time intraoperative control. According to our experience, both methods are complementary and safe and they do not cause any additional complications when used as a navigation tool in microneurosurgical operations. Both methods are highly reliable when used in properly selected patients.

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“…Bone aspirates are now commonly performed in our practices. [33][34][35][36][37][38][39][40][41][42] A craniotomy or burr hole permits transducer placement on the dura or cortical surface. 55 Radiographic evidence of a destructive or destructive-productive bone lesion was identified in the appendicular skeleton of 20 animals and in the axial skeleton of 3.…”

Section: Bonementioning

confidence: 99%