Evaluation of the Use of Intraoperative Ultrasound in Resection of Intraaxial Posterior Fossa Lesions

Abstract

Background: Debate continues on the value of neuronavigation techniques in resection of intraaxial brain tumors. We present our experience with the value of the Intraoperative ultrasound in resection of intraaxial posterior fossa lesions.

Methods: We prospectively observed 45 patients with intraaxial posterior fossa lesions in which we used the IOUS during resection in 23 of them. We evaluated the value of the IOUS with regards to localization of the lesion, definition of the lesion borders and differentiating the solid and cystic parts. We also compared the extent of resection between the IOUS and control groups.

Results:IOUS was able to well localize the lesions in 96% of cases and it was able to differentiate solid and cystic parts in all the cases. There was no significant difference between the residual volumes detected by the IOUS or the postoperative MRI. An extent of resection > 85% was achieved in 19/23 (83%) of the cases in the IOUS group and in 11/22 (50%) of the cases in the control group (p value of 0.03).

Conclusion:Intraoperative ultrasound was found to be valuable in: Localization of the lesion, differentiating solid and cystic part and detection of residual volume in posterior fossa intraaxial lesions. IOUS is a potential competitor (cost effective) to the intraoperative MRI in developing countries with limited resources like Egypt.