By Francesco Prada, Luigi Solbiati, Alberto Martegani, Francesco DiMeco
This e-book is meant as a pragmatic guide at the use of intraoperative ultrasound (IOUS) as a device for imaging tips in the course of cranial and spinal neurosurgical techniques. complete account is taken of the emergence of novel scientific purposes and up to date technical advances, with broad insurance of the impression of advancements comparable to more desirable probe expertise, fusion imaging and digital navigation, 3D ultrasound imaging, contrast-enhanced ultrasound, and elastosonography. easy ideas of ultrasound are elucidated in an effort to help in the optimum use of IOUS and transparent suggestions is equipped at the interpretation of imaging findings in quite a few pathologies. Informative comparisons also are made from using strategies corresponding to fusion imaging and contrast-enhanced ultrasound in most cases radiology and neurosurgery. the purpose of the authors is to augment the overall wisdom concerning intra-operative ultrasound mind imaging, standardizing its use and exploring new strategies, major not directly towards compensating the inability of particular education within the program of ultrasound one of the neurosurgical neighborhood. IOUS is a delicate instrument that may increase surgical precision and support to minimize morbidity.
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Additional resources for Intraoperative Ultrasound (IOUS) in Neurosurgery: From Standard B-mode to Elastosonography
However, three main commands are usually very similar regardless the brand. 4 Gain This tool is very similar to a control for image brightness. Essentially, it controls the amplifica- b Fig. 2 Two different depth setting. (a) The image is set very deep. The Achilles tendon (arrowheads) is seen relatively small but spatial definition is good. C calcaneus. (b) The image is set very superficial. The Achilles tendon is magnified but spatial definition is relatively poor 3 Ultrasound System Setup and General Semeiology a 23 b Fig.
Freeze command is indicated as #2 on Fig. 1. ). When this tool is selected, the pointer usually becomes a small cross. The cross is placed on one side of the lesion and one of the buttons of the trackball is pressed. Then, using the trackball, the cross is moved on the other side of the lesion and the button is clicked again. The system usually traces a line between the two marks and the measure is displayed over/aside the image. ), usually from a side menu. Use of calipers is shown in Fig. 6. 3 General Semeiology Being ultrasound an imaging modality mainly based on gray-scale images, a tissue or an organ can be brighter or darker of another.
Covered by sterile transparent drape) (Fig. 2). The probe is wrapped in plastic sterile sheet together with sterile US-compatible gel. It is mandatory that the surgeon can easily set the US device during all the surgery (Fig. 2). The patient must be positioned, when possible, to allow the surgical field to be horizontal in order to be filled by saline solution for best US coupling. 5 cm) and permitting its free tilting and orientation (Figs. 4). 3 IOUS Exam Main aim of intraoperative B-mode study is to visualize the entire lesion and its relationships with the healthy neurovascular structures/brain parenchyma.