神經(jīng)外科術中超聲掃描七步法

1、7 Steps of Neurosurgery Ultrasound Scanning Alex Fan Asia clinical application & KOL managerGeneral advice Previous surgery and radiotherapy can cause difficulties using ultrasound in the brain or spine. The bone opening must be large enough to accommodate the probe. Good acoustic contact requir

2、es the use of sterile ultrasound gel or saline between the probe and brain/dura. If available, connection to Brainlab navigation will allow faster and more intuitive orientation.7 steps of Neurosurgery US Scanning Enter patient IDRecognize patients positionSelect probe & presetSet frequencyIdent

3、ify left side of probe Recognize ultrasound imagesThree planes of brainPatients position is crucialTypical CT/MR scanIdeal position for US scanningSelect probe & preset Craniotomy probe: 8862 Burr-hole probe: 8863 “Hockey stick”probe: 8809Set frequencyDefault setting is 8MHzDeep Peripheral Ident

4、ify left side of probe Recognize ultrasound imagesEchogenicity Hyper-echoic Iso-echoic Hypo-echoicHomogenicity / Uniformity Homogenous / Uniform Heterogenous / NonuniformShape Regular Irregular Border Clear / Sharp Unclear Recognize ultrasound imagesEchogenicityHyper-echoic Iso-echoicHypo-echoicReco

5、gnize ultrasound imagesHomogenicity / UniformityHomogenous/ Uniform Heterogenous / NonuniformRecognize ultrasound imagesShape Regular Irregular Recognize ultrasound imagesBorder Echogenicity HomogenicityHypoechoicIsoechoicHyperechoicHomogenousHeterogenousWhite materXXGrey MaterXXXVentricleXXSulciXXC

6、horoid PlexusXXBrainstemXXNormal BrainGrey matterWhite matterSulci FalxNormal BrainGyrus Sulci Choroid PlexusventricleThree planes of brainHorizontal Coronal saggitalThree planes of brain Most commonly used in daily work. Horizontally put the probe on the surface of brain tissue after remove part of

7、 skull, then you can have typical horizontal plane. Different images on different levels。 Horizontal planeAnterior horizontal planeAnterior lateral ventricleTemporal window horizontal planeOccipital horizontal planeLevels of horizontal plane Cortex level Lateral ventricle level 4th ventricle level B

8、rainstem levelCortex level1: Cerebral Falx2: Sulci3: Gyrus112233Lateral ventricle level11221、Cerebral Falx 2、Lateral Ventricle4th ventricle level331111223344Brainstem level13322211、Cerebral falx2、Brainstem3、LesionSagittal planeSagittal plane1：Lateral Ventricle 2：Choroid plexus3：Ventriculus tertius 4：Corpus callosun6：Gyrus 7：Sulci Sagittal plane35544311221、Lateral ventricle 2、Corpus callosum 3、Choroid plexus4、Gyrus cinguli 5、LesionVertex Coronal planeVertex Coronal plane1：Lateral ventricle 2：Choroid plexus3：Ventriculus tertius 4：Cerebral falxVertex Coronal plane3112222445531、Cerebral falx 2、La