脳神経外科穿頭術におけるburr-hole用プローブを用いた術中エコーの有用性

Clinical Application of Ultrasonography with a Burr-hole Transducer during Burr-hole Surgery

Ⅰ．はじめに

　穿頭術は脳神経外科手術の中でもよく行われているが，術野が狭く，盲目的操作を強いられることがある．Burr-hole用エコープローブは先端が直径約1cmと小さく，burr-holeに挿入することができ，頭蓋内を観察できる¹⁰⁾．穿頭術におけるburr-hole用プローブを用いた術中エコーの有用性を報告する．

　Ultrasound imaging has become a common method for evaluation of the central nervous system. In this report, we present our novel experience with ultrasonography monitoring conducted through a burr-hole for investigation of intracranial lesions. A portable ultrasound scanner and a small transducer with a straight, untapered head were used. After opening a standard burr-hole, the transducer was inserted through the burr-hole and the intracranial lesion was examined. Intraoperative ultrasonography provides immediate ongoing information about the anatomy and pathological lesions. Distance and trajectory to the best location for the catheter were determined and the catheter was inserted with ultrasound monitoring. The final position of the catheter placed accurately into the intended compartment of the ventricular system. No procedure related complication was noted and pitfalls were minimal. Furthermore, a postoperative CT scan was obtained in each case to confirm the appropriateness of the procedure with ultrasonography. In conclusion, intraoperative ultrasonography using a burr-hole transducer has proved useful in neurological surgery.