gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Ultrasound-navigated burr-hole biopsies in low-grade-glioma

Meeting Abstract

  • H. Allouch - Neurochirurgische Klinik, Zentralklinik Bad Berka
  • J. Behnke-Mursch - Neurochirurgische Klinik, Zentralklinik Bad Berka
  • K. Mursch - Neurochirurgische Klinik, Zentralklinik Bad Berka

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.05-04

DOI: 10.3205/09dgnc021, URN: urn:nbn:de:0183-09dgnc0216

Published: May 20, 2009

© 2009 Allouch et al.
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Outline

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Objective: In contrast to stereotaxy, ultrasound-guided brain biopsies provide a real-time imaging throughout the whole procedure. However, a small probe may have limited image quality. Aim of our study was to evaluate whether a biopsy of non-enhancing, diffuse intracerebral lesions is possible using ultrasound guiding alone.

Methods: We analysed 87 ultrasound guided brain tissue biopsies performed in our department within the last three years. Besides regular preoperative MRI, no additional imaging is required. Through a single burr-hole with a diameter of 11 mm, a 6x9 mm ultrasound probe was placed upon the dura, providing an image of the intracerebral lesion and, by use of integrated Duplex sonography, as well of the surrounding vessels. The needle was safely attached to the probe by a guiding device, which was fixed at the neurosurgical head-holder. Except the brain stem, all regions of the brain, including the cerebellum, were approached.

Results: Among the 87 lesions, 11 were diffuse and did not enhance contrast media preoperatively. No operative complication occurred. All but one could be properly seen on intraoperative ultrasound and specific tissue could be obtained in all 10. Six of these were low-grade gliomas, 3 exhibited to be anaplastic gliomas and one B-cell lymphoma was found. The eleventh biopsy revealed non-specific tissue. However, these lesions did not enlarge within the next two years.

Conclusions: This technique proved to have a high sensitivity and specificity, allowing a safe brain biopsy even in non-enhancing and diffuse lesions. In contrast to frame-based stereotaxy, it saves time and imaging capacity.