Intraoperative neurosurgical ultrasound in the localization and characterization of intracranial masses.

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Abstract
Lesions (72) were demonstrated in 70 patients who were examined using intraoperative real-time ultrasonography. Fifty-five lesions were supratentorial and 17 were infratentorial. Ultrasonography was used to evaluate the operative field before, during and after resection. Nineteen lesions contained cystic components. In 8 cases, ultrasonography added information not provided by CT [computed tomography] including definitive characterization of cystic components and loculations or localization of solid masses within the cysts. Biopsy of 13 lesions was performed under ultrasonic guidance. In all cases, the biopsy probe could be seen passing through the lesions leaving an echogenic trail, possibly blood filled, after the probe had been removed. Three lesions with diameters of less than 1 cm were localized and successfully removed under ultrasonic guidance. Intraoperative realtime ultrasonography is a safe and reliable technique, and it can be a valuable aid to the neurosurgeon.