Intraoperative Ultrasound Imaging: Comparison of Pathomorphological Findings in US Versus CT, MRI and Intraoperative Findings

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Abstract
Since 1987, Ultrasound (US) is performed routinely as real time navigation system in our neurosurgical practice. In 374 cases with different pathologies the preoperative CT and MRI images were compared with the intraoperative US images and the operative findings. In all instances, the lesion could be localized and described in detail. US findings correlated with the findings an CT/MRI, concerning size and shape of lesions. US allowed the differentiation of more structural details within tissue compartments. The demarcation of gliomas was not as well defined in US as compared to CT/ MRI, which correlated with the intraoperative situation. As for CT/ MRI imaging, a correlation between US findings and histopathology of the lesion was not possible. In our opinion, intraoperative US imaging is an excellent tool for localization of cerebral and medullar lesions and for detailed description of their interior. This indicates a widespread applicability of this method in neurosurgery as an anatomical link between preoperative imaging and the reality of the operative field.