The value of micro-doppler in stereotactic brain biopsy
Identifieur interne : 001780 ( Main/Exploration ); précédent : 001779; suivant : 001781The value of micro-doppler in stereotactic brain biopsy
Auteurs : F. Hertel [Allemagne] ; W. Feiden [Allemagne] ; M. Bettag [Allemagne]Source :
- Minimally invasive neurosurgery [ 0946-7211 ] ; 2005.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
- Biopsy, Blood Loss, Surgical (prevention & control), Brain Diseases (diagnostic imaging), Brain Diseases (pathology), Brain Diseases (surgery), Doppler ultrasound study, Encephalon, Female, Hemorrhage, Humans, Male, Middle Aged, Nervous system diseases, Reproducibility of Results, Retrospective Studies, Stereotaxia, Stereotaxic Techniques, Surgery, Surgery, Computer-Assisted, Treatment Outcome, Ultrasonography, Doppler, Pulsed.
- MESH :
- diagnostic imaging : Brain Diseases.
- pathology : Brain Diseases.
- prevention & control : Blood Loss, Surgical.
- surgery : Brain Diseases.
- Biopsy, Female, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Stereotaxic Techniques, Surgery, Computer-Assisted, Treatment Outcome, Ultrasonography, Doppler, Pulsed.
Abstract
Objective: The aim of this study was to analyse the value of intraoperative micro-Doppler in stereotactic brain biopsy (SBB). So far, only a few studies have reported about the usefulness of micro-Doppler in stereotactic brain biopsy. Methods: Between 1998 and 2003,155 SBBs were performed in 153 patients with micro-Doppler (81 males, 72 females, mean age: 59 years). All operations were performed using a ZD-frame and a multiplanar computer tomography-guided trajectory planning system (Leibinger SPP®). A 16 MHz micro-Doppler probe (diameter 1 mm, DWL®) was used in all cases to explore the area of biopsy before the tissue probes were taken. Serial biopsies (mean, 6 samples) were taken with the Sedan side-cutting cannula (n = 145) or the small forceps (n= 10). We evaluated the number of intraoperative detectable vessel signals by micro-Doppler, intraoperative bleedings as well as bleedings detected by postoperative CT (which was performed in all cases). We compared our results according to bleeding-related complications with the data of stereotactic biopsy series from the recent literature. Results: A conclusive histopathological diagnosis was achieved in 150/153 patients (98%). A re-biopsy had to be undertaken in 2 cases. In 98 biopsies (63%), no vessel could be detected with the micro-Doppler. In the remainder, a signal of arterial vessels was detected in 22 (14%) and a signal of venous vessels in 35 cases (23 %). Detection of a vessel in the micro-Doppler led to a change of the biopsy site in each case within the same trajectory. Biopsy-related bleedings were detected in 4 cases (2.6%). Among these, the only bleeding which occurred without any signs of vessels in the micro-Doppler happened in a case of a melanoma. The overall biopsy-related permanent morbidity was 0.6% (n=1). The biopsy-related mortality was 0. Conclusions: Despite the overall high security of SBB, the use of intraoperative micro-Doppler may lead to an additional reduction of the risk for a biopsy-related bleeding without enormous expense.
Affiliations:
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Le document en format XML
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<term>Blood Loss, Surgical (prevention & control)</term>
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<term>Brain Diseases (pathology)</term>
<term>Brain Diseases (surgery)</term>
<term>Doppler ultrasound study</term>
<term>Encephalon</term>
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<term>Hemorrhage</term>
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<term>Male</term>
<term>Middle Aged</term>
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<term>Retrospective Studies</term>
<term>Stereotaxia</term>
<term>Stereotaxic Techniques</term>
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<term>Surgery, Computer-Assisted</term>
<term>Treatment Outcome</term>
<term>Ultrasonography, Doppler, Pulsed</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain Diseases</term>
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<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Blood Loss, Surgical</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Brain Diseases</term>
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<keywords scheme="MESH" xml:lang="en"><term>Biopsy</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Reproducibility of Results</term>
<term>Retrospective Studies</term>
<term>Stereotaxic Techniques</term>
<term>Surgery, Computer-Assisted</term>
<term>Treatment Outcome</term>
<term>Ultrasonography, Doppler, Pulsed</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term>
<term>Hémorragie</term>
<term>Chirurgie</term>
<term>Dopplérométrie</term>
<term>Stéréotaxie</term>
<term>Encéphale</term>
<term>Biopsie</term>
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<front><div type="abstract" xml:lang="en">Objective: The aim of this study was to analyse the value of intraoperative micro-Doppler in stereotactic brain biopsy (SBB). So far, only a few studies have reported about the usefulness of micro-Doppler in stereotactic brain biopsy. Methods: Between 1998 and 2003,155 SBBs were performed in 153 patients with micro-Doppler (81 males, 72 females, mean age: 59 years). All operations were performed using a ZD-frame and a multiplanar computer tomography-guided trajectory planning system (Leibinger SPP®). A 16 MHz micro-Doppler probe (diameter 1 mm, DWL®) was used in all cases to explore the area of biopsy before the tissue probes were taken. Serial biopsies (mean, 6 samples) were taken with the Sedan side-cutting cannula (n = 145) or the small forceps (n= 10). We evaluated the number of intraoperative detectable vessel signals by micro-Doppler, intraoperative bleedings as well as bleedings detected by postoperative CT (which was performed in all cases). We compared our results according to bleeding-related complications with the data of stereotactic biopsy series from the recent literature. Results: A conclusive histopathological diagnosis was achieved in 150/153 patients (98%). A re-biopsy had to be undertaken in 2 cases. In 98 biopsies (63%), no vessel could be detected with the micro-Doppler. In the remainder, a signal of arterial vessels was detected in 22 (14%) and a signal of venous vessels in 35 cases (23 %). Detection of a vessel in the micro-Doppler led to a change of the biopsy site in each case within the same trajectory. Biopsy-related bleedings were detected in 4 cases (2.6%). Among these, the only bleeding which occurred without any signs of vessels in the micro-Doppler happened in a case of a melanoma. The overall biopsy-related permanent morbidity was 0.6% (n=1). The biopsy-related mortality was 0. Conclusions: Despite the overall high security of SBB, the use of intraoperative micro-Doppler may lead to an additional reduction of the risk for a biopsy-related bleeding without enormous expense.</div>
</front>
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