The value of micro-doppler in stereotactic brain biopsy
Identifieur interne : 001944 ( Main/Merge ); précédent : 001943; suivant : 001945The 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 :
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.
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Pascal:05-0329258Le document en format XML
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<term>Doppler ultrasound study</term>
<term>Encephalon</term>
<term>Hemorrhage</term>
<term>Nervous system diseases</term>
<term>Stereotaxia</term>
<term>Surgery</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>
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