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1、7 Steps of Neurosurgery Ultrasound Scanning,Alex FanAsia clinical application&KOL manager,General advice,Previous surgery and radiotherapy can cause difficulties using ultrasound in the brain or spine.The bone opening must be large enough to accommodate the probe.Good acoustic contact requires the u
2、se of sterile ultrasound gel or saline between the probe and brain/dura.If available,connection to Brainlab navigation will allow faster and more intuitive orientation.,7 steps of Neurosurgery US Scanning,Enter patient IDRecognize patients positionSelect probe&presetSet frequencyIdentify left side o
3、f probe Recognize ultrasound imagesThree planes of brain,Patients position is crucial,Typical CT/MR scan,Ideal position for US scanning,Select probe&preset,Craniotomy probe:8862Burr-hole probe:8863“Hockey stick”probe:8809,Set frequency,Default setting is 8MHz,Deep,Peripheral,Identify left side of pr
4、obe,Recognize ultrasound images,EchogenicityHyper-echoicIso-echoic Hypo-echoicHomogenicity/UniformityHomogenous/UniformHeterogenous/NonuniformShapeRegularIrregular BorderClear/SharpUnclear,Recognize ultrasound images,Echogenicity,Hyper-echoic,Iso-echoic,Hypo-echoic,Recognize ultrasound images,Homoge
5、nicity/Uniformity,Homogenous/Uniform,Heterogenous/Nonuniform,Recognize ultrasound images,Shape,Regular,Irregular,Recognize ultrasound images,Border,Normal Brain,Grey matter,White matter,Sulci,Falx,Normal Brain,Gyrus,Sulci,Choroid Plexus,ventricle,Three planes of brain,Horizontal,Coronal,saggital,Thr
6、ee planes of brain,Most commonly used in daily work.Horizontally put the probe on the surface of brain tissue after remove part of skull,then you can have typical horizontal plane.Different images on different levels。,Horizontal plane,Anterior horizontal plane,Anterior lateral ventricle,Temporal win
7、dow horizontal plane,Occipital horizontal plane,Levels of horizontal plane,Cortex levelLateral ventricle level4th ventricle levelBrainstem level,Cortex level,1:Cerebral Falx2:Sulci3:Gyrus,Lateral ventricle level,1、Cerebral Falx 2、Lateral Ventricle,4th ventricle level,Brainstem level,1、Cerebral falx2
8、、Brainstem3、Lesion,Sagittal plane,Sagittal plane,1：Lateral Ventricle 2：Choroid plexus3：Ventriculus tertius 4：Corpus callosun6：Gyrus 7：Sulci,Sagittal plane,1、Lateral ventricle 2、Corpus callosum 3、Choroid plexus4、Gyrus cinguli 5、Lesion,Vertex Coronal plane,Vertex Coronal plane,1：Lateral ventricle 2：Choroid plexus3：Ventriculus tertius 4：Cerebral falx,Vertex Coronal plane,1、Cerebral falx 2、Lateral ventricle 3、Base of skull4、Optic chiasma 5、Lesion,Temporal coronal plane,Temporal coronal plane,Thank You,
