Intraoperative contrast-enhanced ultrasound for cerebral glioma resection and the relationship with microvessel density

PurposeWe studied the value of intraoperative contrast-enhanced ultrasound (iCEUS) for real-time monitoring of resection of cerebral gliomas, and analyzed the relationship between CEUS parameters and microvessel density (MVD) of different pathologic grades of cerebral gliomas. Materials and MethodsICEUS was performed in 49 patients with cerebral gliomas. The enhancement characteristics of cerebral gliomas were observed before and after tumor resection. The number of microvessels was counted by immunostaining with anti-CD34. Differences in these quantitative parameters in cerebral gliomas were compared and subjected to a correlation analysis with MVD. ResultsThe color Doppler flow classification within lesions were significantly different before and after iCEUS (p<0.05). The assessment of iCEUS parameters and tumor MVD showed that cerebral gliomas of different pathological grades had different characteristics. The time-to-peak (Tmax) was significantly shorter, the peak intensity (PI) and MVD were significantly higher in high-grade cerebral gliomas than in low-grade cerebral gliomas (p<0.05). According to the immunostaining, PI was positively (r=0.637) correlated with MVD and Tmax was negatively (r=-0.845) correlated with MVD. ConclusionICEUS may determine the borders of lesions more clearly, indicate the microvascular perfusion in real time, and be helpful in understanding the cerebral gliomas grade.