1、7 Steps of Neurosurgery Ultrasound ScanningAlex FanAsia clinical application&KOL managerGeneral advicePrevious 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 use
2、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 of pr
3、obe Recognize ultrasound imagesThree planes of brainPatients position is crucialTypical CT/MR scanIdeal position for US scanningSelect probe&presetCraniotomy probe:8862Burr-hole probe:8863“Hockey stick”probe:8809Set frequencyDefault setting is 8MHzDeep Peripheral Identify left side of probe Recogniz
4、e ultrasound imagesEchogenicityHyper-echoicIso-echoic Hypo-echoicHomogenicity/UniformityHomogenous/UniformHeterogenous/NonuniformShapeRegularIrregular BorderClear/SharpUnclear Recognize ultrasound imagesEchogenicityHyper-echoic Iso-echoicHypo-echoicRecognize ultrasound imagesHomogenicity/UniformityH
5、omogenous/Uniform Heterogenous/NonuniformRecognize ultrasound imagesShape Regular Irregular Recognize ultrasound imagesBorder Echogenicity HomogenicityHypoechoicIsoechoicHyperechoicHomogenousHeterogenousWhite materXXGrey MaterXXXVentricleXXSulciXXChoroid PlexusXXBrainstemXXNormal BrainGrey matterWhi
6、te matterSulci FalxNormal BrainGyrus Sulci Choroid PlexusventricleThree planes of brainHorizontal Coronal saggitalThree 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.Dif
7、ferent images on different levels。Horizontal planeAnterior horizontal planeAnterior lateral ventricleTemporal window horizontal planeOccipital horizontal planeLevels of horizontal planeCortex levelLateral ventricle level4th ventricle levelBrainstem levelCortex level1:Cerebral Falx2:Sulci3:Gyrus11223
8、3Lateral ventricle level11221、Cerebral Falx 2、Lateral Ventricle4th ventricle level331111223344Brainstem level13322211、Cerebral falx2、Brainstem3、LesionSagittal planeSagittal plane1：Lateral Ventricle 2：Choroid plexus3：Ventriculus tertius 4：Corpus callosun6：Gyrus 7：Sulci Sagittal plane35544311221、Later
9、al ventricle 2、Corpus callosum 3、Choroid plexus4、Gyrus cinguli 5、LesionVertex Coronal planeVertex Coronal plane1：Lateral ventricle 2：Choroid plexus3：Ventriculus tertius 4：Cerebral falxVertex Coronal plane3112222445531、Cerebral falx 2、Lateral ventricle 3、Base of skull4、Optic chiasma 5、LesionTemporal coronal planeTemporal coronal planeThank You
