The use of intraoperative ultrasound (US) during neurosurgical procedures is becoming more widespread. Multiple studies have shown that US is a valuable tool in tumor detection during surgery 1) 2) 3) 4) 5).
Combining awake surgery with intraoperative magnetic resonance is logistically challenging.
Navigable ultrasound (US) is a useful alternative in such cases.
It is a sensitive imaging modality when used in patients with Cushing's disease in whom findings on pituitary MR imaging are negative. The improved ability to detect and localize these tumors positively affects surgical outcome 6).
Intraoperative scanning of the pituitary gland with high-frequency-ultrasound probes may identify intrapituitary anatomy and pathologies even in MRI-negative cases. This may prevent extensive exploration of the gland with the risk of subsequent hypopituitarism 7).
Intra-operative brain swelling consider intraoperative ultrasound if rapidly available to rule-out hematoma (intracerebral, EDH, SDH) which could potentially be immediately evacuated.
It is a valuable tool to detect spinal lesions, evaluate the surgical approach and plan the surgical strategy considering the position and relationships of the lesion with bony, neural and vascular structures 9).
Intraoperative ultrasound is often helpful for:
a) localizing the cyst
b) assessing for septations (to avoid shunting only part of cyst)
Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach 10) 11).