How can intraoperative imaging techniques assist in glioma cutting?

  Neuronavigation technology is an important technological advancement, but intraoperative brain drift caused by surgical traction, tumor removal, brain swelling, or cerebrospinal fluid loss is an important factor that affects the accuracy of neuronavigation. How to correct intraoperative brain drift is an urgent problem to be solved by neuronavigation techniques. Recently, neuronavigation has progressed from anatomical to functional mode by integrating PET, fMRI, MEG, DTI, and MRS techniques, i.e., functional neuronavigation can correct intraoperative brain drift. Intraoperative open MRI can provide very accurate real-time image compensation is the most ideal method to address image drift. However, because the operating room needs to be completely shielded from magnetic fields, and the surgical instruments, microscopes, and monitoring anesthesia are all special magnetically compatible materials, the cost of surgery is too high, which limits the wide application in clinical practice.  We applied domestic ultrasound to locate the anatomical boundary of the tumor. After clipping the dura mater the probe was placed on the arachnoid surface and glided gently, while using saline as a coupling agent and repeatedly flushing water on the brain surface to reduce friction while mitigating the impact on brain tissue. After adjusting the direction of the probe for coronal, sagittal and horizontal planes respectively, the same planes as CT or MRI were obtained for comparative observation, and then frozen after obtaining clear images, the size was measured and recorded. the anatomical boundary of the tumor was determined by ultrasound and marked with capital letters, and after resection of the tumor, the cotton sheet and brain plate were removed from the operative cavity, and the probe was placed in the operative cavity after filling the cavity with saline and then ultrasound scanning was performed. The extent of resection was detected to guide the resection of residual lesions.