Sergei VASILIEV (1) Svetozar PESNYA-PRASOLOV (1) Vladimir

KRYLOV (2) Sergei KUNGURTCEV (3)

(1) Russian Research Center of Surgery, Moscow, Russian Federation

(2) Scientific research Institute of emergency assistanceSklifosofskiy,

Moscow, Russian Federation

(3) Innovative company BIOMEDSTANDART, Moscow, Russian

Federation

http://www.neuro-med.ru 2481129@mail.ru

Introduction:

Evaluated the results of neuroepithelial brain tumor surgery using

cryodestruction,

the efficiency of cryodesruction and the diagnostic value and use of

ultrasound navigation during the procedure to control ice-ball generation

and postoperative changes in cryodesruction and surrounding zones were

estimated with the aid of MRI.

Materials and Method:

The cryodestruction of neuroepithelial tumors was performed on 20

patients. We used new cryosurgical apparatus, with a working

“cryoprobe”based on a passive supply of liquid nitrogen and an active

drainage of forming gas/steamlike nitrogen.

Tumors stereobiopsy was performed before the cryoprobe introductioin

order to find out the tissular structure. Cryosurgery was performed by

introducing the cryoprobe into the tumor with ultrasound

neuronavigation control.

Brain MRI’s were taken before and after operation for all patients.

Patients immune status was evaluated before surgery, 7 days after

surgery and after 6 months.

MRI prior to the operation

Fibrillaryastrocytoma(Grade 2)

Using contract magnification

MRI 6 months after the operation using cryodestructionUsing contract magnification

Intracerebral cyst in the cryodestruction zone

Transformation of the zone which underwent cryodestrution according to CT scans and MRI with the aid of a contrasting agent

MRI prio to the operation

After 4 days 7days 14 days

After 1 month 2month 3month 6 month

Hypoechoic zone–Iceball

Hypoechoic zone–Iceball

Hyperechoic contour

Cryodestruction process: the cryoprobe is submerged into the tumor.

CryoprobeUltra sound deviceCryoprobe.

Ultra sound device

Cryodestruction process

Conclusions :

Cryodestruction enables the effective destruction of brain

tumors in specified volume. Ultrasound neuronavigation is an

effective method of monitoring iceball formation in the brain

during freezing and thawing in real time. This method allows

for the destruction of tumors of a specified volume which are

located in functionally significant areas of the brain and the

removal of which is associated with a high risk of disability and

death.

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writing to my E-mail address: 2481129@mail.ru