颅脑分层重建融合手术辅助系统在癫痫外科的应用

目的探讨颅脑分层重建融合手术辅助系统进行颅脑外科精准定位和微创手术的方法。方法采用影像处理系统Neurotech三维呈现11例癫痫手术患者的头皮、颅骨、颅脑的三维影像,以及脑表面沟回及血管形态、分布、走行信息,判断沟回功能。根据术前评估在三维脑表面上绘制切除范围,确定切除脑沟回,利用融合技术获取切除范围在头皮、颅骨、脑表面各层次的投影位置及范围。据此设计精准合理的头皮切口、颅骨钻孔、铣开范围及硬脑膜剪开范围和大小,精准暴露脑表面切除范围。术中根据三维沟回形态,辨识暴露沟回解剖及功能,结合重要血管及功能区进行手术操作的安全规划。结果 11例患者手术出血在160-250 ml,开颅过程均未伤及静脉...

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Published in临床神经外科杂志 Vol. 14; no. 2; pp. 107 - 111
Main Author 林久銮 孙朝晖 王海祥 张冰清 宋宪成 刘一鸥 徐成伟 柏建军 周文静
Format Journal Article
LanguageChinese
Published 清华大学玉泉医院癫痫中心, 北京,100040 2017
Subjects
三维重建
多模态
癫痫
epilepsy
多模态
3D reconstruction
multimode
癫痫
三维重建
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ISSN1672-7770
DOI10.3969/j.issn.1672-7770.2017.02.007

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Summary:目的探讨颅脑分层重建融合手术辅助系统进行颅脑外科精准定位和微创手术的方法。方法采用影像处理系统Neurotech三维呈现11例癫痫手术患者的头皮、颅骨、颅脑的三维影像,以及脑表面沟回及血管形态、分布、走行信息,判断沟回功能。根据术前评估在三维脑表面上绘制切除范围,确定切除脑沟回,利用融合技术获取切除范围在头皮、颅骨、脑表面各层次的投影位置及范围。据此设计精准合理的头皮切口、颅骨钻孔、铣开范围及硬脑膜剪开范围和大小,精准暴露脑表面切除范围。术中根据三维沟回形态,辨识暴露沟回解剖及功能,结合重要血管及功能区进行手术操作的安全规划。结果 11例患者手术出血在160-250 ml,开颅过程均未伤及静脉窦及脑表面桥静脉,手术均未超出设计范围造成额外的脑功能损伤。术后恢复快,无贫血;术后癫痫Engle评分均为Ⅰ级。结论采用颅脑分层重建融合开颅辅助系统及术中沟回辨识方法,可以很好地帮助外科医师进行手术规划,构建神经外科的影像数字信息平台;实现脑外科手术的三维可视化,达到脑外科手术精准、微创和安全的目的。
Bibliography:muhimode ; epilepsy ;3D reconstruction
LIN Jiu-luan, SUN Zhao-hui, WANG Hai-yang, et al.（ Epilepsy Center of Yuquan Hospital, Tsinghua University, Beijing 100040, China）
32-1727/R
Objective Exploration of a cerebral stratified reconstruction method for precise identification and localization of critical brain regions that cannot be directly visible by open skull surgery. Methods The neuroimaging system Neurotech was employed to display the 3D brain imaging of the patients, revealing the detailed information such as the scalp,the shape and sickness of skull , the sature of skull, blood vessel of the scalp and brain,the shape of gyrus. Neurosurgeons then decided on the brain regions need to be resected on the 3D images and designed ways of operation including the incision, the position of burr hole, where and how to cut, the range of brain need to expose, based on pre-surgical evaluation as well as the above mentioned information. During the surgery, the 3D information guided the surgeons to dynamically adjust the
ISSN:1672-7770
DOI:10.3969/j.issn.1672-7770.2017.02.007