磁共振血管成像和功能性磁共振成像与虚拟现实技术进行运动区脑膜瘤显微手术  

Exploring the Application of MRV,fMRI and Virtual Reality Technique for Microsurgery of Meningioma in Motor Cortex Region

作　　者：汤海亮[1] 宫晔[1] 毛颖[1] 张晓硌[1] 吴劲松[1] 谢立乾[1] 陈衔城[1] 

机构地区：[1]复旦大学附属华山医院神经外科,200040

出　　处：《中国临床神经科学》2011年第2期121-124,共4页Chinese Journal of Clinical Neurosciences

基　　金：国家自然科学基金(编号30872675;30901549);上海市科委专项重点基金(编号08411965100)

摘　　要：目的:探讨磁共振血管成像、功能性磁共振成像和虚拟现实技术在运动皮质区脑膜瘤显微手术中的应用价值。方法:运动功能区脑膜瘤患者30例,术前行头颅CT和MRI检查,将图像数据输入Dextroscope系统进行重建、融合和提取等处理,再进行观察、测量和手术模拟等操作,在术前获得肿瘤与皮质和血管相互关系的信息,以制定周密的手术计划。在显微镜下分离非功能区一侧肿瘤包膜,阻断部分血供,显露肿瘤,行瘤内分块切除,然后在显微镜下将肿瘤切除。结果:30例患者均成功实现术前三维立体虚拟现实影像重建;术前计划对病灶及局部解剖学特征的判断与术中实际情况吻合。结论:术前模拟手术过程,有助于选择适宜的手术入路和避免术中损伤矢状窦、中央沟静脉和脑功能区皮质,对预防术后脑水肿和保护运动功能有重要价值。Aim：To evaluate the value of MRV,fMRI and virtual reality technique in microsurgery of meningioma in motor cortex region.Methods：30 cases of meningiomas were examined with brain CT and MRI before operation.The image data were then transferred to Dextroscope system.A stereoscopic 3D object displayed after reconstructing,merging,extracting,dissecting the data with Radiodexter software in virtual reality environment.A suite of 3D tools accessible inside the Dextroscope workspace enabled operators to obtain measurement and simulate intraoperative viewpoint about the lesion and adjacent anatomic structure. All tumors were resected under microscope.Results：The 3D stereoscopic virtual reality images of 30 cases were reconstructed successfully,and compared with the intra-operation pictures.Conclusion：The pre-operation CT and MRI scanning,together with virtual reality planning could be used to choose appropriate surgical approach and avoid damage to the sagital sinus,cerebral central vein and motor cortex,which can prevent brain edema and preserve brain function after operation.

关 键 词：脑膜瘤 运动区 磁共振血管成像 功能性磁共振成像 虚拟现实技术 

分 类 号：R651.11[医药卫生—外科学] R814.42[医药卫生—临床医学]