CT与Iso-C融合技术在计算机导航辅助骨肿瘤手术中的应用  

Image fusion of Iso-C and CT for computer-assisted orthopaedic oncology surgery

作　　者：刘巍峰[1] 牛晓辉[1] 张清[1] 郝林[1] 丁易[1] 王涛[1] 李远[1] 马珂[1] 赵海涛[1] 

机构地区：[1]北京积水潭医院,北京100035

出　　处：《山东医药》2011年第40期9-11,I0001,共4页Shandong Medical Journal

基　　金：首都医学发展科研基金资助项目(2009-3096)

摘　　要：目的评价术前CT设计与术中Iso-C融合技术在计算机导航辅助骨肿瘤手术中的应用优势。方法对42例良性肿瘤和14例恶性肿瘤患者均进行病灶局部术前CT扫描,并进行术前肿瘤边界、切除及重建设计。术中进行Iso-C导航三维扫描与术前设计CT影像融合,为外科切除边界的实施提供清晰的引导。结果平均融合时间为15.4(11～21)min,其中四肢骨(15.1±2.1)min,中轴骨(16.4±1.3)min,P=0.037。恶性肿瘤中边缘切除2例和广泛切除边界12例,从术后标本显示均具有安全的边界,其余囊内切除通过融合图像均可见足够的切刮范围,组织学证据表明恶性肿瘤标本切缘均为阴性。结论术中Iso-C的精确定位与术前CT良好的图像质量进行融合能够帮助外科医师更准确判定肿瘤边界,实施切除与重建。Objective To evaluate image fusion technology of Iso-C and CT for preoperative design and intraoperative implementation. Methods A total of 42 benign tumors and 14 malignant tumors were involved in the study. Pre-operative CT of each patient was performed. The pre-t^peration CT-base planning was made for every patient with the navigation system software that included confirming the tumor surgical margin, designing resection and reconstruction. Intraoperatively, Iso-C 3- dimensional computer navigation was carried out in accurate localization. With image fusion of both data, all tumor resections were performed under navigation image guidance. Results The mean time for image fusion was 15.4 minutes （ 11-21 minutes ）. The fusion time for extremities was （ 15.1 ± 2.1 ） rain and （ 16.4 ± 1.3 ） rain for axial skeleton （ P = 0. 037 ）. All the marginal （n =2） and wide （n = 12） for malignant tumors resection specimens showed a safe and clear margin. For other pa- tients with intralesional reseetion, the margin confirmed by navigation image fusion was good enough. Histologieal examina- tion of all reseeted speeimens showed tumor-free margins in patients with bone sareoma. Conclusions The fusion of Iso-C and CT helps surgeons determine the surgical margin and implement bone tumor reseetion and reconstruction.

关 键 词：骨肿瘤 图像融合 导航 计算机辅助外科 

分 类 号：R738.1[医药卫生—肿瘤]