虚拟现实系统在蝶骨嵴脑膜瘤手术治疗中的应用  

Application of virtual reality system for individualized preoperative planning of sphenoidal ridge meningioma

作　　者：马顺昌[1] 陈素华[1] 胡业帅[1] 齐建发[1] 李志强[1] 寸恩浩[1] 王利国[1] 石祥恩[1] 杨军[1] 

机构地区：[1]首都医科大学附属复兴医院神经外科,北京100038

出　　处：《中华医学杂志》2014年第45期3562-3566,共5页National Medical Journal of China

基　　金：首都市民健康项目培育（Z111107067311065）;首都医科大学附属复兴医院青年基金（YQN201208）

摘　　要：目的探讨虚拟现实（Virtualreality）技术在蝶骨嵴脑膜瘤个体化手术人路中的应用。方法回顾性分析了2009年7月至2013年6月首都医科大学附属复兴医院41例拟采用手术治疗的蝶骨嵴脑膜瘤患者，将术前采集的CTA及MR数据输入Dextroscope虚拟现实系统进行三维重建，术前获得肿瘤，脑组织，骨质以及神经血管信息，并进行观察，测量、手术入路设计、模拟等操作，制定个体化手术规划。并与随机选取的常规手术的27例蝶骨嵴脑膜瘤病例进行比较：肿瘤切除时间，手术全切率，并发症发生率以及随访后的KPS预后评分。结果41例蝶骨嵴脑膜瘤均成功地实现了3D重建，与术中实际情况吻合，肿瘤切除时间（61±12）min，对照组为（80±14）min，两组比较P〈0．05；手术全切率及KPS评分两组差异无统计学意义（P〉0．05）。结论Dextroscope虚拟现实系统可以提供蝶骨嵴脑膜瘤及其毗邻结构的信息，为颅底病变个体化制定手术方案提供帮助，有助于提高了手术的安全性。Objective To evaluate the usefulness of virtual reality （VR） technique for individualized preoperative planning of sphenoidal ridge meningioma. Methods Multiple imaging data of CTA/MR were acquired from 41 surgical patients with sphenoidal ridge meningioma during the period from July 2009 to June 2013 were transferred into the Dextroscope system. A suite of built-in 3D tools enabled users to obtain measurement and simulated intraoperative viewpoint about the lesion and adjacent anatomic structures. A sophisticated preoperative plan was defined. Operative duration, total resection rate, complication rate and KPS scores were compared with control group undergoing routine operation （n = 27）. Results 3D stereoscopic VR images in accordance with reality were reconstructed for 41 cases. As compared with control group, VR preoperative plan could shorten operative duration and reduce complication rate （ P 〈 0. 05 ）. However, there was no improvement in total resection rate or KPS score （ P 〉 0. 50）. Conclusion VR technique of Dextroscope system offers eomprehensive information of sphenoidal ridge and related neurovascular anatomical structure. Thus it may aid surgical planning and facilitate individualized operation.

关 键 词：虚拟系统 蝶骨 脑膜瘤 

分 类 号：R739.45[医药卫生—肿瘤]