三维重建技术在颅内肿瘤术前风险评估及手术策略制定中的临床价值  

Clinical value of 3D reconstruction technique in preoperative risk assessment and surgical strategy for intracranial tumor

作　　者：信瑞强[1] 刘彤[1] 张双[1] 彭如臣[1] 

机构地区：[1]首都医科大学附属北京潞河医院影像科,北京101149

出　　处：《现代医学》2016年第8期1068-1070,共3页Modern Medical Journal

摘　　要：目的:探讨三维数字影像融合技术结合神经导航在颅内肿瘤术前评估、手术策略及术中导航中的应用价值。方法:对95例颅内肿瘤患者术前行CT、MRI、MRA、MRV等影像学扫描,将影像学资料导入Brain Lab进行影像重建和融合,模拟病变和周围组织的三维模型。术前依据重建模型制定手术方案和手术入路,术中通过神经导航进行定位。比较术前与术中所见的肿瘤、神经、血管、骨骼、脑组织等重要标记点。结果:95例患者颅脑解剖三维影像结构均重建融合成功,符合率极高,与术前原始图像及术中解剖所见吻合很好。在三维重建系统的导航下成功识别了重要的标记点及肿瘤边界,术中未出现因手术入路选择而产生的并发症。术后61例(64.2%)患者症状缓解,32例(33.7%)患者症状无变化,其余2例(2.1%)患者由于病变解剖位置原因导致症状加重,但出院时明显改善。结论:三维多重影像数字化融合技术能准确显示肿瘤组织解剖位置,多角度、动态地呈现其与周围组织的立体关系,在颅内肿瘤术前风险评估及手术策略制定中具有重要临床价值。Objective： To explore the application value of three-dimensional（ 3D） digital image fusion technique combined with neural navigation in preoperative evaluation,surgical strategy and intraoperative navigation of intracranial tumor. Methods： A total of 95 patients with intracranial tumor were enrolled in this study. CT,MRI,MRA,MRV imaging studies were performed,and then the data obtained were imported into Lab Brain for image reconstruction and fusion,the three dimensional model was simulated. Based on the reconstruction model,the surgical procedure and surgical approach were developed. The tumor,nerves,blood vessels,bone,brain tissue and other important markers were compared between preoperative and intraoperative views. Results： All patients with brain anatomy of the three-dimensional imaging structure were reconstructed successfully,the coincidence rate of three-dimensional digital image was very high. The original images and intraoperative anatomy were found to be in good agreement. In the navigation of the 3D reconstruction system,the key points of the marker and the boundary of the tumor were successfully identified. No complications associated with the choice of surgical approach were found.After operation,the symptoms in 61 patients（ 64. 2%） were relieved,32 patients（ 33. 7%） had no change,and the rest 2 patients（ 2. 1%） had exacerbations because of the anatomic location of the lesion,but was significant improved at discharge. Conclusion： 3D multi-image fusion technique can accurately and reliably display the anatomic location of the tumor tissue,and it can be performed under the guidance of a comprehensive surgical strategy.

关 键 词：颅内肿瘤 三维数字影像融合 风险评估 手术策略 

分 类 号：R445.9[医药卫生—影像医学与核医学]