多模态影像融合技术在椎管内病变治疗中的初步应用  

Preliminary study on the application of multimodal image fusion technology to treatment of lesions within the spinal canal

作　　者：张培海[1] 孙振兴[1] 苏伟[1] 郭毅[1] 刘慧婷[1] 王劲[1] 王贵怀[1] 

机构地区：[1]清华大学附属北京清华长庚医院神经外科,清华大学医学中心,102218

出　　处：《中华神经外科杂志》2016年第12期1239-1243,共5页Chinese Journal of Neurosurgery

基　　金：基金项目：北京清华长庚医院青年启动基金（12015C1044）

摘　　要：目的探讨多模态影像融合技术在椎管内病变外科治疗中的初步应用。方法回顾性纳入2015年11月至2016年5月于清华大学附属北京清华长庚医院神经外科采用多模态影像融合技术辅助手术治疗的椎管内病变患者，共11例。其中10例术中使用O-arm影像系统，1例术中未行O-arm扫描（借助后颅窝骨质自动完成融合）。利用SynergyCranial软件，将术中O．arm扫描获取的CT影像与术前CT和MRI的影像融合，构建脊柱、病变、血管等结构的三维模型，导航下完成椎管内病变的定位和切除。结果11例患者均在多模态影像融合技术的辅助下准确完成脊髓病变的定位及手术，均达到镜下病变全切除。O-arm扫描脊柱节段定位的时间为5～7min，联合图像融合定位的操作时间延长7～10min。导航与术中实际测量误差为0．9-5．3mm，平均（1．9±1．0）mm。术后1个月McCormick脊髓功能评分，Ⅰ级9例，Ⅱ级1例，Ⅳ级1例。结论多模态影像融合技术定位脊柱节段及椎管内病变较准确。Objective To conduct a preliminary study on the application of multimodal image fusion technology （MIFT） to treatment of lesions within the spinal canal. Methods From November 2015 to May 2016, a total of 11 patients with lesions within the spinal canal were admitted to Beijing Tsinghua Changgung Hospital for surgical treatment aided by MIFT, and their data were retrospectively analyzed. The O-arm image system was utilized to acquire intraoperative three-dimensional CT images that were subsequently transferred to the navigation system for all patients except 1 casein which preoperative MRI and CT image were fused based on the posterior fossa bone. The image fusion of preoperative CT/MRI and intraoperative CT image was conducted using the Synergy Cranial software, and the reconstructed 3D model of the spine, tumors, vascular structures were employed to guide tumor localization of resection under navigation. Results In all 11 patients, lesions were successfully located and completely resected under microscope with the assistance of MIFT. The O-arm scanning and image fusion took about 5 -7 rain and 7 - 10 min, respectively. The navigation eIror was 0.9 - 5.3 mm with a mean of 1.9 ± 1.0 mm. At the follow- up at 1 month post operations based on the McCormick scale,level Ⅰ was achieved in 9 cases, level Ⅱ in 1 case, and level Ⅳ in 1 case. Conclusion The application of MIFT could help locate the segments of spinal column and lesions within the spinal canal.

关 键 词：多模态影像融合 椎管内病变 神经外科手术 

分 类 号：R687.3[医药卫生—骨科学]