使用便携式X线机在导航手术中定位异物的方法及模型实验  

A study of the accuracy and radiation dose of the use of portable X-ray machine for orientation of foreign body in navigation surgery

作　　者：马旦 谢瑞 王馨 刘琛 吴炜 赵铱民 白石柱 MA Dan;XIE Rui;WANG Xin;LIU Chen;WU Wei;ZHAO Yimin;BAI Shizhu(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,1.Digital Dentistry Center,710032 Xi'an;Department of Oral and Maxillofacial Surgery,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,1.Digital Dentistry Center,710032 Xi'an;Department of Prosthodontics,The Third Affiliated Hospital of Air Force Medical University,China)

机构地区：[1]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室,空军军医大学第三附属医院数字化口腔医学中心,西安710032 [2]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室,空军军医大学第三附属医院口腔颌面头颈肿瘤科,西安710032 [3]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室,空军军医大学第三附属医院口腔修复科,西安710032

出　　处：《实用口腔医学杂志》2025年第1期16-20,共5页Journal of Practical Stomatology

基　　金：国家自然科学基金(编号:81970987);口颌系统重建与再生全国重点实验室面上项目(编号:2019ZA11)。

摘　　要：目的:探讨一种使用便携式X线机在计算机辅助导航手术中确定异物空间位置的方法,并评估其可行性与安全性。方法:在便携式X线机的引导下,由导航设备记录两条经过异物的直线上的4个点,计算这两条直线公垂线段的中点作为异物的探测坐标(双线法)。构建金属异物模型,两名操作员使用双线法分别测量异物坐标10次,将测得的异物坐标与异物实际坐标进行比较,分析定位精度。使用电离辐射探测仪,测量每次定位过程中模型术区与操作者不同部位的辐射剂量。结果:双线法测定异物坐标的精度为(1.98±0.77)mm,不同操作员之间的差异有统计学意义。每次定位过程中,模型术区累计辐射剂量为(221.45±50.15)μSv,操作者胸前累计辐射量为(4.44±1.35)μSv。结论:双线法在术中测量异物坐标,其精度能满足临床需求,不同操作者测量的精度存在一定差异。该方法所产生的辐射剂量较小。Objective:To assess the feasibility and security the orientation of foreign bodies using a portable X-ray machine in computer-aided navigation surgery.Methods:A model with a metallic foreign body was constructed.Under the fluoroscopy of a portable X-ray machine,4 points on 2 straight lines passing through the tip of the foreign body were recorded by the navigation equipment,and subsequently,the midpoints of the common perpendicular segments of the 2 lines were calculated as the coordinates of the foreign body(Bilinear Method).2 operators measured the coordinates of the foreign body 10 times and compared the measured coordinates of the foreign body with the actual coordinates of the foreign body in order to analyze the accuracy of the Bilinear Method.Radiation doses to model area and operators at different locations were measured using ionizing radiation detectors.Results:The accuracy of the Bilinear Method for measuring foreign body coordinates was(1.98+0.77)mm,and that of the 2 operators was 1.55±0.68 and 2.40±0.36 respectively(P=0.02).The radiation dose was(221.45±50.15)μSv in the model and(4.44±1.35)μSv in the operator's chest.Conclusion:The accuracy of the coordinates of the foreign body intraoperation measured by Bilinear Method meets general clinical needs,and different operators may produce different accuracy.The radiation dose is small.

关 键 词：手术导航系统 便携式X线机 异物 定位 

分 类 号：R816.98[医药卫生—放射医学] TP391.73[医药卫生—临床医学]