Schulder M, Sernas T J, Carmel P W
Department of Neurosurgery, New Jersey Medical School, Newark, NJ, USA.
Acta Neurochir Suppl. 2003;85:79-86. doi: 10.1007/978-3-7091-6043-5_11.
Experience with a compact unit for intraoperative magnetic resonance imaging (iMRI) and integrated surgical navigation is presented. The system, commercially known as the PoleStar N-10 (Odin Medical Technologies, Yokne'am, Israel) includes a 0.12 Tesla permanent magnet that docks under a regular OR table. A passive infrared-based optical navigation system is included and the device can be controlled by the operating neurosurgeon and staff. We have operated on 93 patients using the PoleStar N-10. Diagnoses included glioma in 27, pituitary adenoma in 19, meningioma in 15, and others in 40. Lesions were removed from the skull base in 35 patients of whom 8 had posterior fossa masses. Surgery was affected by imaging in 51% of operations. Additional lesion, not otherwise apparent, was removed in 21; in 14 other patients unnecessary dissection was avoided when the new image confirmed that the surgical goals had been achieved. Additional time incurred with use of the PoleStar diminished with increasing experience. Testing of the navigation tool confirmed its accuracy to be comparable to other "frameless stereotactic" devices, on the order of 2 mm; likewise accuracy was increased by using T1 weighted imaging with thin slices. The introduction of new, faster imaging sequences and targeting tools has helped to make the PoleStar N-10 a routine tool for intracranial surgical navigation, with the added benefit of updated imaging during the procedure.
介绍了一种用于术中磁共振成像（iMRI）和集成手术导航的紧凑型设备的使用经验。该系统商业上称为PoleStar N-10（以色列约克奈姆的奥丁医疗技术公司），包括一个0.12特斯拉的永磁体，可对接在普通手术台下方。该设备包含一个基于被动红外的光学导航系统，可由神经外科手术医生和工作人员进行控制。我们使用PoleStar N-10对93例患者进行了手术。诊断包括27例胶质瘤、19例垂体腺瘤、15例脑膜瘤和40例其他疾病。35例患者的病变位于颅底，其中8例有后颅窝肿块。51%的手术受到成像的影响。21例患者切除了原本不明显的额外病变；在另外14例患者中，当新图像确认手术目标已实现时，避免了不必要的解剖。随着经验的增加，使用PoleStar带来的额外时间减少。导航工具的测试证实其准确性与其他“无框架立体定向”设备相当，约为2毫米；同样，使用薄层T1加权成像可提高准确性。新的、更快的成像序列和靶向工具的引入有助于使PoleStar N-10成为颅内手术导航的常规工具，其额外的好处是在手术过程中可进行更新的成像。
