Tuominen J, Yrjänä S K, Katisko J P, Heikkilä J, Koivukangas J
Department of Neurosurgery, Oulu University Hospital, Oulu, Finland.
Acta Neurochir Suppl. 2003;85:115-20. doi: 10.1007/978-3-7091-6043-5_16.
Development of an image-guided operation theatre offering multimodal information for mini-invasive neurosurgical brain tumour operations.
A multi-purpose resistive low-field MR scanner with on-off capability, was installed in a radio frequency-shielded operating room with in-room control panel and display. Intraoperative ultrasound imaging with Doppler mode as needed is used to provide check-up image data between intraoperative MR-imaging sessions. Cortical stimulation and registration are performed during awake craniotomies. The neuronavigation systems are customised arm-based and passive optical. The navigation systems show the positions of the ultrasound probe, cortical stimulation electrode, biopsy needles, endoscope and other instruments on the intraoperative MR-images.
Since 1999, 70 patients (mean age 47, range 3-88 years) have been operated with intraoperative MR-guidance (including 10 tumour biopsies, 56 resections). Twenty-one patients (mean age 46, range 16-67 years) underwent awake craniotomy and tumour resection secured with cortical stimulation and usually preoperative fMR-imaging. The present operating environment offered useful multimodal information for surgery of brain tumours in critical locations. Surgical mortality was 0%, morbidity included 3 (4.3%) infections and 2 (2.9%) permanent hemiparesis. Further removal of tumour was continued in 17 cases (57%) out of the 30 cases where intraoperative MR imaging was used for controlling completeness of the resection.
开发一种图像引导手术室，为微创神经外科脑肿瘤手术提供多模态信息。
将一台具备开关功能的多用途电阻式低场磁共振扫描仪安装在一间带有室内控制面板和显示器的射频屏蔽手术室中。根据需要使用带有多普勒模式的术中超声成像，以在术中磁共振成像检查之间提供检查图像数据。在清醒开颅手术期间进行皮质刺激和配准。神经导航系统采用定制的臂式和被动光学系统。导航系统在术中磁共振图像上显示超声探头、皮质刺激电极、活检针、内窥镜和其他器械的位置。
自1999年以来，70例患者（平均年龄47岁，范围3 - 88岁）接受了术中磁共振引导下的手术（包括10例肿瘤活检，56例切除术）。21例患者（平均年龄46岁，范围16 - 67岁）接受了清醒开颅手术，并通过皮质刺激以及通常的术前功能磁共振成像确保肿瘤切除。当前的手术环境为关键部位脑肿瘤手术提供了有用的多模态信息。手术死亡率为0%，发病率包括3例（4.3%）感染和2例（2.9%）永久性偏瘫。在30例使用术中磁共振成像控制切除完整性的病例中，有17例（57%）继续进一步切除肿瘤。
