Nakao N, Nakai K, Itakura T
Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan.
Minim Invasive Neurosurg. 2003 Apr;46(2):117-20. doi: 10.1055/s-2003-39344.
Image-guided surgery based on preoperatively obtained image data is susceptible to inaccuracy resulting from intraoperative brain shift and distortion. We report a technique of updating neuronavigational data with the aid of a mobile computerized tomographic (CT) scanner. A mobile CT which is readily available in an ordinary operating room was used to acquire intraoperative images. A total of 6 - 7 titanium screws placed on the skull were used as new reference points for updating navigation. Intraoperative CT scanning was performed with a 2 mm slice thickness. After the obtained image data were transferred as Dicom files to the computer workstation of the navigation system through an Ethernet connection, navigational data were updated to registering the new reference points. Under the guidance of the updated navigation, residual lesions were explored, and further resected. Our preliminary experience in 8 patients indicates that interactive image-guidance can stably be updated based on images intraoperatively acquired with a mobile CT scanner. Comparing to intraoperative magnetic resonance imaging, this technique can simply be done in an ordinary operating room without requiring special surgical instruments, thus making it possible to update interactive image guidance on demand during an operation.
基于术前获取的图像数据的图像引导手术容易受到术中脑移位和变形导致的不准确影响。我们报告一种借助移动计算机断层扫描（CT）扫描仪更新神经导航数据的技术。使用在普通手术室中 readily available 的移动CT获取术中图像。总共6至7个放置在颅骨上的钛螺钉用作更新导航的新参考点。术中CT扫描的切片厚度为2毫米。将获取的图像数据通过以太网连接作为Dicom文件传输到导航系统的计算机工作站后，更新导航数据以注册新的参考点。在更新后的导航引导下，探查并进一步切除残留病变。我们对8例患者的初步经验表明，基于用移动CT扫描仪术中获取的图像，可以稳定地更新交互式图像引导。与术中磁共振成像相比，该技术可以在普通手术室中简单完成，无需特殊手术器械，从而使得在手术期间按需更新交互式图像引导成为可能。
