Sure Ulrich, Benes Ludwig, Bozinov Oliver, Woydt Michael, Tirakotai Wuttipong, Bertalanffy Helmut
Department of Neurosurgery, Philipps-University, Baldingerstrasse, 35033 Marburg, Germany.
Surg Neurol. 2005 Feb;63(2):133-41; discussion 141-2. doi: 10.1016/j.surneu.2004.08.040.
The integration of ultrasound technology into neuronavigation systems has recently been the subject of reports by several groups. This article describes our preliminary findings with regard to the integration of data derived from intraoperative duplex (color mode) and Doppler ultrasonography into a neuronavigational data set. It was the aim of the study to investigate (1) whether the intraoperative landmarking of vessels that are outlined with ultrasound technology is possible and (2) whether such a technique might be of clinical interest for neurosurgical interventions.
The video image of an ultrasound plane (Toshiba, Powervision 6000 SSA-370A, Tokyo, Japan) was integrated into our neuronavigation system (VectorVision2, BrainLab, Heimstetten, Germany). For calibration of the ultrasound plane, an instrument adapter was fixed to the ultrasound probe and then calibrated using a special, predefined calibration phantom.
Accordingly, the system supported a combination of the ultrasound plane functionality with the preoperatively acquired neuronavigational data. The duplex and Doppler mode of the ultrasound system displayed the intraoperative vascular anatomy. Once a vessel was outlined during surgery, it could be landmarked by touching the navigation screen. These landmarks were integrated automatically into the neuronavigational data set and could be used to provide intraoperative image updates of the vascular anatomy. This technique was successful in 45 of 47 (95.7%) surgical interventions.
Both image-guided ultrasound and duplex-guided integration of vascular anatomy into the neuronavigational data set are technically possible. In the future, this technology may provide useful intraoperative information during surgery of complex cerebral pathologies.
超声技术与神经导航系统的整合最近已成为多个研究小组报告的主题。本文描述了我们关于将术中双功（彩色模式）和多普勒超声检查获得的数据整合到神经导航数据集中的初步研究结果。本研究的目的是调查：（1）使用超声技术勾勒出的血管在术中进行标记是否可行；（2）这种技术对于神经外科手术是否具有临床意义。
将超声平面（东芝，PowerVision 6000 SSA - 370A，日本东京）的视频图像整合到我们的神经导航系统（VectorVision2，BrainLab，德国海姆斯泰滕）中。为了校准超声平面，将一个仪器适配器固定在超声探头上，然后使用一个特殊的、预定义的校准模型进行校准。
相应地，该系统支持超声平面功能与术前获取的神经导航数据相结合。超声系统的双功和多普勒模式显示了术中血管解剖结构。手术过程中一旦勾勒出血管，通过触摸导航屏幕即可对其进行标记。这些标记会自动整合到神经导航数据集中，并可用于提供血管解剖结构的术中图像更新。该技术在47例手术中的45例（95.7%）中取得了成功。
图像引导超声以及将血管解剖结构双功引导整合到神经导航数据集中在技术上都是可行的。未来，这项技术可能在复杂脑部疾病的手术中提供有用的术中信息。
