Schiavone P, Chassat F, Boudou T, Promayon E, Valdivia F, Payan Y
Laboratoire Techniques de l'Ingénierie Médicale et de la Complexité, Informatique, Mathématiques et Applications de Grenoble, UMR CNRS 5525, Université Joseph Fourier, 38706 La Tronche cedex, France.
Med Image Anal. 2009 Aug;13(4):673-8. doi: 10.1016/j.media.2009.04.001. Epub 2009 Apr 11.
The brain deformation that occurs during neurosurgery is a serious issue impacting the patient "safety" as well as the invasiveness of the brain surgery. Model-driven compensation is a realistic and efficient solution to solve this problem. However, a vital issue is the lack of reliable and easily obtainable patient-specific mechanical characteristics of the brain which, according to clinicians' experience, can vary considerably. We designed an aspiration device that is able to meet the very rigorous sterilization and handling process imposed during surgery, and especially neurosurgery. The device, which has no electronic component, is simple, light and can be considered as an ancillary instrument. The deformation of the aspirated tissue is imaged via a mirror using an external camera. This paper describes the experimental setup as well as its use during a specific neurosurgery. The experimental data was used to calibrate a continuous model. We show that we were able to extract an in vivo constitutive law of the brain elasticity: thus for the first time, measurements are carried out per-operatively on the patient, just before the resection of the brain parenchyma. This paper discloses the results of a difficult experiment and provide for the first time in vivo data on human brain elasticity. The results point out the softness as well as the highly non-linear behavior of the brain tissue.
神经外科手术过程中发生的脑部变形是一个严重问题，会影响患者“安全”以及脑部手术的侵袭性。模型驱动补偿是解决这一问题的切实可行且高效的方法。然而，一个关键问题是缺乏可靠且易于获取的患者特异性脑部力学特性，根据临床医生的经验，这些特性可能会有很大差异。我们设计了一种抽吸装置，它能够满足手术（尤其是神经外科手术）过程中所要求的极其严格的消毒和操作流程。该装置没有电子元件，结构简单、重量轻，可被视为一种辅助器械。通过一面镜子利用外部摄像头对被抽吸组织的变形进行成像。本文描述了实验装置及其在特定神经外科手术中的使用情况。实验数据用于校准一个连续模型。我们表明能够提取出大脑弹性的体内本构定律：因此首次在手术中就在切除脑实质之前对患者进行了测量。本文披露了一项困难实验的结果，并首次提供了关于人脑弹性的体内数据。结果指出了脑组织的柔软性以及高度非线性行为。
