Tonn J C, Schichor C, Schnell O, Zausinger S, Uhl E, Morhard D, Reiser M
Neurochirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Munich, Germany.
Acta Neurochir Suppl. 2011;109:163-7. doi: 10.1007/978-3-211-99651-5_25.
Intraoperative computed tomography (iCT) has gained increasing impact among modern neurosurgical techniques. Multislice CT with a sliding gantry in the OR provides excellent diagnostic image quality in the visualization of vascular lesions as well as bony structures including skull base and spine. Due to short acquisition times and a high spatial and temporal resolution, various modalities such as iCT-angiography, iCT-cerebral perfusion and the integration of intraoperative navigation with automatic re-registration after scanning can be performed. This allows a variety of applications, e.g. intraoperative angiography, intraoperative cerebral perfusion studies, update of cerebral and spinal navigation, stereotactic procedures as well as resection control in tumour surgery. Its versatility promotes its use in a multidisciplinary setting. Radiation exposure is comparable to standard CT systems outside the OR. For neurosurgical purposes, however, new hardware components (e.g. a radiolucent headholder system) had to be developed. Having a different range of applications compared to intraoperative MRI, it is an attractive modality for intraoperative imaging being comparatively easy to install and cost efficient.
术中计算机断层扫描（iCT）在现代神经外科技术中的影响力日益增强。手术室中配备滑动机架的多层CT在血管病变以及包括颅底和脊柱在内的骨骼结构可视化方面提供了出色的诊断图像质量。由于采集时间短以及空间和时间分辨率高，可执行多种模式，如iCT血管造影、iCT脑灌注以及扫描后术中导航与自动重新注册的整合。这允许进行各种应用，例如术中血管造影、术中脑灌注研究、脑和脊柱导航更新、立体定向手术以及肿瘤手术中的切除控制。其多功能性促进了其在多学科环境中的应用。辐射暴露与手术室之外的标准CT系统相当。然而，出于神经外科目的，必须开发新的硬件组件（例如射线可透过的头架系统）。与术中MRI相比，iCT具有不同的应用范围，它是一种有吸引力的术中成像方式，相对易于安装且成本效益高。
