Department of Neurosurgery, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Neurosurgery. 2011 Sep;69(1 Suppl Operative):ons40-8; discussion ons48. doi: 10.1227/NEU.0b013e318211019a.
BACKGROUND: Imaging technologies have evolved to meet the demand for improved presurgical simulations, particularly with the introduction of endoscopic surgery in the neurosurgical field. OBJECTIVE: To evaluate the effectiveness of a 3-dimensional interactive visualization method with a computer graphics model, which was created using hybrid rendering and multimodal fusion methods for neuroendoscopic surgery, and to assess whether the 2-dimensional interactive visualization method could effectively represent the microsurgical anatomical information necessary for endoscopic surgery compared with conventional 3-dimensional computer graphics models. METHODS: Ten patients scheduled for neuroendoscopic surgery for intraventricular lesions were included in the study. For the 3-dimensional interactive visualization method, a hybrid model of volume and surface rendering was created from magnetic resonance images combined with computed tomography and positron emission tomography. Preoperative radiographic images were fused with the normalized mutual information method. Visibility of anatomic structures was compared between the multifusion models and nonfusion models created from only heavy-T2-weighted images that rely solely on the surface rendering method. RESULTS: The average visibility score of the multifusion models was 97.5% (range, 95.6% to 100%), which was significantly higher than that for nonfusion models (35.9% to 64.1%; P = .002). The multifusion model represents an improved visualization method for preoperative virtual simulation for neuroendoscopic intraventricular surgery. CONCLUSION: Our 3-dimensional imaging method is superior to conventional methods and will greatly improve the safety and effectiveness of neuroendoscopic surgical procedures for complex intraventricular lesions.
背景:成像技术的发展满足了术前模拟改良的需求,尤其是神经外科内镜手术的引入。
目的:评估一种使用混合渲染和多模态融合方法创建的计算机图形模型的 3 维交互式可视化方法的有效性,该方法用于神经内镜手术,并评估与传统的 3 维计算机图形模型相比,2 维交互式可视化方法是否可以有效地呈现内镜手术所需的微创手术解剖信息。
方法:纳入 10 例行神经内镜脑室病变手术的患者。对于 3 维交互式可视化方法,从磁共振成像结合计算机断层扫描和正电子发射断层扫描创建了体绘制和表面绘制的混合模型。使用归一化互信息方法将术前放射图像与融合模型融合。比较了多融合模型和仅依赖表面绘制方法的仅重 T2 加权图像创建的非融合模型的解剖结构可视性。
结果:多融合模型的平均可视性评分(范围为 95.6%100%)为 97.5%,显著高于非融合模型(35.9%64.1%;P =.002)。多融合模型代表了神经内镜脑室手术术前虚拟模拟的一种改进的可视化方法。
结论:我们的 3 维成像方法优于传统方法,将极大地提高神经内镜治疗复杂脑室病变手术的安全性和有效性。
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