University of Washington School of Medicine, Departments of Radiology and Neurological Surgery, Seattle, Washington 98195-7115, USA.
J Neurointerv Surg. 2010 Sep;2(3):249-51. doi: 10.1136/jnis.2010.002287.
Flat panel detector CT (FD-CT), three-dimensional image overlay and navigation software on contemporary fluoroscopic units generate less radiation dose while performing imaging of comparable quality to conventional CT. They can superimpose MR and CT datasets and can accurately guide percutaneous procedures providing live instrument visualization and the capability of re-imaging without patient transfer. These techniques, however, have been minimally used for accessing the head.
Using an Allura Xper FD20 unit (Philips Healthcare Andover, Massachusetts, USA), three-dimensional image overlay and FD-CT navigation were used for percutaneous n-butyl cyanoacrylate (nBCA) embolization of an intraorbital mass in a 69-year-old man.
Three-dimensional image overlay provides accurate anatomical relationships between the optic nerve and vascular portions of the mass. Percutaneous nBCA was technically successful without non-target embolization and with no significant bleeding encountered during operative resection.
FD-CT navigation and three-dimensional image overlay provide accurate instrument guidance and spatial resolution comparable with current neuro-navigation systems while also providing real time instrument position and the ability to re-image without moving the patient. These are features not available with other types of neuro-navigation.
平板探测器 CT（FD-CT）、现代透视设备上的三维图像叠加和导航软件在进行成像时，可产生较少的辐射剂量，同时提供与传统 CT 相当的成像质量。它们可以叠加磁共振和 CT 数据集，并能准确引导经皮手术，提供实时器械可视化和无需患者转移即可重新成像的能力。然而，这些技术在用于头部时很少使用。
使用 Allura Xper FD20 设备（美国马萨诸塞州飞利浦医疗安多弗），对一名 69 岁男性的眶内肿块进行经皮 n-丁基氰基丙烯酸酯（nBCA）栓塞，使用三维图像叠加和 FD-CT 导航。
三维图像叠加提供了视神经和肿块血管部分之间的准确解剖关系。经皮 nBCA 技术上是成功的，没有发生非目标栓塞，在手术切除过程中也没有遇到明显出血。
FD-CT 导航和三维图像叠加提供了与当前神经导航系统相当的准确器械引导和空间分辨率，同时还提供了实时器械位置和无需移动患者即可重新成像的能力。这些是其他类型的神经导航所不具备的功能。
