Musculoskeletal Division, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA.
AJR Am J Roentgenol. 2012 Mar;198(3):W266-73. doi: 10.2214/AJR.11.6918.
The purpose of this study was to prospectively evaluate the accuracy of an augmented reality image overlay system in MRI-guided spinal injection procedures.
An augmented reality prototype was used in conjunction with a 1.5-T MRI system. A human lumbar spine phantom was used in which 62 targets were punctured to assess the accuracy of the system. Sixty anatomic targets (facet joint, disk space, and spinal canal) were punctured to assess how the accuracy of the system translated into practice. A visualization software interface was used to compare planned needle paths and final needle locations on coregistered CT images (standard of reference). Outcome variables included entry error, angle error, depth error, target error, successful access of anatomic targets, number of needle adjustments, and time requirements.
Accuracy assessments showed entry error of 1.6 ± 0.8 mm, angle error of 1.6° ± 1.0°, depth error of 0.7 ± 0.5 mm, and target error of 1.9 ± 0.9 mm. All anatomic targets (60 of 60 insertions) were successfully punctured, including all 20 facet joints, all 20 disks, and all 20 spinal canals. Four needle adjustments (6.7%) were required. Planning of a single needle path required an average of 55 seconds. A single needle insertion required an average of 1 minute 27 seconds.
The augmented reality image overlay system evaluated facilitated accurate MRI guidance for successful spinal procedures in a lumbar spine model. It exhibited potential for simplifying the current practice of MRI-guided lumbar spinal injection procedures.
本研究旨在前瞻性评估增强现实图像叠加系统在 MRI 引导下脊柱注射程序中的准确性。
使用增强现实原型与 1.5-T MRI 系统相结合。使用人体腰椎模型，共穿刺 62 个靶点，以评估系统的准确性。穿刺 60 个解剖靶点（关节突关节、椎间盘间隙和椎管），以评估系统的准确性如何转化为实际应用。使用可视化软件界面将计划的针道与 CT 图像（参考标准）上的最终针道位置进行比较。观察指标包括进针误差、角度误差、深度误差、靶点误差、解剖靶点的成功穿刺、针道调整次数和时间要求。
准确性评估显示进针误差为 1.6±0.8mm，角度误差为 1.6°±1.0°，深度误差为 0.7±0.5mm，靶点误差为 1.9±0.9mm。所有解剖靶点（60/60 个穿刺）均成功穿刺，包括所有 20 个关节突关节、所有 20 个椎间盘和所有 20 个椎管。仅需 4 次针道调整（6.7%）。单个针道规划平均需要 55 秒。单个针道插入平均需要 1 分 27 秒。
评估的增强现实图像叠加系统在腰椎模型中为成功的脊柱手术提供了准确的 MRI 引导，具有简化当前 MRI 引导下腰椎脊柱注射程序的潜力。
