Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Freiburg, Killianstr. 5, 79106 Freiburg, Germany.
Eur Arch Otorhinolaryngol. 2012 Sep;269(9):2145-51. doi: 10.1007/s00405-012-2010-y. Epub 2012 Apr 6.
To evaluate the image quality and clinical implementation after setting modification of a three-dimensional isocentric C-arm fluoroscopic image intensifier system combined with a digital flatpanel detector as a new tool for sinus and petrous bone surgery. Image acquisition was performed using two cadaveric heads. Experimental design was oriented to the clinically sensible intraoperative setup. Different tube currents and orbital movements of the C-arm system were evaluated for image quality by three otolaryngological surgeons using predetermined landmarks. Modification of the X-ray intensity did not attain statistically significant values compared to the X-ray-intensity predetermined by producer (12.0-18.5 mA, p > 0.05) for either sinus or for petrous bone scans. Elliptical orbital movement resulted in significantly superior image quality than data sets acquired by circular orbital movement (3.194 vs. 2.809, p < 0.0001). New C-arm systems with 3D-capabiltity offer a promising tool for intraoperative near real-time image guidance. Image quality of the skull base can be improved significantly with optimized system settings.
为了评估一款三维等中心 C 臂透视影像增强器系统与数字平板探测器相结合的新型鼻窦和岩骨手术工具在经过设定修改后的图像质量和临床应用效果。该系统使用两个尸体头颅进行图像采集。实验设计针对的是临床可行的术中设置。三位耳鼻喉科医生使用预定的标志点评估不同的管电流和 C 臂系统的轨道运动对图像质量的影响。与制造商预设的射线强度（12.0-18.5 mA）相比，鼻窦或岩骨扫描的 X 射线强度的修改并未达到统计学显著差异（p > 0.05）。椭圆形轨道运动产生的图像质量明显优于圆形轨道运动采集的数据组（3.194 比 2.809，p < 0.0001）。具有 3D 功能的新型 C 臂系统为术中实时近程图像引导提供了一种有前途的工具。通过优化系统设置，可以显著提高颅底的图像质量。
