Jakola Asgeir S, Reinertsen Ingerid, Selbekk Tormod, Solheim Ole, Lindseth Frank, Gulati Sasha, Unsgård Geirmund
Department of Neurosurgery, St. Olavs University Hospital, Trondheim; National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; MI Lab, Medical Faculty, Norwegian University of Science and Technology, Trondheim; Department of Neuroscience, Medical Faculty, Norwegian University of Science and Technology, Trondheim.
National Competence Centre for Ultrasound and Image-Guided Therapy, St. Olavs University Hospital, Trondheim; Department of Medical Technology, SINTEF, Trondheim, Norway.
World Neurosurg. 2014 Sep-Oct;82(3-4):536.e5-9. doi: 10.1016/j.wneu.2013.08.021. Epub 2013 Aug 23.
Many studies demonstrate that the accuracy of freehand catheter placement for cerebrospinal fluid drainage is suboptimal. The aim of placement should be a single pass with a free-floating catheter tip in the intended position. The objective of this study was to achieve an accurate and user-friendly system for three-dimensional (3D) ultrasound-navigated catheter placement through a regular burr hole.
A new phased-array ultrasound burr hole probe (4-10 MHz, 8 mm×9 mm footprint) was especially developed and optimized for navigated 3D ultrasound with the SonoWand Invite system. A catheter holder for optical tracking was also developed. Head immobilization was achieved with a vacuum cushion. With the described setup, 4 patients underwent surgery.
Ultrasound image quality and visualization of the ventricles was good in all cases. Optimal placement of the catheter was achieved in a single pass in all patients. One of the trajectories was slightly more medial on postoperative computed tomography than anticipated from the neuronavigation system. None of the patients experienced any adverse event related to the procedure.
3D ultrasound with the described setup is a promising technique for accurate, fast, and user-friendly navigated placement of catheters for cerebrospinal fluid diversion.
许多研究表明，徒手放置脑脊液引流导管的准确性欠佳。放置的目标应是一次性将自由漂浮的导管尖端置于预期位置。本研究的目的是开发一种准确且用户友好的系统，用于通过常规骨孔进行三维（3D）超声引导下的导管放置。
专门开发并优化了一种新型相控阵超声骨孔探头（4 - 10 MHz，8 mm×9 mm 探头面积），用于与 SonoWand Invite 系统配合进行导航 3D 超声检查。还开发了一种用于光学跟踪的导管固定器。使用真空垫实现头部固定。采用上述设置，4 例患者接受了手术。
所有病例中超声图像质量及脑室可视化效果均良好。所有患者均一次性实现了导管的最佳放置。术后计算机断层扫描显示，其中一条轨迹比神经导航系统预期的略偏内侧。所有患者均未出现与该操作相关的不良事件。
采用上述设置的 3D 超声是一种有前景的技术，可用于准确、快速且用户友好的脑脊液分流导管导航放置。
