Miga Michael I, Staubert Andreas, Paulsen Keith D, Kennedy Francis E, Tronnier Volker M, Roberts David W, Hartov Alex, Platenik Leah A, Lunn Karen E
Dartmouth College, Thayer School of Engineering, HB8000, Hanover, NH 03755.
Dartmouth Hitchcock Medical Center, Lebanon, NH 03756.
Med Image Comput Comput Assist Interv. 2000 Oct;1935:115-124. doi: 10.1007/978-3-540-40899-4_12.
In this paper, initial clinical data from an intraoperative MR system are compared to calculations made by a three-dimensional finite element model of brain deformation. The preoperative and intraoperative MR data was collected on a patient undergoing a resection of an astrocytoma, grade 3 with non-enhancing and enhancing regions. The image volumes were co-registered and cortical displacements as well as subsurface structure movements were measured retrospectively. These data were then compared to model predictions undergoing intraoperative conditions of gravity and simulated tumor decompression. Computed results demonstrate that gravity and decompression effects account for approximately 40% and 30%, respectively, totaling a 70% recovery of shifting structures with the model. The results also suggest that a non-uniform decompressive stress distribution may be present during tumor resection. Based on this preliminary experience, model predictions constrained by intraoperative surface data appear to be a promising avenue for correcting brain shift during surgery. However, additional clinical cases where volumetric intraoperative MR data is available are needed to improve the understanding of tissue mechanics during resection.
在本文中，将术中磁共振成像（MR）系统的初始临床数据与脑变形三维有限元模型的计算结果进行了比较。术前和术中MR数据是在一名接受3级星形细胞瘤切除术的患者身上收集的，该肿瘤有非强化和强化区域。对图像体积进行了配准，并回顾性测量了皮质位移以及皮下结构运动。然后将这些数据与在术中重力条件和模拟肿瘤减压情况下的模型预测结果进行比较。计算结果表明，重力和减压效应分别约占40%和30%，模型总共能恢复70%的移位结构。结果还表明，肿瘤切除过程中可能存在非均匀的减压应力分布。基于这一初步经验，受术中表面数据约束的模型预测似乎是手术中校正脑移位的一个有前景的途径。然而，需要更多可获得术中MR体积数据的临床病例，以增进对切除过程中组织力学的理解。
