Govsa Figen, Karakas Asli Beril, Ozer Mehmet Asim, Eraslan Cenk
Digital Imaging and Modelling Laboratory, Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey.
Digital Imaging and Modelling Laboratory, Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey.
World Neurosurg. 2018 Feb;110:e141-e149. doi: 10.1016/j.wneu.2017.10.119. Epub 2017 Oct 31.
Despite significant improvement in clinical care, operative strategies, and technology, neurosurgery is still risky, and optimal preoperative planning and anatomical assessment are necessary to minimize the risks of serious complications. Our purpose was to document the dural venous sinuses (DVS) and their variations identified during routine 3-dimensional (3D) venography created through 3D models for the teaching of complex cerebral anatomy.
3D models of the DVS networks were printed. Compared with the controls, cases with cortical venous thrombosis have altered venous anatomy, which has not been previously compared.
Geometrical changes between the neighboring DVS could be easily manipulated and explored from different angles. Modeling helped to conduct the examination in detail with reference to geometrical features of DVS, degree of asymmetry, its extension, location, and presence of hypoplasia/atresia channels. Challenging DVS anatomy was exposed with models of adverse anatomical variations of the DVS network, including highly angulated, asymmetrical view, narrowed lumens, and hypoplasia and atresia structures. It assisted us in comprehending spatial anatomy configuration of life-like models.
Patient-specific models of DVS geometry could provide an improved understanding of the complex brain anatomy and better navigation in difficult areas and allow surgeons to anticipate anatomical issues that might arise during the operation. Such models offer opportunities to accelerate the development of expertise with respect to new and novel procedures as well as new surgical approaches and innovations, thus allowing novice neurosurgeons to gain valuable experience in surgical techniques without exposing patients to risk of harm.
尽管在临床护理、手术策略和技术方面有了显著改善，但神经外科手术仍然存在风险，因此需要进行最佳的术前规划和解剖评估，以将严重并发症的风险降至最低。我们的目的是记录在通过三维（3D）模型创建的常规3D静脉造影过程中识别出的硬脑膜静脉窦（DVS）及其变异情况，用于复杂脑解剖学的教学。
打印出DVS网络的3D模型。与对照组相比，皮质静脉血栓形成的病例静脉解剖结构发生了改变，此前尚未进行过比较。
相邻DVS之间的几何变化可以很容易地从不同角度进行操作和探索。建模有助于参照DVS的几何特征、不对称程度、延伸范围、位置以及发育不全/闭锁通道的存在情况进行详细检查。具有挑战性的DVS解剖结构通过DVS网络不良解剖变异模型得以展现出来，包括高度成角、不对称视图、管腔狭窄以及发育不全和闭锁结构等情况。它帮助我们理解逼真模型的空间解剖结构。
针对患者的DVS几何模型能够增进对复杂脑解剖结构的理解，在困难区域实现更好的导航，并使外科医生能够预见手术过程中可能出现的解剖问题。这样的模型为加速新的和新颖手术程序以及新的手术方法和创新方面的专业技能发展提供了机会，从而使新手神经外科医生能够在不使患者面临伤害风险的情况下获得宝贵的手术技术经验。
