Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany.
Institute of Applied Medical Engineering, Deptartment of Rehabilitation & Prevention Engineering, RWTH Aachen University, Aachen, Germany.
Minim Invasive Ther Allied Technol. 2022 Aug;31(6):902-908. doi: 10.1080/13645706.2021.2002363. Epub 2021 Dec 4.
The aim of the study was to demonstrate the feasibility of a prototype for accelerometer-based guidance for percutaneous CT-guided punctures and compare it with free-hand punctures.
The prototype enabled alignment with the CT coordinate system and a wireless connectivity. Its feasibility was tested in a swine cadaver model: 20 out-of-plane device-assisted punctures performed without intermittent control scans (one-step punctures) were evaluated regarding deviation to target and difference between planned and obtained angle. Thereafter, 22 device-assisted punctures were compared with 20 free-hand punctures regarding distance to target, deviation from the planned angle, number of control scans and procedure time. Differences were compared with the Mann-Whitney U-test ( < .05).
The one-step punctures revealed a deviation to target of 0.26 ± 0.37 cm (axial plane) and 0.21 ± 0.19 cm (sagittal plane) and differences between planned and performed puncture angles of 0.9 ± 1.09° (axial plane) and 1.15 ± 0.91° (sagittal planes). In the comparative study, device-assisted punctures showed a significantly higher accuracy, 0.20 ± 0.17 cm vs. 0.30 ± 0.21 cm ( < .05) and lower number of required control scans, 1.3 ± 1.1 vs. 3.7 ± 0.9 ( < .05) compared with free-hand punctures.
The accelerometer-based device proved to be feasible and demonstrated significantly higher accuracy and required significantly less control scans compared to free-hand puncture.
本研究旨在展示一种基于加速度计的引导经皮 CT 引导穿刺的原型设备的可行性，并将其与徒手穿刺进行比较。
该原型设备可与 CT 坐标系对齐并实现无线连接。在猪尸体模型中对其可行性进行了测试：在 20 次平面外的设备辅助穿刺中（一步穿刺），评估了目标的偏差以及计划角度和实际获得角度之间的差异。此后，将 22 次设备辅助穿刺与 20 次徒手穿刺在目标距离、偏离计划角度、控制扫描次数和手术时间方面进行了比较。采用 Mann-Whitney U 检验（ < .05）比较差异。
一步穿刺的目标偏差为 0.26 ± 0.37 cm（轴向平面）和 0.21 ± 0.19 cm（矢状平面），计划和实际穿刺角度之间的差异为 0.9 ± 1.09°（轴向平面）和 1.15 ± 0.91°（矢状平面）。在对比研究中，设备辅助穿刺的准确性明显更高，0.20 ± 0.17 cm 与 0.30 ± 0.21 cm（ < .05），所需控制扫描次数更少，1.3 ± 1.1 次与 3.7 ± 0.9 次（ < .05）。
基于加速度计的设备被证明是可行的，与徒手穿刺相比，其具有更高的准确性，且所需的控制扫描次数明显更少。
