Jian Zhi-Heng, Li Jia-Yan, Wu Kai-Hua, Li Yu, Li Shi-Xue, Chen Hai-Dong, Chen Gang
Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated With Jinan University, China), Zhuhai, China.
Department of Radiology, Zhuhai's People Hospital, Zhuhai, China.
Front Neurol. 2022 May 12;13:895638. doi: 10.3389/fneur.2022.895638. eCollection 2022.
To analyze the surgical effects of resecting skull base tumors using multimodal three-dimensional (3D) image fusion technology in the neurosurgery department and present some typical cases.
From October 2019 to October 2021, we included 47 consecutive patients with skull base tumors in the Neurosurgery Department at Zhuhai People's Hospital in this study. Pre-operative head computed tomography and magnetic resonance imaging data acquisition was performed using the GE AW workstation software for registration fusion, image fusion, and 3D reconstruction. The surgical approach and surgical plan were designed based on the multimodal 3D image, and the resection rate, complication rate, and operative time of the surgery using the multimodal image fusion technique were analyzed.
The reconstructed multimodal 3D images precisely demonstrated the size, location, and shape of the tumor along with the anatomical relationship between the tumor and surrounding structures, which is consistent with the intraoperative findings. Among 47 patients, 39 patients (78.7%) underwent total resection, 5 (14.9%) underwent subtotal resection, and 3 (6.4%) underwent partial resection. The mean operative time was 4.42 ± 1.32 h. No patient died during the inpatient period. Post-operative complications included 6 cases of cerebrospinal fluid leakage (14.9%), 3 cases of intracranial infection (6.4%), 6 cases of facial paralysis (12.8%), 2 cases of dysphagia (4.3%), and 1 case of diplopia (2.1%), all of which were improved after symptomatic treatment. The application value of pre-operative 3D image fusion technology was evaluated as outstanding in 40 cases (85.1%) and valuable in 7 cases (14.9%).
Pre-operative multimodal image fusion technology can provide valuable visual information in skull base tumor surgery and help neurosurgeons design the surgical incision, choose a more rational surgical approach, and precisely resect the tumor. The multimodal image fusion technique should be strongly recommended for skull base tumor surgery.
分析神经外科应用多模态三维（3D）图像融合技术切除颅底肿瘤的手术效果，并展示一些典型病例。
2019年10月至2021年10月，本研究纳入了珠海市人民医院神经外科连续收治的47例颅底肿瘤患者。使用GE AW工作站软件进行术前头部计算机断层扫描和磁共振成像数据采集，以进行配准融合、图像融合和3D重建。基于多模态3D图像设计手术入路和手术方案，并分析使用多模态图像融合技术手术的切除率、并发症发生率和手术时间。
重建的多模态3D图像精确显示了肿瘤的大小、位置和形态以及肿瘤与周围结构的解剖关系，与术中所见一致。47例患者中，39例（78.7%）行全切除，5例（14.9%）行次全切除，3例（6.4%）行部分切除。平均手术时间为4.42±1.32小时。住院期间无患者死亡。术后并发症包括脑脊液漏6例（14.9%）、颅内感染3例（6.4%）、面瘫6例（12.8%）、吞咽困难2例（4.3%）、复视1例（2.1%），经对症治疗后均有改善。术前3D图像融合技术的应用价值在40例（85.1%）中被评估为优秀，7例（用价值在40例（85.1%）中被评估为优秀，7例（14.9%）中被评估为有价值。
术前多模态图像融合技术可为颅底肿瘤手术提供有价值的视觉信息，帮助神经外科医生设计手术切口、选择更合理的手术入路并精确切除肿瘤。强烈推荐在颅底肿瘤手术中应用多模态图像融合技术。
