用于乙状窦后开颅手术规划的增强现实技术。

Augmented Reality for Retrosigmoid Craniotomy Planning.

作者信息

Leuze Christoph, Neves Caio A, Gomez Alejandro M, Navab Nassir, Blevins Nikolas, Vaisbuch Yona, McNab Jennifer A

机构信息

Department of Radiology, Stanford School of Medicine, Stanford, United States.

Department of Otolaryngology, Stanford School of Medicine, Stanford, United States.

出版信息

J Neurol Surg B Skull Base. 2021 Sep 10;83(Suppl 2):e564-e573. doi: 10.1055/s-0041-1735509. eCollection 2022 Jun.

Abstract

While medical imaging data have traditionally been viewed on two-dimensional (2D) displays, augmented reality (AR) allows physicians to project the medical imaging data on patient's bodies to locate important anatomy. We present a surgical AR application to plan the retrosigmoid craniotomy, a standard approach to access the posterior fossa and the internal auditory canal. As a simple and accurate alternative to surface landmarks and conventional surgical navigation systems, our AR application augments the surgeon's vision to guide the optimal location of cortical bone removal. In this work, two surgeons performed a retrosigmoid approach 14 times on eight cadaver heads. In each case, the surgeon manually aligned a computed tomography (CT)-derived virtual rendering of the sigmoid sinus on the real cadaveric heads using a see-through AR display, allowing the surgeon to plan and perform the craniotomy accordingly. Postprocedure CT scans were acquired to assess the accuracy of the retrosigmoid craniotomies with respect to their intended location relative to the dural sinuses. The two surgeons had a mean margin of d  = 0.6 ± 4.7 mm and d  = 3.7 ± 2.3 mm between the osteotomy border and the dural sinuses over all their cases, respectively, and only positive margins for 12 of the 14 cases. The intended surgical approach to the internal auditory canal was successfully achieved in all cases using the proposed method, and the relatively small and consistent margins suggest that our system has the potential to be a valuable tool to facilitate planning a variety of similar skull-base procedures.

摘要

虽然医学影像数据传统上是在二维(2D)显示器上查看的,但增强现实(AR)使医生能够将医学影像数据投射到患者身体上,以定位重要的解剖结构。我们展示了一种用于乙状窦后颅骨切开术规划的手术AR应用程序,这是一种进入后颅窝和内耳道的标准方法。作为表面标志物和传统手术导航系统的一种简单而准确的替代方法,我们的AR应用程序增强了外科医生的视野,以指导皮质骨切除的最佳位置。在这项工作中,两名外科医生在八个尸体头部上进行了14次乙状窦后入路手术。在每种情况下,外科医生使用透视AR显示器在真实尸体头部上手动对齐由计算机断层扫描(CT)得出的乙状窦虚拟渲染图,从而使外科医生能够相应地规划和进行颅骨切开术。术后进行CT扫描,以评估乙状窦后颅骨切开术相对于硬脑膜窦预期位置的准确性。两名外科医生在所有病例中,截骨边界与硬脑膜窦之间的平均边缘分别为d = 0.6±4.7毫米和d = 3.7±2.3毫米,并且在14例病例中有12例仅为正边缘。使用所提出的方法在所有病例中均成功实现了对内耳道的预期手术入路,并且相对较小且一致的边缘表明我们的系统有可能成为促进各种类似颅底手术规划的有价值工具。

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Augmented Reality for Retrosigmoid Craniotomy Planning.

J Neurol Surg B Skull Base. 2021-9-10

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