Olexa Joshua, Trang Annie, Kim Kevin, Rakovec Maureen, Saadon Jordan, Parker Whitney
Neurosurgery, University of Maryland School of Medicine, Baltimore, USA.
Cureus. 2024 Jan 16;16(1):e52383. doi: 10.7759/cureus.52383. eCollection 2024 Jan.
Image guidance technologies can significantly improve the accuracy and safety of intracranial catheter insertions. Augmented reality (AR) allows surgeons to visualize 3D information overlaid onto a patient's head. As such, AR has emerged as a novel image guidance technology that offers unique advantages when navigating intracranial targets. A 71-year-old woman with a history of brain metastasis from breast cancer and prior resection surgery and chemotherapy presented with altered mental status and generalized weakness worse on her left side. Magnetic resonance imaging (MRI) demonstrated right frontotemporoparietal edema with a contrast-enhancing mass. MR perfusion confirmed an active tumor with an enlarging right temporal pole cyst. A cyst aspiration was performed via Ommaya reservoir placement. Neuro-navigation (BrainLab, Munich, Germany) and AR navigation were used to plan the trajectory from the temporal gyrus to the cyst. Post-operative computed tomography (CT) demonstrated good placement of the reservoir, reconstitution of the temporal horn of the lateral ventricle with decreased external mass effect, and no areas of hemorrhage. AR has tremendous potential in the field of neurosurgery for improving the accuracy and safety of procedures. This case demonstrates an encouraging application of AR and can serve as an example to drive expanded clinical use of this technology.
图像引导技术可以显著提高颅内导管插入的准确性和安全性。增强现实(AR)使外科医生能够可视化叠加在患者头部的三维信息。因此,AR已成为一种新型的图像引导技术,在颅内靶点导航方面具有独特优势。一名71岁女性,有乳腺癌脑转移病史,曾接受过切除手术和化疗,现出现精神状态改变和全身无力,左侧更严重。磁共振成像(MRI)显示右侧额颞顶叶水肿,有一个强化肿块。磁共振灌注成像证实为活动性肿瘤,右侧颞极囊肿增大。通过放置Ommaya储液器进行囊肿抽吸。使用神经导航(德国慕尼黑BrainLab公司)和AR导航来规划从颞回至囊肿的路径。术后计算机断层扫描(CT)显示储液器放置良好,侧脑室颞角恢复,外部肿块效应减轻,且无出血区域。AR在神经外科领域具有巨大潜力,可提高手术的准确性和安全性。本病例展示了AR令人鼓舞的应用情况,可作为推动该技术扩大临床应用的范例。
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