Gleason P L, Kikinis R, Altobelli D, Wells W, Alexander E, Black P M, Jolesz F
Surgical Planning Laboratory, Brigham and Women's Hospital, Boston, Mass., USA.
Stereotact Funct Neurosurg. 1994;63(1-4):139-43. doi: 10.1159/000100305.
We have combined three-dimensional (3D) computer-reconstructed neuroimages with a novel video registration technique for virtual reality-based, image-guided surgery of the brain and spine. This technique allows the surgeon to localize cerebral and spinal lesions by superimposing a 3D-reconstructed MR or CT scan on a live video image of the patient. Once the patient's scan has been segmented into the relevant components (e.g., tumor, edema, ventricles, arteries, brain and skin), the surgeon studies the 3D anatomy to determine the optimal surgical approach. The proposed intraoperative surgeon's perspective is displayed in the operating room at the time of surgery using a portable workstation. The patient is then brought to the operating room and positioned according to the planned approach. A video camera is trained on the patient from the proposed intraoperative surgeon's perspective. A video mixer merges the images from the video camera and the 3D computer reconstruction. This video mixer can vary the output intensity of the two input images between 100% of either and 50% of both. This visually superimposes the two images, not unlike a photographic double exposure. The patient's position and the 3D reconstruction are then adjusted until the images on the video mixer's output monitor are identical in terms of scale, position and rotation. This superimposition is facilitated by aligning various surface landmarks such as the external auditory canal, lateral canthus, and nasion. In some cases, such as with spinal tumors, capsules placed on the skin prior to scanning serve as fiducials.(ABSTRACT TRUNCATED AT 250 WORDS)
我们将三维（3D）计算机重建神经影像与一种新颖的视频配准技术相结合，用于基于虚拟现实的脑和脊柱图像引导手术。这项技术使外科医生能够通过将3D重建的磁共振成像（MR）或计算机断层扫描（CT）叠加在患者的实时视频图像上，来定位脑和脊髓病变。一旦患者的扫描图像被分割成相关组件（如肿瘤、水肿、脑室、动脉、脑和皮肤），外科医生就会研究3D解剖结构以确定最佳手术方案。所提议的术中外科医生视角在手术时通过便携式工作站显示在手术室中。然后将患者送至手术室并按照计划的方案进行定位。从所提议的术中外科医生视角用摄像机对准患者。视频混合器将摄像机图像与3D计算机重建图像合并。该视频混合器可以在两个输入图像各自的100%到两者的50%之间改变输出强度。这在视觉上叠加了两个图像，类似于摄影中的双重曝光。然后调整患者的位置和3D重建，直到视频混合器输出监视器上的图像在比例、位置和旋转方面完全相同。通过对齐各种表面标志（如外耳道、外眦和鼻根）来促进这种叠加。在某些情况下，如对于脊柱肿瘤，扫描前放置在皮肤上的胶囊用作基准标记。（摘要截短于250字）
