Cohen D S, Lustgarten J H, Miller E, Khandji A G, Goodman R R
Department of Neurological Surgery, Neurological Institute of New York, Columbia Presbyterian Medical Center, New York, USA.
J Neurosurg. 1995 May;82(5):772-9. doi: 10.3171/jns.1995.82.5.0772.
Coregistration of different modality imaging serves to increase the ease and accuracy of stereotactic procedures. In many cases, magnetic resonance (MR) stereotaxis is supplanting computerized tomography (CT). The advantages of increased anatomical detail and multiplanar imaging afforded by MR, however, are offset by its potential inaccuracy as well as the more cumbersome and less available nature of its hardware. A system has been developed by one of the authors by which MR imaging can be performed separately without a stereotactic fiducial headring. Then, immediately prior to surgery, a stereotactic CT scan is obtained and software is used to coregister CT and MR images anatomically by matching cranial landmarks in the two scans. The authors examined this system in six patients as well as with the use of a lucite phantom. After initially coregistering CT and MR images, six separate anatomical (for the patients) and eight artificial (for the phantom) targets were compared. With coregistration, in comparison to CT fiducial scans, errors in each axis are less than or equal to 1 mm using the Cosman-Roberts-Wells system. In fact, the coregistered images are more accurate than MR fiducial images, in the anteroposterior (p = 0.001), lateral (p < 0.05), and vertical (p < 0.03) planes. Three-dimensional error was significantly less in the coregistered scans than the MR fiducial images (p < 0.005). The coregistration procedure therefore not only increases the case of MR stereotaxis but also increases its accuracy.
不同模态成像的配准有助于提高立体定向手术的便捷性和准确性。在许多情况下，磁共振（MR）立体定向技术正在取代计算机断层扫描（CT）。然而，MR所提供的解剖细节增加和多平面成像的优势，被其潜在的不准确性以及硬件更为笨重且可用性较低的特点所抵消。其中一位作者开发了一种系统，通过该系统可以在不使用立体定向基准头环的情况下单独进行MR成像。然后，在手术即将开始前，获取立体定向CT扫描图像，并使用软件通过匹配两次扫描中的颅骨标志在解剖学上对CT和MR图像进行配准。作者在6名患者以及使用有机玻璃模型的情况下对该系统进行了研究。在最初对CT和MR图像进行配准后，比较了6个单独的解剖学靶点（针对患者）和8个人造靶点（针对模型）。通过配准，与CT基准扫描相比，使用Cosman-Roberts-Wells系统时每个轴向上的误差小于或等于1毫米。事实上，在前后（p = 0.001）、横向（p < 0.05）和垂直（p < 0.03）平面上，配准后的图像比MR基准图像更准确。配准扫描中的三维误差明显小于MR基准图像（p < 0.005）。因此，配准程序不仅提高了MR立体定向的便捷性，还提高了其准确性。
