Burtscher J, Kremser C, Seiwald M, Obwegeser A, Wagner M, Aichner F, Twerdy K, Felber S
Department of Neurosurgery, University of Innsbruck, Austria.
Comput Aided Surg. 1998;3(1):27-32. doi: 10.1002/(SICI)1097-0150(1998)3:1<27::AID-IGS4>3.0.CO;2-N.
Usually, conventional magnetic resonance spin echo images (MRI) are sufficient to establish the diagnosis of intracranial pathology. Planning and executing a neurosurgical procedure requires the ability of the neurosurgeon to transform these two-dimensional MRI into a three-dimensional (3-D) virtual image of the pathology and the surrounding neuronal anatomy. Such mentally performed transformations after sequential observation of the individual two-dimensional slices (i.e., MRI and angiography) may be virtual tasks that are very difficult or sometimes impossible to achieve. Using 3-D MRI data sets and a semiautomatic computer assisted segmentation technique, we tried to simulate intraoperative situs-based 3-D MRI reconstructions of parasagittal and parafalcine central region tumors. The MRI reconstructions were integrated into the neurosurgical planning procedure as an additional tool. They proved to be an important adjunct in determining the distinct anatomy of the intracranial pathology in its relation to the surrounding and overlying brain and vascular (especially venous) anatomy. With 10 patients with central region parasagittal and parafalcine tumors, we found that the 3-D MRI reconstructions revealed additional information compared to conventional cross-sectional images and had an influence on neurosurgical planning and strategy, improving neurosurgical performance and patient outcome.
通常，传统的磁共振自旋回波图像（MRI）足以确诊颅内病变。规划和实施神经外科手术需要神经外科医生具备将这些二维MRI转化为病变及周围神经解剖结构的三维（3-D）虚拟图像的能力。在依次观察各个二维切片（即MRI和血管造影）后，通过这种在脑海中进行的转换可能是非常困难甚至有时无法完成的虚拟任务。利用3-D MRI数据集和半自动计算机辅助分割技术，我们试图模拟矢状旁和镰旁中央区肿瘤基于术中位置的3-D MRI重建。MRI重建作为一种额外的工具被整合到神经外科手术规划程序中。它们被证明是确定颅内病变与周围及上方脑和血管（尤其是静脉）解剖结构关系的独特解剖结构的重要辅助手段。对于10例患有中央区矢状旁和镰旁肿瘤的患者，我们发现与传统横断面图像相比，3-D MRI重建显示了更多信息，并对神经外科手术规划和策略产生了影响，提高了神经外科手术的效果和患者的预后。
