Iseki H, Masutani Y, Iwahara M, Tanikawa T, Muragaki Y, Taira T, Dohi T, Takakura K
Department of Neurosurgery, Tokyo Women's Medical College, Japan.
Stereotact Funct Neurosurg. 1997;68(1-4 Pt 1):18-24. doi: 10.1159/000099897.
We have developed an overlaid three-dimensional image (Volumegraph)-guided navigation system that allows navigation during operative procedures. The three-dimensional image is superimposed on the patient's head and body via a semi-transparent mirror. The Volumegraph can display three-dimensional images in the air by a light beam which is based on CT/MRI.
The system consists of a Volumegraph (thin plate of three-dimensional recorded medium), a Volumegraphscope and an original designed triangular-shaped marker system for registration. The three-dimensional data obtained from CT and MRI before the operation were processed by a computer. Such image data are applied for preoperative investigation to recognize the three-dimensional structure of organs and tumor. These reconstructed three-dimensional images were superimposed and registered at the patient's head according to a fiducial marker (registration). Then the operator can operate with this three-dimensional-image-guided navigation system.
Based on clinical application in 7 cases, the system was found to be advantageous because the surgical procedures could be navigated easily by augmented reality in the surgical field. Invisible parts of the surgical field were supplemented with the overlaid three-dimensional images (Volumegraph) as if it were the virtual operative field. At another time, spatial positioning and overlaid visualization by the Volumegraph was useful for identifying anatomical structures and functional location in the image.
This preliminary study of overlaid three-dimensional-image-guided navigation demonstrated its clinical usefulness. The application of augmented reality in the surgical field makes it possible to do a neurosurgical intervention easily and accurately.
我们开发了一种叠加式三维图像（容积图）引导导航系统，可在手术过程中进行导航。三维图像通过半透明镜子叠加在患者头部和身体上。容积图可通过基于CT/MRI的光束在空中显示三维图像。
该系统由一个容积图（三维记录介质薄板）、一个容积图观察镜和一个用于配准的原创设计三角形标记系统组成。术前从CT和MRI获得的三维数据由计算机处理。此类图像数据用于术前检查，以识别器官和肿瘤的三维结构。这些重建的三维图像根据基准标记（配准）叠加并在患者头部进行配准。然后，操作人员可以使用这个三维图像引导导航系统进行操作。
基于7例临床应用，发现该系统具有优势，因为在手术视野中通过增强现实可以轻松进行手术操作导航。手术视野中不可见的部分由叠加的三维图像（容积图）补充，就好像它是虚拟手术视野一样。同时，容积图的空间定位和叠加可视化对于识别图像中的解剖结构和功能位置很有用。
这项关于叠加式三维图像引导导航的初步研究证明了其临床实用性。增强现实在手术领域的应用使得轻松、准确地进行神经外科干预成为可能。
