Wirtz C R, Tronnier V M, Bonsanto M M, Knauth M, Staubert A, Albert F K, Kunze S
Department of Neurological Surgery, Ruprecht Karl University, Heidelberg, Germany.
Stereotact Funct Neurosurg. 1997;68(1-4 Pt 1):39-43. doi: 10.1159/000099900.
Intraoperative shifts and resulting inaccuracies have been a concern in frame based and frameless stereotactically guided interventions, particularly in open microsurgical procedures. Trying to solve this problem, we developed a method to perform intraoperative MRI (0.2 tesla, Magnetom Open) and use intraoperatively acquired data sets to update neuronavigation. In 21 patients, intraoperative images could be used to reference navigation (mean accuracy of 0.83 +/- 0.31 mm). The operation was continued in 10 cases to resect detected tumor remnants using navigation, leaving 4 patients (19%) with residual tumor postoperatively. We showed that update of frameless stereotaxy to compensate for brain shift is feasible and might increase the number of cases where radiologically complete resection can be achieved.
术中移位及由此产生的误差一直是基于框架和无框架立体定向引导干预中的一个问题，尤其是在开放式显微外科手术中。为了解决这个问题，我们开发了一种方法来进行术中磁共振成像（0.2特斯拉，开放式Magnetom），并使用术中获取的数据集来更新神经导航。在21例患者中，术中图像可用于参考导航（平均精度为0.83±0.31毫米）。10例患者继续手术，使用导航切除检测到的肿瘤残余，术后4例患者（19%）有残留肿瘤。我们表明，更新无框架立体定向以补偿脑移位是可行的，并且可能增加能够实现放射学上完全切除的病例数量。
