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MRI-CT褰卞儚铻嶅悎瀵艰埅鎶€鏈湪绁炵粡澶栫鍒囬櫎鎵嬫湳涓殑搴旂敤

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纭?a href="http://flywand.com/">鍗氳鏂囩綉鏄竴瀹朵笓涓氭彁渚涜鏂囧畾鍒朵慨鏀规湇鍔$殑缃戠珯锛屼笂10骞寸殑璁烘枃缁忛獙锛屾棤璁烘槸鏈璁烘枃銆佺澹鏂囪繕鏄湡鍒婅鏂囷紝鍗氬+璁烘枃锛屾垜浠兘鑳戒负鎮ㄦ彁渚涙柟渚裤€佸揩鎹枫€佸畨鍏ㄧ殑璁烘枃鏈嶅姟銆備互涓嬫槸纭曞崥璁烘枃缃戝皬缂栦负鎮ㄧ簿蹇冩寫閫夌殑涓€绡囧尰瀛?a href="http://flywand.com/index.php?upcache=1">璁烘枃鑼冩枃锛屽唴瀹规槸鍏充簬MRI-CT褰卞儚铻嶅悎瀵艰埅鎶€鏈湪绁炵粡澶栫鍒囬櫎鎵嬫湳涓殑搴旂敤銆傛湰鏂囧垎鏋?nbsp;MRI-CT褰卞儚铻嶅悎瀵艰埅鎶€鏈殑搴旂敤锛屽彲鍗忓姪绁炵粡澶栫鍖荤敓鏇村姞鍑嗙‘鍦拌繘琛屾墜鏈畾浣嶏紝澧炲己瀵规墜鏈繘搴︾殑涓昏鎶婃帶锛屾彁楂樻墜鏈垚鍔熺巼銆備互渚涘悇浣嶅悓瀛﹀弬鑰冿紝甯屾湜瀵瑰ぇ瀹舵湁鎵€甯姪銆?/strong>
銆€鎽樿锛氱洰鐨?鎬荤粨MRI-CT褰卞儚铻嶅悎瀵艰埅鎶€鏈湪绁炵粡澶栫鎵嬫湳涓殑搴旂敤鍙婄浉鍏抽棶棰樻€濊€冦€傛柟娉?鍥為【鎬у垎鏋愯В鏀惧啗鎬诲尰闄㈢鍏尰瀛︿腑蹇冿紙鍘熸捣鍐涙€诲尰闄級 2016骞?鏈堣嚦2017骞?2鏈堝紑灞曠殑351渚嬪湪MRI-CT褰卞儚铻嶅悎瀵艰埅杈呭姪涓嬭寮€棰呰偪鐦ゅ垏闄ゆ墜鏈殑涓村簥璧勬枡锛屽寘鎷墜鏈墠鍑嗗璁″垝锛屾墜鏈腑璋ㄦ厧搴旂敤锛屾墜鏈悗淇濆吇缁存姢銆傜粨鏋?351渚嬫墜鏈鑸晥鏋滄弧鎰忥紝鎴愬姛瀹屾垚浜嗙梾鐏跺垏闄わ紝鏈腑瀹氫綅绮惧噯锛岃绠$缁忎繚鎶ゅ畬濂斤紝鏈悗鏃?渚嬫剰澶栫缁忓姛鑳藉彈鎹燂紝鎮h€呮仮澶嶈壇濂姐€傛墜鏈鑸鍒掗浂澶辫锛屽鑸澶囧強瀵艰埅鍣ㄦ闆舵瘉鎹熴€侀浂缁翠慨锛屽簲鐢ㄨ壇濂姐€傜粨璁?MRI-CT褰卞儚铻嶅悎瀵艰埅鎶€鏈殑搴旂敤锛屽彲鍗忓姪绁炵粡澶栫鍖荤敓鏇村姞鍑嗙‘鍦拌繘琛屾墜鏈畾浣嶏紝澧炲己瀵规墜鏈繘搴︾殑涓昏鎶婃帶锛屾彁楂樻墜鏈垚鍔熺巼銆傚仛濂芥墜鏈墠鍑嗗锛屾湳涓啛缁冩搷浣滐紝鏈悗璁惧鍙婂櫒姊扮淮鎶や繚鍏荤瓑鐩稿叧宸ヤ綔锛屽璇ラ」鎶€鏈湪鎵嬫湳涓殑鏈夋晥搴旂敤鑷冲叧閲嶈銆傚悓鏃跺鎶ょ悊浜哄憳绉瀬瀛︿範鏂版妧鏈紝涓嶆柇鏇存柊鐭ヨ瘑鎶€鑳藉偍澶囷紝涓庢椂淇辫繘鐨勫伐浣滆姹傛彁鍑烘柊鐨勬寫鎴樸€?/span>

MRI-CT褰卞儚铻嶅悎瀵艰埅鎶€鏈湪绁炵粡澶栫鍒囬櫎鎵嬫湳涓殑搴旂敤

銆€銆€鍏抽敭璇嶏細MRI-CT褰卞儚铻嶅悎鎶€鏈紱 鎵嬫湳瀵艰埅鎶€鏈紱 绁炵粡澶栫鎵嬫湳锛?/span>

銆€銆€Abstract:

銆€銆€Objective To summarize the application of the MRI-CT image fusion navigation technology in neurosurgical operations and thinking of related problems. Methods Clinical data of 351 patients who underwent craniotomy with the MRI-CT image fusion navigation assisted by craniotomy from June 2016 to December 2017 were retrospectively analyzed in the study. The corresponding data included pre-surgical plan,careful application in surgery and post-surgical maintenance. Results The efficacy of all the 351 surgical cases was satisfactory,with accurate positioning,successful resection of all the foci,intact of vascular vessels and nerves,and no case of accidental damage to neural functions after surgery. As a result,all the patients had good recovery. There was zero error in surgical navigation plans,and there was also zero damage to navigation systems and instruments in the process of surgery. Conclusion The MRI-CT image fusion navigation technology could help neurosurgeons to make more accurate surgical positioning,improve subjective control of surgical progress,and ultimately increase the success rate of surgery.

銆€銆€Keyword:

銆€銆€MRI-CT image fusion technology; Surgical navigation technology; Neurosurgery;

 

銆€銆€鏈夎皟鏌ユ樉绀篬1],绁炵粡瀵艰埅鎶€鏈湪绁炵粡澶栫鍒囬櫎鍗婄悆鑲跨槫銆侀搴曡偪鐦ゃ€佸瀭浣撶槫锛堢粡铦舵墜鏈級銆佽绠$暩褰㈢瓑鎵嬫湳涓殑搴旂敤鐜囧垎鍒彲杈?2.3%銆?0.0%銆?2.3%鍜?2.3%.鍏跺浜庣缁忓绉戦鍩熸槸鏂扮殑椋炶穬锛屽疄鐜颁簡鍑嗙‘鎬с€佺伒娲绘€с€佸井鍒涙€у強蹇€熸€х殑楂樺害缁熶竴锛岄泦褰卞儚-瀵煎悜-鎵嬫湳涓轰竴浣擄紝瀹屾垚鏈腑鐨勭簿鍑嗗畾浣嶃€傞殢鐫€鍖诲褰卞儚铻嶅悎鎶€鏈湪褰撳墠鎶€鏈爺绌堕鍩熺殑鏃ユ笎鍙戠儹锛屽妯℃€佸奖鍍忚瀺鍚堝鑸妧鏈垚涓哄綋浠婄缁忓绉戣繘涓€姝ュ父瑙勬墜鏈簿鍑嗗寲銆佸紑鏀炬墜鏈井鍒涘寲銆佸鏉傛墜鏈畝鍗曞寲鐨勫繀澶囧伐鍏穂2],缁熶竴灏嗗璞″湪涓嶅悓鎴愬儚鍘熺悊涓嬪緱鍒扮殑澶氬箙鍥惧儚缁忚繃绌洪棿閰嶅噯鍜屽彔鍔犲悗鍚堟垚涓€骞呭浘鍍忥紝浠庤€岃揪鍒板涓奖鍍忔暟鎹紭鍔夸簰琛ワ紝缁煎悎鍒╃敤鐨勭洰鐨勩€傚叾涓婧愬奖鍍忔暟鎹彔鍔犳妧鏈紝鍙互鍚屾椂瀵笴T銆丆TA銆丮R_T1銆丮R_T2銆丮RA銆乫 MRI銆丳ET鍙婅剳纾佸浘绛変换鎰?绉嶄互涓婂奖鍍忔暟鎹繘琛岃嚜鍔ㄦ垨鎵嬪姩铻嶅悎[3].瑙f斁鍐涙€诲尰闄㈢鍏尰瀛︿腑蹇冿紙鍘熸捣鍐涙€诲尰闄級鑷?012骞村紩杩涚敱寰峰浗BrainLAB AG鍏徃浜olibri 2.0鍨嬪绉戞墜鏈鑸郴缁燂紝鑷?016骞?鏈堣嚦2017骞?2鏈堣闄㈠紑灞曞鑸妧鏈緟鍔╀笅绁炵粡澶栫鎵嬫湳351渚嬶紝鏈腑鍧囬噰鐢∕RI-CT褰卞儚铻嶅悎瀵艰埅鎶€鏈紝瀵艰埅鏁堟灉婊℃剰锛屾墜鏈垚鍔熴€傚熀浜庡妯℃€佸奖鍝嶈瀺鍚堝鑸妧鏈鎻愰珮鎵嬫湳鎴愬姛鐜囩殑绐佸嚭浼樺娍锛屽叾鍦ㄧ缁忓绉戞墜鏈腑鐨勫簲鐢ㄤ篃瓒婃潵瓒婂箍娉涳紝涓烘洿濂藉畬鎴愭绫绘墜鏈殑鍖绘姢濞寸啛閰嶅悎锛岃繘涓€姝ユ彁楂樻墜鏈簿鍑嗙巼锛屾湰鏂囬€氳繃鍥為【鎬у垎鏋?51渚嬫墜鏈祫鏂欙紝缁撳悎涓村簥宸ヤ綔涓殑瀹為檯搴旂敤闂锛屽鎵嬫湳鍓嶅噯澶囷紝瀵艰埅璁″垝瑙勫垝锛屾湳涓簿銆佸噯銆佽交銆佺ǔ鐨勬搷浣滆姹傦紝鏈悗璁惧鍙婂鑸櫒姊版竻娲楁秷姣掋€佺淮鎶や繚鍏诲拰褰掔疆瀹夋斁绛夊唴瀹硅繘琛屾€荤粨锛屾彁鍑虹浉鍏抽棶棰樻€濊€冦€傜幇鎶ラ亾濡備笅銆?/span>

銆€銆€1 璧勬枡涓庢柟娉?/span>

銆€銆€1.1 涓村簥璧勬枡

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銆€銆€1.2 鏂规硶

銆€銆€1.2.1 MRI-CT褰卞儚铻嶅悎鎶€鏈?/span>

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銆€銆€1.2.2 鎵嬫湳瀵艰埅鎶€鏈?/span>

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銆€銆€1.3 鎵嬫湳閰嶅悎

銆€銆€1.3.1 鏈墠鍏ㄩ潰鍑嗗璁″垝

銆€銆€1.3.1. 1 鎮h€呭噯澶?/span>

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銆€銆€1.3.1. 2 鍖荤敓鍑嗗

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銆€銆€1.3.1. 3 鎶ゅ+鍑嗗

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銆€銆€1.3.2 鏈腑濞寸啛绮剧ǔ鎿嶄綔

銆€銆€1.3.2. 1 鍖绘姢鎿嶄綔鍩硅

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銆€銆€1.3.2. 2 鎵嬫湳鍖荤敓鎿嶄綔

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銆€銆€1.3.2. 3 鎵嬫湳鎶ゅ+鎿嶄綔

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銆€銆€1.3.3 鏈悗缁嗚嚧缁存姢淇濆吇

銆€銆€1.3.3. 1 瀵艰埅璁惧

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銆€銆€1.3.3. 2 瀵艰埅鍣ㄦ

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銆€銆€2 缁撴灉

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銆€銆€3 璁ㄨ

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銆€銆€鍙傝€冩枃鐚?br /> 銆€銆€[1]璧靛竼锛岄檲琛旇瘹锛屽惔鍔叉澗銆傛垜鍥界缁忓鑸妧鏈紑灞曠幇鐘惰皟鏌J].涓浗鍖荤枟鍣ㄦ淇℃伅锛?007,13锛?锛夛細6-7.
銆€銆€[2]鍐礌閾讹紝榛勮繘锛岀▼瓒咃紝绛夈€傚妯℃€佺缁忓鑸奖鍍忓姛鑳藉湪澶嶆潅鍨備綋鑵虹槫鎵嬫湳涓殑搴旂敤[J].姹熻嫃鍖昏嵂锛?014,40锛?0锛夛細2442-2444.
銆€銆€[3]瀛欓獜锛岄偟鍚涢锛屾埓鏁忚秴锛岀瓑銆傚妯℃€佸奖鍍忚瀺鍚堢缁忓鑸湪缁忚澏鍨備綋鑵虹槫鎵嬫湳涓殑搴旂敤[J].姹熻嫃鍖昏嵂锛?015,41锛?2锛夛細2676-2677.
銆€銆€[4]鍚村姴鏉撅紝鍛ㄨ壇杈咃紝楂樻瓕鍐涖€傚褰卞儚铻嶅悎鎶€鏈湪绁炵粡瀵艰埅鎵嬫湳鐨勪复搴婂簲鐢╗J].涓崕绁炵粡澶栫鏉傚織锛?005,21锛?锛夛細227-231.
銆€銆€[5]鍚村姴鏉撅紝鍛ㄨ壇杈咃紝楂樻瓕鍐涳紝绛夈€傝瀺鍚堝姛鑳界鍏辨尟褰卞儚鐨勭缁忓鑸湪鑴戠毊璐ㄨ繍鍔ㄥ尯鑲跨槫涓殑搴旂敤[J].涓崕鍖诲鏉傚織锛?004,84锛?锛夛細632-633.
銆€銆€[6]灏逛簯娓咃紝鏉庤幑銆傜缁忓鑸笅棰呰剳鎵嬫湳鐨勬姢鐞嗛厤鍚圼J].褰撲唬鎶ゅ+锛?017,3锛?锛夛細129.
銆€銆€[7]绗﹂泤鍚涳紝鍚撮倱濞冦€傜缁忓鑸华杈呭姪涓嬮鑴戣偪鐦ゆ樉寰垏闄ょ殑鎶ょ悊閰嶅悎[J].瀹炵敤涓村簥鍖昏嵂鏉傚織锛?013,17锛?2锛夛細1-2.
銆€銆€[8]鐜嬬帀闇烇紝鑻忕鑿娿€傜缁忓鑸妧鏈湪鏄惧井绁炵粡澶栫鎵嬫湳涓殑鎶ょ悊[J].涓浗璇瘖瀛︽潅蹇楋紝2016,6锛?4锛夛細28015-28016.
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銆€銆€[11]Patel SN,Youssef AS,Vale FL,et al.Re-evaluation of the role of image guidance in minimally invasive pituitary surgery:benefits and outcomes[J].Comp Aided Surg,2011,16锛?锛夛細47-53.
銆€銆€[12]浣曟案鐢燂紝榛勫厜瀵岋紝绔犵繑銆傛柊缂栫缁忓绉戝[M].鍖椾含锛氫汉姘戝崼鐢熷嚭鐗堢ぞ锛?014:150-162.

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