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目的:探讨三维数字影像融合技术结合神经导航在颅内肿瘤术前评估、手术策略及术中导航中的应用价值。方法:对95例颅内肿瘤患者术前行CT、MRI、MRA、MRV等影像学扫描,将影像学资料导入Brain Lab进行影像重建和融合,模拟病变和周围组织的三维模型。术前依据重建模型制定手术方案和手术入路,术中通过神经导航进行定位。比较术前与术中所见的肿瘤、神经、血管、骨骼、脑组织等重要标记点。结果:95例患者颅脑解剖三维影像结构均重建融合成功,符合率极高,与术前原始图像及术中解剖所见吻合很好。在三维重建系统的导航下成功识别了重要的标记点及肿瘤边界,术中未出现因手术入路选择而产生的并发症。术后61例(64.2%)患者症状缓解,32例(33.7%)患者症状无变化,其余2例(2.1%)患者由于病变解剖位置原因导致症状加重,但出院时明显改善。结论:三维多重影像数字化融合技术能准确显示肿瘤组织解剖位置,多角度、动态地呈现其与周围组织的立体关系,在颅内肿瘤术前风险评估及手术策略制定中具有重要临床价值。
Objective: To explore the application of three-dimensional digital image fusion and neuronavigation in preoperative evaluation of intracranial tumors, surgical strategies and intraoperative navigation. Methods: Ninety-five patients with intracranial tumors were scanned with CT, MRI, MRA and MRV before imaging. The imaging data were imported into Brain Lab for image reconstruction and fusion, and the three-dimensional models of lesions and surrounding tissues were simulated. Preoperative reconstruction model based on the development of surgical options and surgical approach, intraoperative navigation through the nerve positioning. Comparison of preoperative and intraoperative findings of the tumor, nerves, blood vessels, bone, brain and other important markers. Results: Three-dimensional images of craniocerebral anatomy were successfully reconstructed in 95 patients. The coincidence rate was very high, which was in good agreement with the original images and intraoperative anatomy. Under the navigation of the 3D reconstruction system, important mark points and tumor boundaries were successfully identified. No complications occurred due to surgical options during the operation. Symptoms were relieved in 61 (64.2%) patients and in 32 (33.7%) patients. The remaining 2 patients (2.1%) were exacerbated due to the anatomical location of the lesion. CONCLUSION: 3D multi-image digital fusion technique can accurately display the anatomical location of tumor tissue, display its stereo relationship with the surrounding tissue dynamically, and has important clinical value in preoperative risk assessment and surgical strategy development of intracranial tumors.