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首页> 外文期刊>World neurosurgery >Preoperative 3-Dimensional Angiography Data and Intraoperative Real-Time Vascular Data Integrated in Microscope-Based Navigation by Automatic Patient Registration Applying Intraoperative Computed Tomography
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Preoperative 3-Dimensional Angiography Data and Intraoperative Real-Time Vascular Data Integrated in Microscope-Based Navigation by Automatic Patient Registration Applying Intraoperative Computed Tomography

机译：术前三维血管造影数据和术中实时血管数据集成在基于显微镜的导航中，通过自动患者登记应用术中计算断层扫描

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ObjectiveTo establish a workflow integrating preoperative 3-dimensional (3D) angiography data and intraoperative real-time vascular information in microscope-based navigation for aneurysm and arteriovenous malformation (AVM) surgery. MethodsIn 7 patients (3 with AVMs and 4 with aneurysms), preoperative 3D rotational angiography or computed tomography (CT) or magnetic resonance angiography data were navigated applying a 32-slice movable CT scanner for low-dose registration scanning. The 3D vasculature was segmented and visualized by microscope-based navigation along with navigated intraoperative real-time imaging data from indocyanin green angiography and duplex ultrasonography. ResultsAutomatic registration applying intraoperative CT resulted in high accuracy (registration error, 0.80 ± 0.79?mm). The effective radiation dose of the registration CT scans (0.28–0.42 mSv) was only approximately one-sixth of a standard diagnostic head CT scan. The 3D vessel architecture could be visualized accurately in the operating microscope heads-up display and on the navigation screens in the same projection as the view angle of the surgeon, both facilitating orientation in 3D space, providing a better understanding of anatomy. In addition, intraoperative real-time modalities could be coregistered with high precision, providing further information during the course of the vascular procedure. ConclusionsRegistration CT imaging facilitates integrating preoperative and intraoperative vascular image data with a low registration error and low radiation exposure for the patient, improving the understanding of 3D vascular anatomy during surgery with easier identification of feeding vessels in AVMs, and of the projection and configuration of aneurysms.
机译：ObjectiveTo在基于显微镜的导航和动脉畸形（AVM）手术中，建立了整合术前三维（3D）血管造影数据和术中实时血管信息的工作流程。方法7患者（3例患有AVM和4带动脉瘤），术前3D旋转血管造影或计算断层扫描（CT）或磁共振血管造影数据用于低剂量登记扫描应用32片移动CT扫描仪。通过基于显微镜的导航分割和可视化3D脉管系统以及来自吲哚菁绿色血管造影和双工超声检查的导航术中实时成像数据。结果木质注册应用术中CT产生高精度（配准误差，0.80±0.79Ωmm）。注册CT扫描的有效辐射剂量（0.28-0.42msv）仅为标准诊断头CT扫描的大约六分之六。在操作显微镜抬头显示器中可以精确地可视化3D船舶架构，并在与外科医生的视角相同的导航屏幕上，既促进3D空间中的取向，则提供更好地理解解剖学。此外，术中的实时方式可以高精度地注入高精度，在血管手术过程中提供进一步的信息。结论Registration CT成像有助于与患者的低登记误差和低辐射暴露的术前和术中血管图像数据集成，在手术期间改善了对3D血管解剖学的理解，更容易识别AVM中的饲养容器，以及动脉瘤的投影和配置。

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