神经导航融合技术在颅底肿瘤中的应用

Study on the application of neuronavigation fusion in management of skull base neoplasm

目的探讨神经导航融合技术在颅底肿瘤中的应用。方法通过术前准备、注册、CT与MRI 等影像模式融合、术中导航定位,比较各种注册方法的精确性,融合精确度,术中定位精确性、术中持续精确性,扩大暴露范围等,提出和改进神经导航技术在颅底手术中的应用技术。结果神经导航用于颅底肿瘤手术切除,术前有助于开颅皮肤切口及骨瓣的设计,选择最短的手术途径;术中可为肿瘤的切除定向定位,在颅底手术中使术者随时了解颅底肿瘤与周围重要解剖结构(如脑干、颅神经及重要血管等的关系)。结论颅底肿瘤以及颅底结构位置相对固定,影响因素较小,脑移位最小,定位精确,及时反馈肿瘤的切除深度,增加手术的安全性,加快手术进程,避免脑重要结构的副损伤。

Objective To investigate the value of neuronavigation in skull base approach. Methods By preoperative preparation, registration, the mergence of CT and MRI images, the navigation of lesion during operation, and improvement of the surgical exposure, we analysed the technique of neuronavigation in skull base approach. Rusults This technique is very beneficial to the planning of surgical approach, knowing about the relative structures around the lesion, such as brainstem, cranial nerves and the key vessels. Surgeon can learn more accurate and helpful information provided by CT or MRI images with the aid of the fusion of CT and MRI images. Conclusions The application of neuronavigation in skull base approach can offer the feedback of the location and depth of manipulation so as to enhance the security, decrease the surgical time and reduce the harm of brain tissue.