神经导航整合超声(双超和多普勒)技术在术中血管解剖标记的作用

The effect of intraoperative landmark of vascular anatomy by integration of ultrasound(duplex and doppler ultrasonography)into neuronavigation system

目的探讨神经导航整合超声技术在术中标记血管中的作用。方法建立在神经导航中整合进超声平面视频影像的技术,并将该技术应用于47例患者(动静脉畸形22例、胶质瘤17例、海绵状血管瘤8例)的手术中。结果该系统支持超声平面函数与术前获得导航资料的结合。多普勒超声和双向超声可以显示术中血管解剖结构,并确定其界标。这些界标可以自动整合入神经导航数据集中,用来提供血管解剖的术中更新影像。本组病例应用该技术的成功率是45/47(96%),45例患者手术过程顺利、全切病灶,且保护了病灶周围的血管结构。结论超声和双向超声所显示的血管解剖资料整合入神经导航数据集中在技术上是可行的。该技术为复杂脑部病变的手术提供有价值的术中信息,尤其显示血管的解剖结构。

Objictive Explore the effect of the intraoperative landmark of vessels via a technique of integration ultrasound （ duplex and Doppler uhrasonography ） into neuronavigation systems. Methods Establish the video image of an ultrasound plane being integrated into neuronavigation system. Then this technique was used in 47 patients, including 22 cases with AVM, 17 with glioma, 8 of eavernoma, during surgery. Results Accordingly, the system supported a combination of the ultrasound plane functionality with the preoperatively acquired neuronavigational data. The duplex and Doppler mode of the ultrasound system displayed the intraoperative vascular anatomy. These landmarks were integrated automatically into the neuronavigational data set and could be used to provide intraoperative image updates of the vascular anatomy. This technique was successful in 45 of 47 （95.7%） surgical interventions. In the 45 cases, the lesions were totally removed; furthermore the vessels around lesions were preserved. Conclusions Both image-guided ultrasound and duplex-guided integration of vascular anatomy into the neuronavigational data set are technically possible. In the future, this technology may provide useful intraoperative information during surgery of complex cerebral pathologies, especially to demonstrate the vascular anatomy.