虚拟现实技术在颅底外科中的应用(附34例分析)

Application of Dextroscope virtual reality technology in skull base surgery: analysis of 34 cases

目的探索虚拟现实技术在颅底外科手术中的应用价值和使用方法。方法对34例颅底病变病人于手术前采集头部MRI、CTA、MRV、MRA,在虚拟现实工作站Dextroscope进行影像融合和手术入路设计。记录治疗效果、术后脑血管损伤并发症发生情况和Karnofsky生活质量评分(KPS)。结果32例肿瘤病人中,肿瘤全切除27例(84.4%);2例难治性脑脊液耳漏均封堵成功。术后仅发生脑血管损伤并发症3例。出院时KPS(86.47±9.6)分,术后6个月达(91.17±9.2)分,但P>0.05。结论采用虚拟现实技术有助于明确颅底疾病诊断和分析复发病例手术失败原因;且能在术前计划筛选出最佳的个性化手术入路,为手术中保护血管结构、减少并发症及获得良好的术后生活质量打下坚实基础。

Objective To explore the use value and use methods of virtual reality technology in skull base surgery. Methods Before operation, image data such as head MRI, MRA or MRV and CTA of 34 patients with skull base lesions were collected. Image registration and surgical approach designs were made by Dextroscope. Surgical treatment results, complications related to cerebral vessels injury and Karnofsky performance score （KPS） were recorded. Results Total resection rate of tumors in 32 tumor patients was 83.4% （27）, and refractory CSF leakage was stopped completely in 2 patients. Complications related to cerebral vessel injury were seen only in 3 patients. KPS at discharge was 86.47±9.6, while that at the 6th month after the surgery reached 91.17±9.2 （P〉 0.05）. Conclusion Application of virtual reality technology in skull base surgery can help to make certain diagnosis and analyze causes for surgical failure in recurrence cases and select the optimum surgical approach in preoperative plan, thus laying a solid foundation for protecting cerebrovascular structures, reducing the complications and achieving better quality-of-life after surgery.