导航辅助射频温控热凝术中注册标记系统的改良

Modifying registration markers of navigation -guided radiofrequency thermocoagulation

目的:改进导航辅助射频温控热凝术中的注册标记系统,使其更加无创,同时达到导航系统的精确要求。方法:采用热塑型塑料面罩,依照人体面部特征加热塑型,表面双侧颞部、眉弓中点和颧骨最高点安置6个塑料标记点,内部随意安置6个标记点。CT扫描获得影像学数据,输入SurgView-RFT电磁导航系统后,分别选用4个(内外各2个)、6个(内外各3个)和8个(内外各4个)标记点进行注册和配准,每组设置5种组合,每点读取3次坐标值,取平均值代入配准误差公式。采用SAS6.12软件包对数据进行t检验。结果:取4个标记点时,系统误差为(1.58±0.25)mm;取6个标记点时,系统误差为(1.28±0.21)mm;当标记点数量达到8个时,导航系统的配准精度达(1.06±0.10)mm。4点组与6点组间有显著差异(P=0.0149),6点组与8点组间无显著差异(P=0.1402)。结论:热塑型塑料面罩表面放置标记点可避免患者创伤,配准精度完全符合导航系统的要求和卵圆孔穿刺的特定要求,在应用中至少应有6个标记点。

PURPOSE： To modify the registration markers of navigation-guided radiofrequency thermoeoagulation（RFT）, in order to make them non-invasive and more accurate. METHODS： A kind of thermoplastic facial mask was healed and moulded according to hmnan being＇s face. 6 plastic markers were placed on the surface of the mask, while 6 were inside. CT scans were made to get the radiological data. By using SurgView-RFT navigation system, three groups of 4 markers （2 on the surface and 2 inside） , 6 makers （3 on the surface and 3 inside） and 8 markers （4 on the surface and 4 inside） were registered. SAS 6.12 software package was used for statistical analysis. RESULTS： There was significant difference in 4 markers and 6 markers （P=0.0149）. There was no significant difference in 6 markers and 8 markers （P=0.1402）. The registration errors were （1.58±0.25）mm in the group of 4 markers, （1.28±0.21）mm in the group of 6 markers, and （1.06± 0.10）mm in the group of 8 markers. CONCLUSIONS： The modified registration markers facilitates registration without invasiveness. At least 6 markers should be used to fulfill the requirement of navigation and puncture via the oval foramen. Supported by Science and Technology Commission of Shanghai Municipality（Grant No.08DZ 2271100） and Research Fund of Medicine and Technology of Shanghai Jiao Tong University （Grant No. YG2007MS30）.