CT-超声实时影像虚拟导航引导穿刺活检的实验研究

Biopsy guided by real-time virtual navigation system using computed tomography imaging data：a phantom study

目的 利用体模验证CT-超声实时影像虚拟导航（real-time virtual navigation system,RVS）引导活检的可行性及准确性.方法 体外模型内含30个红色球形胶块,胶块CT可见但超声不可见.两名不同经验操作者针对每个胶块以RVS引导与常规超声引导两种方法各活检一次,记录活检是否成功及检出的目标胶条长度.结果 两名操作者无论采用RVS引导还是常规超声引导,其活检成功率及检出的目标胶条长度差异均无统计学意义；RVS引导法及常规超声引导法活检成功率分别为96.7％（58/60）及43.3％（26/60）,检出目标胶条长度的中位数分别为7.5（6～9）mm及0（0～5）mm.RVS引导法活检成功率及检出目标胶条的长度均高于常规超声引导法,差异有统计学意义（P＜0.05）.结论 RVS引导活检超声不可见目标是可行的,且具较高的准确性,有望为介入性超声提供一种新的引导方法.

Objective To verify the feasibility and the accuracy for the biopsy of targets not visible on sonography but shown on CT in a phantom by using real-time virtual navigation system（RVS）.Methods The tissue mimicking phantom,made of gel,contained 30 red spheres which were 10 mm in diameter,randomly placed.These spheres were invisible on sonography,but visible on CT.A junior operator and a senior operator performed the biopsy respectively,and each sphere was biopsied once guide by both RVS and conventional ultrasound for each operator.The red dye in the biopsied sample meant successful performance.The success rate of biopsy and the length of the red dyed sample were recorded.Results There was no statistically difference between the performance results of the two operators.The success rate and the median length of red dyed sample biopsy of RVS were respectively 96.7% （58/60） and 7.5 mm （rang,6-9 mm） which were statistically higher and longer than that of conventional ultrasound,43.3%（26/60） and 0 mm（rang,0 - 5 mm） （ P 〈0.05）.Conclusions Biopsy guided by RVS for the target invisible to ultrasound is a feasible and accuracy method,which will be a new guided method for interventional ultrasound.