虚拟现实技术在颅颈交界区病变手术中的应用

Application of virtual reality technique in operations of lesions in craniocervical junction

目的 探讨Dextroscope虚拟现实技术在颅颈交界区病变患者个体化手术方案制定中的作用.方法 回顾性纳入2013年9月至2017年8月于首都医科大学附属复兴医院神经外科行手术治疗的21例颅颈交界区病变患者.术前将患者的MRI、CT数据输入Dextroscope虚拟现实系统中进行影像融合、三维重建、数据提取、模拟操作并设计个体化手术方案,从而指导手术治疗.结果 通过进行病变及其周围神经、血管、骨质等结构的三维虚拟现实影像重建,可清晰显示病变与脑干、小脑、动脉、静脉、颅骨等的解剖关系.所有患者均成功完成虚拟现实的手术模拟和手术设计,所得三维影像与术中所见吻合.21例患者中,病变全切除19例,近全切除2例.结论 应用Dextroscope虚拟现实系统能够三维呈现并量化病变与周围结构的解剖关系,通过解剖研究以及手术模拟,有助于个体化设计最佳手术方案,提高手术疗效.

Objective To investigate the values of virtual reality（VR） technique in surgical planning of lesions in craniocervical junction.Methods We retrospectively analyzed 21 cases with craniocervical junction lesions who were admitted to Department of Neurosurgery,Fuxing Hospital Affiliated to Capital Medical University from September 2013 to August 2017.Surgical plans were made in the Dextroscope VR system.Preoperative data including MRI and CT images were transferred into the VR computer for image fusion,reconstruction,withdrawal and surgery simulation for guidance in operation.Results VR three-dimensional（3D） images of the 21 cases were successfully achieved,including nerves,vessels,skull and lesions.The anatomical relationship of lesions to the brainstem,cerebellum,arteries,veins and skull was clearly demonstrated.Surgical simulation and surgical planning of VR in the 21 patients were successfully performed.The 3D images obtained from VR were consistent with the real conditions.Total resection was achieved in 19 cases and near-total resection in 2.Conclnsion Dextroscope VR system could clearly demonstrate and quantify the 3D anatomical relationship of craniocervical junction lesions to their surrounding structures,which is helpful for optimal individualized surgical planning and improvement of surgical effect.