混合现实技术辅助矢状窦旁脑膜瘤显微切除术的价值

Application efficiency of mixed reality technology in surgical removal of parasaggital meningiomas

目的探讨混合现实(MR)技术在辅助矢状窦旁脑膜瘤显微切除术中的应用价值。方法回顾2021年1月至2022年1月于河北医科大学第二医院神经外科诊治的11例窦旁脑膜瘤患者临床资料,应用3D Slicer软件重建肿瘤全息影像模型辅助术前评估、手术方案制定,应用MR技术辅助肿瘤切除和引流静脉保护。术后评价肿瘤切除程度和术后并发症。结果利用MR技术成功显示11例肿瘤全息影像模型,术中所见肿瘤与上矢状窦及其引流静脉三维比邻关系与术前评估一致:受侵矢状窦Ⅰ型6例、Ⅱ型3例和Ⅲ型2例。11例患者均成功应用MR技术精准指导头皮切口设计、骨瓣成型、硬膜剪开,特别是指导肿瘤及其受侵矢状窦壁切除,无引流静脉损伤发生,其中,SimpsonⅠ级切除9例、Ⅱ级切除2例,无并发症发生。结论MR技术能够精准术前评估、制定手术策略,能够辅助头皮切口设计、颅骨成型、硬膜切开,特别对指导术中肿瘤和受侵矢状窦切除、保护引流静脉有着重要意义。

Objective To evaluate the application efficiency of mixed reality(MR)technology in surgical removal of parasaggital meningiomas.Methods The clinical data of 1l patients with parasagittal meningiomas admitted to the Department of Neurosurgery,the Second Hospital of Hebei Medical Univisity from January 2021 to January 2022 were retrospectively analyzed.Holographic model images were constructed with 3D Slicer software for performing preoperative evaluation and individualized surgical planning.Also,MR technology was employed to assist surgical removal of tumors and invaded walls of superior sagittal sinus as well as protection of draining veins.The extent of tumor removal and surgical complications were postoperatively evaluated.Results Holographic model images of 1l cases were successfully conducted using MR technology.Three-dimensional adjacency relationship between the tumors and the superior sagittal sinus and their draining veins revealed during operation were consistent with the preoperative assessments,including type Ⅰ invaded sagittal sinus walls in 6 cases,type Ⅱin 3 cases and type Ⅱin 2 cases.All 1l patients successfully accurately underwent scalp incision design,bone flap craniotomy,duratomy without accidental venous injury,and especially including surgical removal of tumors and sagittal sinus walls by applying MR technology.Among them,9 cases underwent Simpson grade Ⅰ resection and 2 cases did grade Ⅱresection,and no complications occurred.Conclusion MR technology can not only assist in preoperative evaluation and individualized surgical planning,but also accurately provide aid in scalp incision design,craniotomy and duratomy,especially including precisely surgical removal of tumors and invaded sagittal sinus walls as well as avoid of draining vein damage.