基于CTA-MRI融合图像的三维重建技术对前中颅底脑膜瘤术中血管保护及术后并发症的研究

Influence of three-dimensional reconstruction technology based on CTA-MRI fusion images on intraoperative vascular protection and postoperative rehabilitation of anterior and middle skull base meningiomas

目的 探讨基于CTA-MRI融合图像的三维重建技术对前中颅底脑膜瘤术中血管保护及术后并发症的影响。方法 选择2017年1月至2022年3月经三门峡市中心医院神经外科收治50例行开颅手术前中颅底脑膜瘤患者,按随机数字表法分对照组及观察组,对照组行常规检查后实施手术,观察组采用3D Slicer软件将颅骨、血管、颅神经、锥体束等CTA、MRI等图像融合后行三维重建,待制定术前规划及术中设计后实施手术,比较两组手术疗效、术中血管保护及术后并发症情况。结果 观察组肿瘤切除程度优于对照组,术中出血量更少,手术时间及住院时间更短,差异有统计学意义(P<0.05);两组术中血管损伤率及术后复发率比较,差异无统计学意义(P>0.05);观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 前中颅底脑膜瘤患者应用CTA-MRI融合图像的三维重建技术可获高肿瘤全切率,手术时间及住院时间短,术中出血量少,血管保护良好,且并发症较少,有利于术后恢复。

Objective To investigate the effect of three-dimensional reconstruction technology based on CTA-MRI fu-sion images on intraoperative vascular protection and postoperative complications of anterior and middle skull base menin-giomas.Methods Totally 50 patients with middle skull base meningioma before craniotomy were selected to the depart-ment of Neurosurgery of Sanmenxia Central Hospital from Jan.2017 to Mar.2022 and divided into control group and ob-servation group according to random number table method.The control group underwent routine examination and then underwent surgery.Pyramid beam and other CTA,MRI and other images were fused and then 3D reconstruction was performed in the observation group.The operation was performed after the preoperative planning and intraoperative de-sign were formulated.The surgical fficacy,intraoperative vascular protection and postoperative complications were com-pared between the two groups.Results The degree of tumor resection in the observation group was better than that in the control group,with less intraoperative blood loss,shorter operation time and hospital stay,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the rates of intraoperative vascular injury and postoperative recurrence between the two groups(P>0.05);The incidence of postoperative complications in the observation group was lower than that in the control group.The difference was statistically significant(P<0.05).ConclusionThe three-dimensional reconstruction of CTA-MRI fusion images in patients with anterior and middle skull base meningiomas can achieve high tumor resection rate,short operation time and hospital stay,less intraoperative blood loss,good blood vessel protection,and fewer complications,facilitate postoperative recovery.