基于增强现实的经皮角度定位系统对肝穿刺的精准度

The accuracy of augmented reality-based percutaneous angle localization system in liver puncture

目的评价基于增强现实的经皮角度定位系统在提高肝脏穿刺精准度的应用价值。方法在比格犬肝内置入显影环作为穿刺靶点,由有5年以上穿刺经验的熟练医师及穿刺经验不足的初学医师分别采用基于增强现实的经皮角度定位系统(导航)和不使用该系统仅CT引导下(非导航)对预设穿刺靶点进行穿刺获得相应穿刺数据组:非导航熟练组(A组)、非导航不熟练组(B组)、导航熟练组(C组)、导航不熟练组(D组)。对比A组与B组间、C组与D组间,A组与C组间、B组与D组间CT扫描次数、调针次数、手术时间、误差距离等评价指标的差异。结果A组与B组、A组与C组及B组与D组间比较,扫描次数、调针次数、手术时间、误差距离差异均有统计学意义(均P<0.05);而C组与D组间比较,扫描次数、调针次数、手术时间、误差距离得分情况及总分差异均无统计学意义(均P>0.05)。结论经皮穿刺角度定位器能减少穿刺的CT扫描次数、调针次数并节约手术时间、提高穿刺精度,为由该系统引导的穿刺技术在基层医院的推广提供依据。

Objective To evaluate the application value of percutaneous angle positioning system based on augmented reality in improving the accuracy of liver puncture.Methods A canine liver with an embedded marking ring was used as the target for puncture.A skilled physician with over 5 years of experience in liver puncture and a novice physician with limited experience in liver puncture separately performed liver puncture using either the augmented reality-based percutaneous angle localization system(navigation)or CT-guided technique alone(non-navigation).The corresponding puncturing data of non-navigation skilled group(Group A),non-navigation non-skilled group(Group B),navigation skilled group(Group C),and navigation non-skilled group(Group D)were obtained.The differences in the evaluation indicators,including the number of CT scans,number of needle adjustment,time spent for operation,and distance of error,between Group A and Group B,between Group C and Group D,between Group A and Group C,and between Group B and Group D,were analyzed.Results Statistically significant differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error existed between Group A and Group B,between Group A and Group C,and between Group B and Group D(all P<0.05),while the differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error between Group C and Group D were not statistically significant(all P>0.05)Conclusion In performing liver puncture,the use of percutaneous angle localization system can reduce the number of CT scans,number of needle adjustment,time spent for operation and distance of error,and improve the puncture accuracy as well,which provides a basis for the clinical utilization of this system and the employment of this system-guided puncture technology in primary hospitals.