混合现实技术与医学影像结合在临床手术中的应用

The application of mixed reality technology combined with medical imaging in clinical surgery

微创手术是一种通过小切口或穿刺来进行的外科手术,可减少患者的疼痛,缩短恢复时间并减少术后风险。在临床基于传统医学影像设备导航的微创手术中,存在着解剖结构不清晰、实时性不足,高度依赖医生的手眼协调能力和经验等问题。近年来随着混合现实(Mixed reality,MR)技术的发展,将其赋能于传统医学影像设备,可提高临床手术穿刺的准确性和安全性,同时减少手术中不必要的侵入和创伤,提高手术的成功率和患者的治疗效果。本文结合近年来国内外的研究文献,从MR在医学影像应用过程中所需的关键技术、方式方法和在各微创手术中产生的影响和帮助进行综述。文献复习结果表明,虚实匹配是MR应用中至关重要技术,大部分需依靠识别标志物并基于特征点匹配。MR与CT结合大多为静态虚实匹配,重建出患者三维模型后和真实人体匹配,可减少辐射剂量。MR与超声结合的静态匹配多为利用MR简单投影超声图像,解决手眼协调问题;动态匹配可在此基础上改善成像效果不好,难以捕捉针尖等问题。这些结果表明MR在外科手术导航上是一个具有光明前景的技术和方向。

Minimally invasive surgery is a type of surgical procedure that utilizes small incisions or puncture wounds,which can reduce a patient's pain,recovery time,and postoperative risks.Clinically,traditional medical imaging equipment is used to navigate minimally invasive surgery,but there are issues such as unclear anatomical structures,lack of real-time feedback,and high dependence on a surgeon's manual dexterity and experience.In recent years,with the development of mixed reality(MR)technology,it can be integrated with traditional medical imaging equipment to improve the accuracy and safety of clinical surgical puncture while reducing unnecessary invasiveness and trauma,and increasing the success rate of surgery and patient treatment outcomes.This article summarizes the key technologies,methods,and impacts of MR in medical imaging application and in various minimally invasive surgeries based on recent research literature both at home and abroad.Results of literature review indicate that virtual-real matching is a crucial technology for MR application,and mostly rely on recognition of markers and feature point matching.Most combinations of MR and CT are static virtual-real matches,which reconstruct the patient's three-dimensional model and match it with the real human body,reducing radiation doses.Static matches between MR and ultrasound often use MR to project simple ultrasound images,improving hand-eye coordination.Dynamic matches can further improve imaging quality and capture small objects such as needle tips.These results indicate that MR is a promising technology in surgical navigation.