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个体化定制3D打印定位导板辅助显微手术切除幕上脑肿瘤
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作者 刘发健 张孙鑫 +5 位作者 刘齐东 曹德乾 黄祚韵 汪洋 徐如祥 冯金周 《中国临床神经外科杂志》 2024年第4期227-231,共5页
目的探讨基于CT与MRI多模态影像的3D打印技术辅助显微手术切除幕上脑肿瘤的可靠性与安全性。方法回顾性分析2021年6月至2022年6月手术切除的56例幕上脑肿瘤的临床资料。27例采用导航引导(导航组),29例采用3D打印导板定位辅助(3D打印组)... 目的探讨基于CT与MRI多模态影像的3D打印技术辅助显微手术切除幕上脑肿瘤的可靠性与安全性。方法回顾性分析2021年6月至2022年6月手术切除的56例幕上脑肿瘤的临床资料。27例采用导航引导(导航组),29例采用3D打印导板定位辅助(3D打印组)。个体化3D打印导板定制流程:将术前CT、MRI等影像的DICOM格式的原始数据,发送至医学3D打印中心数据库,进行影像多模态融合并三维建模,清晰显示病灶与邻近重要血管神经的毗邻关系;根据模型进行手术路径合理规划,再利用手术路径与颅表特定部位关系,设计定位导板。结果两组病人均顺利完成手术,无手术死亡病例。3D打印组定位耗费时间较导航组明显缩短(P<0.05),但两组病灶精准度优良率、病灶全切除率、术后3月GOS评分均无统计学差异(P>0.05)。结论多模态影像融合3D打印技术可获得个体化的脑肿瘤三维实物模型和手术定位导板,能很好地指导手术切除幕上脑肿瘤,可替代部分神经导航的功能。 展开更多
关键词 幕上脑肿瘤 显微手术 3D打印导板 神经导航 疗效
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颅内巨大动脉瘤的血管内治疗分析 被引量:5
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作者 张振海 沈春森 +3 位作者 吴中学 杨新健 穆士卿 xu ru-xiang 《中国临床神经外科杂志》 2015年第8期469-472,共4页
目的 探讨血管内治疗颅内巨大动脉瘤的安全性和有效性。方法 回顾性分析连续收治的74例颅内巨大动脉瘤患者的临床资料,其中采用血管内栓塞治疗57例,保守治疗17例。采用Logistic回归分析检验预后影响因素。结果 17例保守治疗患者随访4-7... 目的 探讨血管内治疗颅内巨大动脉瘤的安全性和有效性。方法 回顾性分析连续收治的74例颅内巨大动脉瘤患者的临床资料,其中采用血管内栓塞治疗57例,保守治疗17例。采用Logistic回归分析检验预后影响因素。结果 17例保守治疗患者随访4-71个月,平均(30.7±7.7)个月,死亡4例,症状加重6例、无变化6例、改善1例。57例血管内治疗患者中,术后即刻造影显示完全栓塞38例,次全栓塞6例,部分栓塞13例;28例影像随访3-63个月,平均(11.7±15.2)个月,复发10例(35.7%);51例临床随访4-71个月,平均(30.7±17.7)个月,42例(73.7%)预后良好(改良Rankin量表评分0-1分)。年龄〉60岁、动脉瘤位于后循环和保守治疗与不良预后显著相关(P〈0.05)。结论 对于年龄〉60岁以及动脉瘤位于后循环的颅内巨大动脉瘤患者,治疗应慎重;血管内治疗颅内巨大动脉瘤复发率较高。 展开更多
关键词 颅内巨大动脉瘤 血管内治疗 预后 影响因素
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Combined application of virtual imaging techniques and three-dimensional computed tomographic angiography in diagnosing intracranial aneurysms 被引量:14
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作者 GUO Yan-wu KE Yi-quan +5 位作者 ZHANG Shi-zhong WANG Qiu-jing DUAN Chuan-zhi JIA Hong-shun ZHOU Li xu ru-xiang 《Chinese Medical Journal》 SCIE CAS CSCD 2008年第24期2521-2524,共4页
Background The diagnostic value of virtual imaging combined with three-dimensional computed tomographic angiography (3D-CTA) for intracranial aneurysms has not been fully elucidated yet. This study aimed to evaluate... Background The diagnostic value of virtual imaging combined with three-dimensional computed tomographic angiography (3D-CTA) for intracranial aneurysms has not been fully elucidated yet. This study aimed to evaluate the value of combined application of virtual imaging techniques and 3D-CTA in diagnosing patients with aneurismal subarachnoid hemorrhage (SAH) at the acute stage. Methods Eighty patients with non-traumatic SAH received 3D-CTA examinations. The raw CT data of these patients were reconstructed and transferred into the 3D mode through the surgical plan system based on virtual reality (VR) image, and the 3D virtual images of skulls and brain blood vessels were acquired. The location, size and shape of aneurysms and their anatomic relationship with adjacent tissues were measured from many points of view. Results Seventy-three aneurysms were detected in 68 of the 80 patients, but 2 aneurysms were detected in 2 of the 5 patients who had been found free of aneurysms previously and had received 3D-CTA examinations for a second time one month later. The 3D virtual images produced by the virtual imaging system were clear and vivid, and they could reveal the location and size of the aneurysm and its relations to the parent artery and skull directly. Conclusions The imaging of 3D-CTA is convenient, reliable and fast in diagnosing intracranial aneurysms and can be regarded as the first choice for the diagnosis and treatment of ruptured intracranial aneurysms. Combined with the surgical plan system based on the VR image, 3D-CTA may obtain more imaging information about aneurysms. 展开更多
关键词 intracranial aneurysm cerebral angiography virtual reality CT angiography
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Effect of sub-hypothermia therapy on coagulopathy after severe head injury 被引量:4
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作者 LI Gang xu ru-xiang +4 位作者 KE Yi-quan JIANG Xiao-dan ZHANG Shu-fen DENG Bi-lan YU Xing 《Chinese Medical Journal》 SCIE CAS CSCD 2008年第22期2350-2352,共3页
Sub-hypothermia therapy is one of the treatments for patients with severe head injury. The objective of the therapy is to treat traumatic brain injury (TBI) by alleviating brain edema, protecting blood brain barrier... Sub-hypothermia therapy is one of the treatments for patients with severe head injury. The objective of the therapy is to treat traumatic brain injury (TBI) by alleviating brain edema, protecting blood brain barrier (BBB), and preventing subsequent damage to neurons. It can protect brain function by depressing metabolism, reducing the release of excitatory amino acids and free radicals, reducing the level of lactic acid, and lowering the damage of cytoskeletal structure However, 展开更多
关键词 sub-hypothermia brain injury blood coagulation HYPERFIBRINOLYSIS
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