虚拟现实技术在远外侧入路显微解剖和颅底肿瘤个性化手术入路的应用研究
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摘要
本论文的第一部分进行了远外侧入路局部显微解剖及虚拟解剖研究。本研究采用的方法成人湿头颅标本共10个,按照远外侧入路手术过程,由外向内依次解剖。逐层观察肌肉椎动脉寰枢椎寰枕关节及手术入路涉及的重要结构,对部分血管性骨性结构进行测量及拍照。成人干性颅骨标本20个,寰椎标本15个进行骨性结构间的数据测量。30例正常成人的薄扫CT,CTA,影像数据载入Dextroscope工作站,在虚拟标本上,模拟远外侧入路的显微解剖入路,测量与远外侧手术入路相关血管性,骨性结构,获得相应解剖数据,将数据同实际解剖获得相对应结构的数据结果进行比照分析。通过对远外侧入路中三维虚拟显微解剖和实际显微解剖的对比研究,评价虚拟现实技术在远外侧入路中应用价值。
在第二部分进行了虚拟现实技术在颅底肿瘤个性化手术入路的应用研究,通过在15例颅底肿瘤患者手术前应用虚拟现实技术,将患者的MRI,MRA,MRV,CT,CTA等影像资料,输入Dextroscope工作站,利用RadioDexterl.OIR软件,进行影像融合后,对15例颅底肿瘤患者手术手术前分析及模拟手术,每个患者进行个体化手术入路设计,评价虚拟现实技术在颅底肿瘤手术中应用价值。
本论文成功探讨了虚拟现实技术与个性化手术手段为临床颅底肿瘤治疗提供了理论基础及治疗靶点。
1.Study on far lateral approach of local Microsurgical anatomy and virtual anatomy
1.1 Objective:study of anatomical in far lateral approach applied for lesions treatment in the cranio-cervical junction Through micro-anatomy studies of the occipital muscles, vertebral artery, atlanto-cone, the foramen magnum, occipital condyle, the hypoglossal canal and other important structures,provide anatomical data for clinical application of far-lateral approach.
Through the far lateral approach in the three-dimensional virtual micro- anatomy and actual comparative study of microscopic anatomy, we evaluate the the application invirtual reality technology in the far lateral approach .
1.2 Methods: a total of 10 adult Wet- Dead skull specimens (20 sides). a total of 20 adult dry–dead skull specimens (40 sides) and atlas specimens 15 specimens (30 sides).
First, According to far-lateral approach for surgical procedure, we dissected dead skull from outside to inside under 5-10 times enlarged by the microscope. Observation of muscle, vertebral artery, atlanto-axial, atlanto- occipital joint and the surgical approach involved an important structure Layer by layer, part of the vascular structure of bone were measured and photographed. We measuremented data of structure of bone on skull specimens and atlas specimens 30 normal adult thin sweep CT, CTA, images data loaded into Dextroscope workstations .in the virtual specimens we simulated the far-lateral approach into the path of the micro-anatomy, and measured the far-lateral surgical approach-related vascular, bone structure, and obtained the corresponding anatomical data, and analysis the data obtained by the actual anatomical structure and virtual anatomical structure.
1.3 Results: Corresponding to anatomy of the data Virtual dissection group's and the actual dissection group's are a high degree of match, statistically no significant difference.
1.4 Conclusion:
1) Proficiency in far-lateral approach related to occipital muscles, vertebral artery, atlanto-cone, the foramen magnum, occipital condyle, the hypoglossal canal and other important structures of the microscopic anatomy of the surgery,reduce damage of vertebral artery, cranial nerve, reduce the extension of spinal cord and the maximum removal of tumors significance.
2) Corresponding to anatomy of the data Virtual dissection group's and the actual dissection group's are a high degree of match, statistically no significant difference. of Virtual reality technology can comprehensive evaluate the far-lateral approach vascular and bone structure, and have application value in the far lateral approach anatomy .
2.Virtual reality technology in skull base surgery
2.1 Objective: we perform individualized surgical approach design by virtual reality technology in the skull base cancer patients before surgery, and evaluate the value of virtual reality technology in the skull base tumor surgery.
2.2 Methods: 15 cases of skull base tumors. Preoperative acquisition MR, MRA, MRV, CTA imaging data, scan data loaded into Dextroscope workstation, formulated the detailed preoperative plan. Research the adjacent relationship of tumor and surrounding structures, developed individualized surgical approach.
2.3 Results : 15 cases formulation the virtual reality surgical planning, the results of three-dimensional image clarity, true, observation comprehensive, and completed the simulation surgical of 15 cases. The images data be outputed.
2.4 Conclusion: 1) Used virtual reality technology in the skull base tumor patients and helps clear the preoperative diagnosis.
2) Virtual reality technology provide individual patients the pathological anatomy, as well as the lesion with the surrounding vital structures in the three-dimensional relationship and help doctors to locate and design of surgical approach.
在第二部分进行了虚拟现实技术在颅底肿瘤个性化手术入路的应用研究,通过在15例颅底肿瘤患者手术前应用虚拟现实技术,将患者的MRI,MRA,MRV,CT,CTA等影像资料,输入Dextroscope工作站,利用RadioDexterl.OIR软件,进行影像融合后,对15例颅底肿瘤患者手术手术前分析及模拟手术,每个患者进行个体化手术入路设计,评价虚拟现实技术在颅底肿瘤手术中应用价值。
本论文成功探讨了虚拟现实技术与个性化手术手段为临床颅底肿瘤治疗提供了理论基础及治疗靶点。
1.Study on far lateral approach of local Microsurgical anatomy and virtual anatomy
1.1 Objective:study of anatomical in far lateral approach applied for lesions treatment in the cranio-cervical junction Through micro-anatomy studies of the occipital muscles, vertebral artery, atlanto-cone, the foramen magnum, occipital condyle, the hypoglossal canal and other important structures,provide anatomical data for clinical application of far-lateral approach.
Through the far lateral approach in the three-dimensional virtual micro- anatomy and actual comparative study of microscopic anatomy, we evaluate the the application invirtual reality technology in the far lateral approach .
1.2 Methods: a total of 10 adult Wet- Dead skull specimens (20 sides). a total of 20 adult dry–dead skull specimens (40 sides) and atlas specimens 15 specimens (30 sides).
First, According to far-lateral approach for surgical procedure, we dissected dead skull from outside to inside under 5-10 times enlarged by the microscope. Observation of muscle, vertebral artery, atlanto-axial, atlanto- occipital joint and the surgical approach involved an important structure Layer by layer, part of the vascular structure of bone were measured and photographed. We measuremented data of structure of bone on skull specimens and atlas specimens 30 normal adult thin sweep CT, CTA, images data loaded into Dextroscope workstations .in the virtual specimens we simulated the far-lateral approach into the path of the micro-anatomy, and measured the far-lateral surgical approach-related vascular, bone structure, and obtained the corresponding anatomical data, and analysis the data obtained by the actual anatomical structure and virtual anatomical structure.
1.3 Results: Corresponding to anatomy of the data Virtual dissection group's and the actual dissection group's are a high degree of match, statistically no significant difference.
1.4 Conclusion:
1) Proficiency in far-lateral approach related to occipital muscles, vertebral artery, atlanto-cone, the foramen magnum, occipital condyle, the hypoglossal canal and other important structures of the microscopic anatomy of the surgery,reduce damage of vertebral artery, cranial nerve, reduce the extension of spinal cord and the maximum removal of tumors significance.
2) Corresponding to anatomy of the data Virtual dissection group's and the actual dissection group's are a high degree of match, statistically no significant difference. of Virtual reality technology can comprehensive evaluate the far-lateral approach vascular and bone structure, and have application value in the far lateral approach anatomy .
2.Virtual reality technology in skull base surgery
2.1 Objective: we perform individualized surgical approach design by virtual reality technology in the skull base cancer patients before surgery, and evaluate the value of virtual reality technology in the skull base tumor surgery.
2.2 Methods: 15 cases of skull base tumors. Preoperative acquisition MR, MRA, MRV, CTA imaging data, scan data loaded into Dextroscope workstation, formulated the detailed preoperative plan. Research the adjacent relationship of tumor and surrounding structures, developed individualized surgical approach.
2.3 Results : 15 cases formulation the virtual reality surgical planning, the results of three-dimensional image clarity, true, observation comprehensive, and completed the simulation surgical of 15 cases. The images data be outputed.
2.4 Conclusion: 1) Used virtual reality technology in the skull base tumor patients and helps clear the preoperative diagnosis.
2) Virtual reality technology provide individual patients the pathological anatomy, as well as the lesion with the surrounding vital structures in the three-dimensional relationship and help doctors to locate and design of surgical approach.
引文
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