摘要
目的探讨简单、实用且有效的颅脑体表投射定位装置的制作。方法对烟雾病患者和大脑凸面浅表肿瘤患者试行体表定位装置,步骤如下:为患者佩戴体表定位标志;进行放射影像检查并获取放射影像资料(包括X线平片、CT、MRI、脑血管造影等);图像处理软件标记病变部位或兴趣区;对标记后影像进行微型投影仪注册并将病变部位或兴趣区精确投射到对应体表;确定体表靶区,设计手术入路并进行临床精准性验证。结果体表投射定位装置对烟雾病患者颞浅动脉及其分支定位准确,误差<3 mm,同时标示了脑膜中动脉及其分支,防止了术中损伤;对大脑凸面浅表肿瘤能够准确定位,并可根据定位精确设计手术入路,使肿瘤边缘距离骨缘误差<1 cm。结论烟雾病患者临床应用体表投射定位装置能够准确定位颞浅动脉、脑膜中动脉,从而避免了在开颅过程中的损伤;对颅内浅表肿瘤,特别是微小病变,可精确划定手术靶区、合理设计手术入路、最大限度减少损伤。该装置组件简单,可操作性强,经济实用。
Objective To establish a simple and practical surface projection brain locating device.Methods The locating device was tested on the hospital patients with moyamoya disease and convex superficial brain tumors with the following steps;patients worn surface location mark;radiological examination was conducted and the information of radiology images of patients（including CT,MRI,DSA,X-ray,etc.） was obtained.The interest area or lesions area were marked by image processing software.Labeled images were projected onto the micro-projector,and then images of the area of lesion or interest were projected onto the corresponding surface location.The target and design of surgical incision were determined and the clinical accuracy was verified.Results The device accurately positioned superficial temporal arteries and its branches of patient with moyamoya disease（error3 mm）,the middle meningeal arteries and its branches were marked,and the intraoperative injury was prevented.The device was able to accurately locate the brain convex superficial tumors,and according to the location,precision surgical incision was designed（error〈1 cm）.Conclusion For moyamoya disease,the clinical application of the surface projection positioning device can accurately locate the superficial temporal arteries,middle meningeal arteries,and injury in the craniotomy process can be avoided.For intracranial superficial tumors,especially small lesions,it can precisely delineate the surgical target area.The device is easy to assemble and operate and also can help to design the rational surgical approach with minimum injuries.
出处
《临床误诊误治》
2012年第4期49-51,共3页
Clinical Misdiagnosis & Mistherapy
基金
首都医学发展科研基金重点项目(2007~2028)
