Intraoperative brain shift prediction using a 3D inhomogeneous patient-specific finite element model
Intraoperative brain shift prediction using a 3D inhomogeneous patient-specific finite element model
复制标题
DOI：
10.3171/jns.2007.106.1.164
复制
发表时间：
2007-01-01
影响因子：
4.1
通讯作者：
King, Albert I.
中科院分区：
文献类型：
--
作者：
Hu, Jingwen;Jin, Xin;King, Albert I.
Object.本研究的目的是开发一种三维患者特定的有限元（FE）脑模型，具有详细的解剖结构和适当的材料特性，以预测术中脑移位在神经外科手术和术前磁共振（MR）图像更新使用FE建模术前规划。开发了基于模板的算法来构建3D患者特异性FE脑模型。模板模型是具有灰质和白色物质、脑室、软脑膜、硬脑膜、大脑镰、小脑幕、脑干和小脑的第50百分位男性FE脑模型。基于一例计算机辅助神经外科手术的临床病例，模拟了硬脑膜开放后重力引起的脑移位，以进行模型验证。使用FE模型更新术前MR图像，并显示为外科医生易于识别的术中MR图像。为了证明有限元建模在术前计划中的潜力，我们预测了两个额外的头部方向的术中脑移位。所得模型的网格质量与模板模型一样高。选择两个FE模型中的一个，以根据术中MR成像采集的数据验证模型预测的脑移位。使用该模型预测的脑移位大于术中观察到的脑移位，但被认为是手术可接受的。提出了一组用于开发3D患者特定FE脑模型的算法。重力引起的脑移位可以使用该模型进行预测，并显示在高分辨率的MR图像上。该策略不仅可用于更新术中MR成像，还可用于术前规划。
Object. The aims of this study were to develop a three-dimensional patient-specific finite element (FE) brain model with detailed anatomical structures and appropriate material properties to predict intraoperative brain shift during neurosurgery and to update preoperative magnetic resonance (MR) images using FE modeling for presurgical planning.Methods. A template-based algorithm was developed to build a 3D patient-specific FE brain model. The template model is a 50th percentile male FE brain model with gray and white matter, ventricles, pia mater, dura mater, falx, tentorium, brainstem, and cerebellum. Gravity-induced brain shift after opening of the dura was simulated based on one clinical case of computer-assisted neurosurgery for model validation. Preoperative MR images were updated using an FE model and displayed as intraoperative MR images easily recognizable by surgeons. To demonstrate the potential of FE modeling in presurgical planning, intraoperative brain shift was predicted for two additional head orientations.Two patient-specific FE models were constructed. The mesh quality of the resulting models was as high as that of the template model. One of the two FE models was selected to validate model-predicted brain shift against data acquired on intraoperative MR imaging. The brain shift predicted using the model was greater than that observed intraoperatively but was considered surgically acceptable.Conclusions. A set of algorithms for developing 3D patient-specific FE brain models is presented. Gravity-induced brain shift can be predicted using this model and displayed on high-resolution MR images. This strategy can be used not only for updating intraoperative MR imaging, but also for presurgical planning.