Intraoperative brain shift and deformation: A quantitative analysis of cortical displacement in 28 cases
Intraoperative brain shift and deformation: A quantitative analysis of cortical displacement in 28 cases
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DOI：
10.1097/00006123-199810000-00010
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发表时间：
1998-10-01
期刊：
影响因子：
4.8
通讯作者：
Paulsen, KD
中科院分区：
文献类型：
--
作者：
Roberts, DW;Hartov, A;Paulsen, KD
目的：术中皮质移位和变形的定量分析，以获得更好地了解这个问题的性质和程度，并在手术过程中的空间准确性的损失coregistered术前imaging studies.METHODS：三维特征跟踪和二维图像分析的皮质表面被用来量化观察到的运动。一个安装在天花板上的机器人平台为数据采集提供了便利，该平台提供了一些精确的跟踪能力。在手术开始时记录患者的头部位置以及开颅术的大小和方向。误差分析表明表面位移测量方法精确到1到2 mm。进行统计学检验以检查位移量与手术类型、颅骨开口的性质、涉及的脑区域、手术持续时间和侵入程度之间的相关性。结果表明，发生了平均1厘米的位移，主要方向分量与重力有关。的平均位移被确定为独立的大小和方向的颅opening.CONCLUSION：这些数据表明，损失的空间注册与术前图像是重力为主，并在足够的程度上，注意在手术过程中造成的错误注册是必要的。
OBJECTIVE: A quantitative analysis of intraoperative cortical shift and deformation was performed to gain a better understanding of the nature and extent of this problem and the resultant loss of spatial accuracy in surgical procedures coregistered to preoperative imaging studies.METHODS: Three-dimensional feature tracking and two-dimensional image analysis of the cortical surface were used to quantify the observed motion. Data acquisition was facilitated by a ceiling-mounted robotic platform, which provided a number of precision tracking capabilities. The patient's head position and the size and orientation of the craniotomy were recorded at the start of surgery. Error analysis demonstrated that the surface displacement measuring methodology was accurate to 1 to 2 mm. Statistical tests were performed to examine correlations between the amount of displacement and the type of surgery, the nature of the cranial opening, the region of the brain involved, the duration of surgery, and the degree of invasiveness.RESULTS: The results showed that a displacement of an average of 1 cm occurred, with the dominant directional component being associated with gravity. The mean displacement was determined to be independent of the size and orientation of the cranial opening.CONCLUSION: These data suggest that loss of spatial registration with preoperative images is gravity-dominated and of sufficient extent that attention to errors resulting from misregistration during the course of surgery is warranted.