Initial experience of intraoperative three-dimensional navigation for liver resection using real-time virtual sonography.
Initial experience of intraoperative three-dimensional navigation for liver resection using real-time virtual sonography.
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DOI：
10.1016/j.surg.2013.08.009
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发表时间：
2014-02
期刊：
影响因子：
3.8
通讯作者：
Shouichi Satou;T. Aoki;J. Kaneko;Y. Sakamoto;K. Hasegawa;Y. Sugawara;O. Arai;T. Mitake;K. Miura;N. Kokudo
中科院分区：
文献类型：
--
作者：
Shouichi Satou;T. Aoki;J. Kaneko;Y. Sakamoto;K. Hasegawa;Y. Sugawara;O. Arai;T. Mitake;K. Miura;N. Kokudo
背景实时虚拟超声检查是一种创新成像技术，可检测超声探头的空间位置，并根据超声图像立即重建计算机断层扫描（CT）和/或磁共振切片，从而实现这些模式的实时比较。设计了一种新型实时虚拟超声肝切除术中导航系统，用于肿瘤检测和切除平面导航。方法本研究涉及16例肝脏恶性肿瘤患者（共26个肿瘤），并在术中使用该系统。肿瘤大小范围为 2 至 140 毫米（中位 23 毫米）。通过导航系统，操作员可以将电视监视器上显示的术中超声图像与相应的 CT 和/或磁共振图像并排参考。此外，系统将术前模拟叠加在CT图像上，并突出显示切除范围，以便导航切除平面。由于该系统在手术室内使用电磁动力，因此对系统的可行性、安全性以及有效性进行了考察。结果系统在每次手术中都能顺利使用。导航系统全部检测到了计划切除的 26 个肿瘤。切除标本的重量与术前模拟体积相关(R = 0.995,P< .0001)。结论证实了导航系统的可行性和安全性。该系统应有助于术中肿瘤检测和肝切除导航。
BackgroundReal-time virtual sonography is an innovative imaging technology that detects the spatial position of an ultrasound probe and immediately reconstructs a section of computed tomography (CT) and/or magnetic resonance in accordance with the ultrasound image, thereby allowing a real-time comparison of those modalities. A novel intraoperative navigation system for liver resection using real-time virtual sonography has been devised for the detection of tumors and navigation of the resection plane.MethodsSixteen patients with hepatic malignancies (26 tumors in total) were involved in this study, and the system was used intraoperatively. The tumor size ranged 2 to 140 mm (23 mm in median). By the navigation system, operators could refer intraoperative ultrasound image displayed on the television monitor side-by-side with corresponding images of CT and/or magnetic resonance. In addition, the system overlaid preoperative simulation on the CT image and highlighted the extent of resection so as to navigate the resection plane. Because the system used electromagnetic power in the operation room, the feasibility and safety of the system was investigated as well as its validity.ResultsThe system could be used uneventfully in each operation. All of the 26 tumors scheduled to be resected were detected by the navigation system. The weight of the resected specimen correlated with the preoperatively simulated volume (R = 0.995,P< .0001).ConclusionThe feasibility and safety of the navigation system were confirmed. The system should be helpful for intraoperative tumor detection and navigation of liver resection.