Augmented Reality in the Surgery of Cerebral Aneurysms: A Technical Report
Augmented Reality in the Surgery of Cerebral Aneurysms: A Technical Report
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DOI：
10.1227/neu.0000000000000328
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发表时间：
2014-06-01
影响因子：
2.3
通讯作者：
Schaller, Karl
中科院分区：
文献类型：
--
作者：
Cabrilo, Ivan;Bijlenga, Philippe;Schaller, Karl
背景：增强现实是计算机生成的图像在现实世界结构上的叠加。它以前曾被用于在外科手术过程中的图像引导，但它从来没有被用于脑动脉瘤的手术，目的：报告我们的经验，脑动脉瘤手术辅助增强reality.METHODS：28例患者39个未破裂的动脉瘤进行了手术，在一个前瞻性的方式与增强现实。术前三维图像数据集（血管磁共振成像、血管计算机断层扫描和三维数字减影血管造影）用于创建患者血管、动脉瘤、动脉瘤颈、颅骨和头部的虚拟分割。这些图像在术中注入手术显微镜的目镜中。一个未破裂的后交通动脉瘤夹闭的例子在一个视频中说明。结果：所描述的操作程序允许连续监测患者与神经导航数据配准的准确性，并有助于执行定制的手术入路和最佳夹闭，最大限度地减少暴露。结论：增强现实可以增加微创方法的性能，尽管需要进行进一步的研究来评估某些动脉瘤组是否更有可能从中受益。需要进行开发，以提高其用户友好性。
BACKGROUND: Augmented reality is the overlay of computer-generated images on real-world structures. It has previously been used for image guidance during surgical procedures, but it has never been used in the surgery of cerebral aneurysms.OBJECTIVE: To report our experience of cerebral aneurysm surgery aided by augmented reality.METHODS: Twenty-eight patients with 39 unruptured aneurysms were operated on in a prospective manner with augmented reality. Preoperative 3-dimensional image data sets (angio-magnetic resonance imaging, angio-computed tomography, and 3-dimensional digital subtraction angiography) were used to create virtual segmentations of patients' vessels, aneurysms, aneurysm necks, skulls, and heads. These images were injected intraoperatively into the eyepiece of the operating microscope. An example case of an unruptured posterior communicating artery aneurysm clipping is illustrated in a video.RESULTS: The described operating procedure allowed continuous monitoring of the accuracy of patient registration with neuronavigation data and assisted in the performance of tailored surgical approaches and optimal clipping with minimized exposition.CONCLUSION: Augmented reality may add to the performance of a minimally invasive approach, although further studies need to be performed to evaluate whether certain groups of aneurysms are more likely to benefit from it. Further technological development is required to improve its user friendliness.