Microsurgery Simulator of Cerebral Aneurysm Clipping with Interactive Cerebral Deformation Featuring a Virtual Arachnoid
Microsurgery Simulator of Cerebral Aneurysm Clipping with Interactive Cerebral Deformation Featuring a Virtual Arachnoid
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DOI：
10.1093/ons/opx155
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发表时间：
2018-05-01
影响因子：
2.3
通讯作者：
Saito, Nobuhito
中科院分区：
文献类型：
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作者：
Shono, Naoyuki;Kin, Taichi;Saito, Nobuhito
背景：颅内动脉瘤夹闭手术的虚拟现实模拟器是神经外科医生的一个有吸引力的研究目标。脑变形是精确夹闭模拟器所需的最重要的功能之一，并且受到支持组织（例如蛛网膜）状态的极大影响。然而，没有虚拟现实模拟器实现支持组织的大脑还没有developed.Objective：开发一个虚拟现实裁剪模拟器具有交互式的大脑变形能力密切依赖于蛛网膜解剖，并将其应用于临床cases.Methods：脑组织和周围结构的三维计算机图形模型提取的医学图像。我们开发了一种新的方法，可修改的脑组织复杂的变形，将非医学图像衍生的虚拟蛛网膜/小梁的过程中称为多组织集成交互式变形（MTID）。MTIID使脑组织复合体在解剖部位选择性变形成为可能。术前对8例实际夹闭手术进行模拟，并评估其在手术入路规划中的有用性。结果：术前，每个手术野都精确再现，并与用户定义的虚拟脑回缩可视化。MTIID.CONCLUSION：虚拟夹闭模拟器主要关注支持组织，较少关注物理特性，在脑动脉瘤夹闭手术模拟中似乎是有用的。据我们所知，这篇文章是第一次报告基于支持组织的脑变形。
BACKGROUND: A virtual reality simulator for aneurysmal clipping surgery is an attractive research target for neurosurgeons. Brain deformation is one of the most important functionalities necessary for an accurate clipping simulator and is vastly affected by the status of the supporting tissue, such as the arachnoid membrane. However, no virtual reality simulator implementing the supporting tissue of the brain has yet been developed.OBJECTIVE: To develop a virtual reality clipping simulator possessing interactive brain deforming capability closely dependent on arachnoid dissection and apply it to clinical cases.METHODS: Three-dimensional computer graphics models of cerebral tissue and surrounding structures were extracted from medical images. We developed a new method for modifiable cerebral tissue complex deformation by incorporating a nonmedical image-derived virtual arachnoid/trabecula in a process called multitissue integrated interactive deformation (MTIID). MTIID made it possible for cerebral tissue complexes to selectively deform at the site of dissection. Simulations for 8 cases of actual clipping surgery were performed before surgery and evaluated for their usefulness in surgical approach planning.RESULTS: Preoperatively, each operative field was precisely reproduced and visualized with the virtual brain retraction defined by users. The clear visualization of the optimal approach to treating the aneurysm via an appropriate arachnoid incision was possible with MTIID.CONCLUSION: A virtual clipping simulator mainly focusing on supporting tissues and less on physical properties seemed to be useful in the surgical simulation of cerebral aneurysm clipping. To our knowledge, this article is the first to report brain deformation based on supporting tissues.