Image-guided neurosurgery with intraoperative MRI: update of frameless stereotaxy and radicality control.
Image-guided neurosurgery with intraoperative MRI: update of frameless stereotaxy and radicality control.
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术中 MRI 图像引导神经外科：无框架立体定位和激进控制的更新。
DOI：
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发表时间：
1997
影响因子：
1.7
通讯作者：
S. Kunze
中科院分区：
文献类型：
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作者：
C. Wirtz;Volker M. Tronnier;Mario M. Bonsanto;Michael Knauth;A. Staubert;F. Albert;S. Kunze
在基于框架和无框架的立体定向干预中，特别是在开放显微外科手术中，术中移位和由此产生的不准确性一直是人们关注的问题。为了解决这一问题，我们开发了一种术中MRI （0.2 tesla, Magnetom Open）的方法，并使用术中获取的数据集来更新神经导航。21例患者术中图像可作为导航参考（平均精度0.83±0.31 mm）。10例患者继续手术，通过导航切除检测到的肿瘤残余，术后残留肿瘤4例（19%）。我们发现更新无框架立体定位来补偿脑移位是可行的，并且可能增加放射学上完全切除的病例数量。
Intraoperative shifts and resulting inaccuracies have been a concern in frame based and frameless stereotactically guided interventions, particularly in open microsurgical procedures. Trying to solve this problem, we developed a method to perform intraoperative MRI (0.2 tesla, Magnetom Open) and use intraoperatively acquired data sets to update neuronavigation. In 21 patients, intraoperative images could be used to reference navigation (mean accuracy of 0.83 +/- 0.31 mm). The operation was continued in 10 cases to resect detected tumor remnants using navigation, leaving 4 patients (19%) with residual tumor postoperatively. We showed that update of frameless stereotaxy to compensate for brain shift is feasible and might increase the number of cases where radiologically complete resection can be achieved.