Development of Computer System Supporting Neurological Surgery

一种新的CT立体定向装置（神经导航仪）已经开发出来，它可以将手术点转换到术前CT图像上。我们将该系统应用于神经外科手术的各个方面，以检查其在神经外科中的有用性。该系统由一个6关节传感臂和一台16位个人计算机组成。它通过光标将臂尖端的位置投影到相应的CT切片上，从而在开放手术期间引导外科医生朝向颅内目标。该系统还将头端位置投影到血管造影片上，当与回波描记术结合使用时，导航能力得到增强。系统在神经外科手术中疲劳。导航系统作为多模态3D数据库的核心，在手术过程中非常有用。最大检测误差为3 mm，这被认为足以进行开放式显微手术。它也被证明是有用的开颅手术，在针对深部肿块和跟踪肿瘤的边缘，已确定的CT扫描。当血管造影与导航仪相结合时，在小的操作范围内识别关键血管变得容易。该系统还结合了超声回波描记术。该系统可将倾斜回波图像转换为标准的水平T图像，提高了对回波图像解剖结构的理解精度，并与CT三维重建系统结合使用。3D系统配备了在屏幕上模拟骨手术解剖的功能。当导航仪连接到3D系统时，导航仪提供患者头部点的3D坐标，使3D系统能够模拟实际开颅手术前的手术过程。

A new CT-stereotactic device (neuronavigator) has been developed which translates the operating point onto preoperative CT images. We applied this system to various aspects of neurosurgical procedures to examine its usefulness in neurosurgery. The system consists of a 6-joint sensing arm and a 16-bit personal computer. It projects the location of the arm tip onto a corresponding CT slice with a cursor, which guides a surgeon toward the intracranial target during open surgery. The system also projicts the tip location onto angiograms, and when used in conjunction with echography the ability of navigation is enhanced. The system was tired in neurosurgical procedures. The navigation system worked as the core of a multi-modal 3D data base which was useful during surgery. The maximum detection error was 3 mm which was considered to be sufficient for open microsurgery. It also proved useful in besigning craniotomy, in targeting deep seated mass lesions and in tracing the tumor edge which had been identified on CT scan. When the angiogram was combined with the navigator, it become easy to identify key vessels within a small operating field. The system was also combined with an ultrasonic echography. The combination makes it possible to translate the oblique echo image into standard horizontal T image, improving the precision of anatomical understanding t of the echo image.The guiding system has also been used in combination with three dimensional CT reconstruction (3D) system. The 3D system equipped with a function which simulates the operative dissection of the bone on the screen. When navigator was connected to the 3D system, navigator offered the 3D coordinates ofthe point on the patient's head, enabling the 3D system simulates the operative procedure before the actual craniotomy.