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1.
神经导航术中脑移位的研究 总被引:22,自引:0,他引:22
目的定量研究不同神经导航手术中的脑移位,评价术中脑移位对神经导航手术定位准确性的影响。方法在73例颅脑手术中应用StealthStation神经导航系统指导手术操作,制作骨瓣前在骨窗外作对照参考点,然后分别测量硬膜、皮层和病灶移位程度,并分别对不同病理性质肿瘤的移位情况进行分析。结果平均注册误差(2.13±0.74)mm,术中持续准确性为(1.17±0.67)mm;所有73例的硬膜、皮层和病灶移位程度分别为(2.80±2.48)mm、(5.14±4.05)mm以及(3.53±3.67)mm。胶质瘤组的硬膜、皮层和病灶移位均是最大的,而海绵状血管瘤组以及颅底肿瘤组的移位明显低于胶质瘤组。结论术中脑移位是影响神经导航手术定位准确性的重要因素,对不同性质和部位病变术中脑移位的了解有助于指导手术操作。 相似文献
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目的 探讨颅外体表参考线与大脑前、后联合(AC-PC)线之间的关系.为脑功能性立体定向手术的颅内靶点定位提供可靠、准确的体表参考线.方法 收集我院2005年11月至2010年3月39例颅内肿瘤患者的头颅MRI神经导航资料,在GE Insta Trak 3500导航工作站中打开,在轴面与矢状面上将AC-PC线通过一系列的水平移动移至颅外并通过眼外眦,测量该线到外耳门中心的距离.结果 AC-PC线同一轴面体表平行线距离外耳门中心点的距离:男(49.31±6.28)mm,女(46.60±6.13)mm,男女差异有统计学意义,总体均数为(47.71±6.26)mm.通过眼外眦AC-PC平行线距离外耳门中心点的距离:男(32.27±6.32)mm,女(27.41±5.79)mm,检验结果差异有统计学意义.结论 使用神经导航测量AC-PC线的颅外体表平行线方法直接、可靠.通过眼外眦的AC-PC线的平行线距离外耳门中心距离男女之间不同.Abstract: Objective To study the correlation between extracranial reference line and intracranial AC -PC line for finding an extracranial scan basic line and using it as reference line before stereotactic intracranial neurosurgery.Methods Brain MRI images neuronavigation data of 39 patients of intracranial tumors admitted to our hospital from Nov.2005 to March 2010 were analyzed.The data were treated by GE Insta Trak 3500 navigation workstation.The AC - PC line was moved to extracranial surface parallelly in sagittal plane and axial plane.The distances from these lines to the center of external mestus were measured.Results The distance from the parallel line of AC - PC line in the same axial plane to the central of external mestus in males and females were ( 49.31 ± 6.28 ) mm and ( 46.60 ± 6.13 ) mm respectively and the general average was (47.71 ± 6.26 )mm.There was no difference between males and females.The distance from the line , being the parallel line of AC - PC line and outer canthus, to the central of external mestus in males and females were (32.23 ± 6.32 )mm and (27.41 ± 5.79)mm respectively .The results showed statistical difference.Conclusion Using neuronavigation to measure extral cranial line of AC - PC line is direct and reliable.The distances from the line , being the parallel line of AC - PC line and crossing outer canthus, to the central of external mestus in males and females are different. 相似文献
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神经导航辅助下的颅内微侵袭手术 总被引:2,自引:0,他引:2
目的 研究神经导航技术在神经外科手术中的应用。方法 术前的导航工作站依据三维影像显示的病灶与周围结构的解剖特点设计手术入路、规划手术范围,术中在观察棒及镜内导航下寻找病灶。结果 导航下完成75例手术,均准确定位,减少了对周围组织的损伤。结论 神经导航在部位深、病灶小或边界不清、肉眼难以识别的胶质瘤等手术中应用,有效地保护了神经功能。 相似文献
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脑胶质瘤的神经导航手术治疗 总被引:9,自引:1,他引:9
目的 介绍神经导航系统在切除脑胶质瘤手术中的初步应用体会。方法 应用Brain-LAB公司VV2导航系统辅助切除大脑半球胶质瘤62例,并对神经导航用于胶质瘤手术的疗效,以及其优越性和注意事项进行分析。结果 本组病例中,平均注册误差为1.2±0.5 mm,术后近期复查CT或MRI证实肿瘤影像学全切除率为57%,患者临床症状均得到改善,肢体活动等重要神经功能较术前未受明显影响,无手术并发症,短期随访期间3例复发。结论 神经导航系统对于切除邻近重要功能区胶质瘤具有定位准确、动态示踪、微侵袭等特点,有助于提高胶质瘤的全切除率及降低手术并发症的发生。 相似文献
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神经导航注册准确性的实验研究 总被引:9,自引:2,他引:7
目的研究神经导航注册准确性的影响因素,为临床应用提供理论指导。方法自制神经导航定位模型,分别进行CT和MRI扫描。使用不同数量、不同位置的注册坐标进行注册。结果CT组:4个坐标组的平均坐标误差(MFE)与其他3组有显著性差别,各组间预期准确性(PA)均有显著性差别。MRI组:各组间MFE均有显著性差别,除了4个坐标组的PA与6个坐标组有显著性差别外,其他各组无显著性差别。同样使用4个注册坐标,分散排列者的准确性高于平面排列者,有显著性差别。结论自制的神经导航定位模型制作简便、准确性高。随着注册坐标的增加,注册准确性和预期准确性均提高。使用CT导航,最少使用6个注册坐标;使用MRI导航,应使用10个注册坐标。注册坐标应尽量分散排列。 相似文献
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目的 总结神经导航辅助显微手术切除脑功能区胶质瘤的术中配合经验。方法 应用神经导航辅助显微手术治疗脑功能区胶质瘤15例,总结术中配合经验。结果 15例手术在神经导航下,避开脑运动区、语言区和视觉区,肿瘤顺利全切。术中配合熟练未发生失误。结论 神经导航技术能精确定位脑皮层下病变,避免重要脑功能区损伤,保护病人神经功能;神经导航仪的熟练应用、术前做好充分准备、术中的熟练配合是手术顺利进行的重要保证。 相似文献
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董永飞 《中国微侵袭神经外科杂志》2011,16(5):235-237
术中超声神经导航技术的应用,为手术切除颅内肿瘤带来病灶高切除率,周围正常脑组织高保留率,手术过程微侵袭的效果,越来越受到临床神经外科医师的重视.本文就该技术在颅内胶质瘤手术中的应用作一综述. 相似文献
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目的研究术中监护下神经导航手术切除功能区及深部病变的疗效.方法在神经导航引导的显微神经外科手术中,对32例脑功能区及深部病变病人进行正中神经N20、P25和胫后神经P40、N50体感诱发电位(SEP)监护,以及大鱼际肌和胫前肌运动诱发电位(MEP)监护,以指导手术操作.结果术后MR复查示均达到全切除.24例偏瘫病人中术后症状改善21例,17例癫癎病人中癫癎症状术后消失13例,12例失语病人中术后改善10例.术后未产生新的神经损害症状,无手术并发症及死亡.结论术中神经电生理监护对于提高脑功能区及深部区域病变的手术疗效和安全性有重要意义. 相似文献
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目的探讨在神经导航引导下利用神经内镜治疗高血压脑出血的疗效。方法回顾性分析2016年11月至2018年11月我科收治的34例高血压脑出血患者的临床资料,该组患者采用神经导航引导下利用神经内镜手术治疗高血压脑出血。结果患者平均手术时间约90分钟,术中平均失血量约100 ml,术后6小时常规复查颅脑CT,32例血肿完全清除,2例残留少量血块,所有患者无术后迟发性出血,无死亡病例,平均住院时间14天。34例患者术后均随访半年以上,ADL评分Ⅰ级11例,Ⅱ级17例,Ⅲ级5例,Ⅳ级2例,Ⅴ级0例。结论神经导航引导下利用神经内镜治疗高血压脑出血创伤小,出血少,能明显缩短手术时间及平均住院时间,能很好的保护神经功能,预后良好,值得在临床上广泛推广和应用。 相似文献
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目的 利用Brain Lab整体超声导航实时监测并切除脑深部肿瘤,探讨术中超声结合导航在神经外科手术中的价值.方法 应用Brain Lab整体超声导航系统对30例脑深部肿瘤进行显微神经外科手术,结合导航图像,术中超声动态了解病变移位情况,实时显示病变边界,进行移位后病灶的全切除.结果 术中实时超声证实在30例导航手术过程中均有不同程度的病灶移位,在超声引导下,探寻残余肿瘤并在监测下进一步全切除,术后未出现明显的并发症.结论 术中整体超声导航不仅可以在移位情况下重新准确定位肿瘤边界,而且可以在实时超声监测下进一步切除肿瘤,缩短手术时间,增加了全切除率,提高了手术的安全性. 相似文献
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背景:国内外学者已应用有限元分析在前臂的桡骨骨折及其固定、尺骨骨折及其固定等方面进行了生物力学评价,但还未见应用该方法对下尺桡关节进行生物力学评价相关的文献报道。
目的:建立并验证下尺桡关节三维有限元模型,用于临床的生物力学研究。
方法:将1名健康男性志愿者右肱骨远端到腕关节中段的CT和MRI图像,导入Mimics10.01和ANSYS10.0中,建立下尺桡关节三维有限元模型,模拟体外生物力学试验,在横向拉伸、轴向压缩、旋前和旋后扭转4种工况下观测下尺桡关节各结构的应力分布,所得结果与文献报道的生物力学实测数据比较验证。
结果与结论:所构建的下尺桡关节有限元模型共有333 805个单元,508 384个节点,客观反映下尺桡关节真实解剖形态。所建模型在横向拉伸、轴向压缩、旋前和旋后扭转4种工况下,理论分析结果与生物力学实测数据一致。证实所建的下尺桡关节有限元模型真实性较高,可用于生物力学分析实验。 相似文献
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X刀治疗脑转移瘤临床效果观察 总被引:3,自引:1,他引:3
目的 :总结X刀治疗脑转移瘤临床效果。方法 :X刀治疗脑转移瘤 5 8例 ,共 78个病灶 ,肿瘤周边剂量平均为 19 73Gy ,一般以 70 %~ 10 0 %等剂量线覆盖肿瘤周边 ,2 8例患者配合全脑放疗。结果 :随访 3~ 2 6个月 ,CT和MRI随访 47例 ,证实肿瘤治疗后完全消失 (CR) 2 0例( 42 6% ) ,大部分消失 (PR) 8例 ( 17 0 % ) ,部分消失 (MR) 8例 ( 17 0 % ) ,无变化 (NC) 6例 ( 12 8% ) ,增大 (PG) 5例 ( 10 6% ) ;脑水肿反应严重 3例。临床随访 5 0例 ,死亡 36例 ,平均存活期 12 0个月 ;生存 14例 ,已平均存活 9 5个月。X刀术后颅外病变稳定者生存期比颅外病变活跃者长。对部分患者应配合全脑放疗。结论 :该技术治疗脑转移瘤近期效果较为满意 ,是一种安全有效的方法。 相似文献
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《Brain stimulation》2020,13(3):664-674
BackgroundVarying treatment outcomes in transcranial electrical stimulation (tES) recipients may depend on the amount of current reaching the brain. Brain atrophy associated with normal aging may affect tES current delivery to the brain. Computational models have been employed to compute predicted tES current inside the brain. This study is the largest study that uses computational models to investigate tES field distribution in healthy older adults.MethodsIndividualized head models from 587 healthy older adults (mean = 73.9years, 51–95 years) were constructed to create field maps. Two electrode montages (F3-F4, M1-SO) with 2 mA input current were modeled using ROAST with modified codes. A customized template of healthy older adults, the UFAB-587, was created from the same dataset and used to warp individual brains into the same space. Warped models were analyzed to determine the relationship between computed field measures, brain atrophy and age.Main resultsComputed field measures were inversely correlated with brain atrophy (R2 = 0.0829, p = 1.14e-12). Field pattern showed negative correlation with age in brain sub-regions including part of DLPFC and precentral gyrus. Mediation analysis revealed that the negative correlation between age and current density is partially mediated by brain-to-CSF ratio.ConclusionsComputed field measures showed decreasing amount of tES current reaching the brain with increasing atrophy. Therefore, adjusting current dose by modifying tES stimulation parameters in older adults based on degree of atrophy may be necessary to achieve desired stimulation benefits. Results from this study may inform future tES application in healthy older adults. 相似文献
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目的分析额、枕部直接冲击造成中脑应力响应,探讨颅脑直接冲击导致脑干损伤的力学机制。方法构建头颅三维有限元模型,模拟计算额、枕部直接冲击损伤,分析中脑上、下交界面节点应力分布,总结中脑应力响应。结果中脑-间脑界面在冲击初始阶段,2ms即出现应力增高,中脑-桥脑界面应力升高开始于冲击后期(10ms),两交界面节点应力在冲击时程中均持续升高,额部冲击比枕部冲击在中-间脑界面造成的应力峰值高。结论中脑在颅脑直接冲击伤的致伤机制中占有突出地位,中脑的应力改变可解释脑震荡的意识障碍及部分原发脑干伤的临床表现。 相似文献
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目的 建立具有详细解剖结构的颈椎三维有限元模型并验证其有效性.方法 对1 名健康成年男性进行颈椎的薄层CT 扫描,将CT 数据导入到Mimics10.0 中得到颈椎的三维图像数据,然后导入到Geomagic studio 9.0 中得到颈椎的几何模型,最后在ANSYS 11.0 中建立颈椎的有限元模型.采用与文献中相同... 相似文献
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Mile Stanojcic Tal Burstyn-Cohen Nadia Nashi Greg Lemke Boris Sakic 《Brain, behavior, and immunity》2009,23(7):1003-1013
Brain atrophy and neuronal degeneration of unknown etiology are frequent and severe concomitants of the systemic autoimmune disease lupus erythematosus (SLE). Using the murine MRL/lpr model, we examined populations of proliferative brain cells during the development of SLE-like disease and brain atrophy. The disease onset was associated with reduced expression of Ki67 and BrdU proliferation markers in the dorsal part of the rostral migratory stream, enhanced Fluoro Jade C staining in the subgranular zone of the dentate gyrus, and paradoxical increase in density of Ki67+/BrdU− cells in the paraventricular nucleus. Protuberances containing clusters of BrdU+ cells were frequent along the lateral ventricles and in some cases were bridging ventricular walls. Cells infiltrating the choroid plexus were Ki67+/BrdU+, suggesting proliferative leukocytosis in this cerebrospinal fluid-producing organ. The above results further support the hypothesis that systemic autoimmune disease induces complex CNS pathology, including impaired neurogenesis in the hippocampus. Moreover, changes in the paraventricular nucleus implicate a metabolic dysfunction in the hypothalamus–pituitary-adrenal axis, which may account for altered hormonal status and psychiatric manifestations in SLE. 相似文献
18.
Development of a postnatal 3-day-old rat model of mild hypoxic-ischemic brain injury 总被引:2,自引:0,他引:2
Improvements in both obstetric and paediatric care have been responsible for a continuing reduction in mortality in extremely premature infants. However, higher survival rates have been at the expense of more long-term neurological damage. Various animal models have been developed to study the effect of hypoxic-ischemic insults on the brain. However, established models like the postnatal day 7 rat model represent damage found in term infants rather than in preterm infants of 24-28 weeks' gestation, and produce a severe form of injury resulting in high mortality rates. In this study we developed a reliable model of minor hypoxic-ischemic brain injury in postnatal day 3 rats. At this maturity, the pattern of damage represents that expected in a preterm infant suffering a non-lethal perinatal insult.We found that minor changes in duration of insult and both temperature and humidity produced wide fluctuations in the degree of injury observed. By maintaining strict control over experimental conditions including duration of insult, temperature and humidity, we produced a reliable model of minor injury primarily affecting all five areas of the cerebral cortex, and also the thalamus (area 7) and basal ganglia (area 8). Differences were significant compared to normal controls and sham-operated animals (p<0.05). These areas represent the primary motor, insular, visual and temporal cortices. The overall mortality rate in this study was 12.3%. 相似文献
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Accurate detection of spontaneous seizures using a generalized linear model with external validation
Nicolas F. Fumeaux Senan Ebrahim Brian F. Coughlin Adesh Kadambi Aafreen Azmi Jen X. Xu Maurice Abou Jaoude Sunil B. Nagaraj Kyle E. Thomson Thomas G. Newell Cameron S. Metcalf Karen S. Wilcox Eyal Y. Kimchi Marcio F. D. Moraes Sydney S. Cash 《Epilepsia》2020,61(9):1906-1918
20.
建立完整的正常人股骨三维有限元模型,并应用于正常站立位生物力学分析。基于序列CT断层扫描图像,应用逆向工程原理,用自编图像处理程序从图像提取点云,并在逆向工程软件和有限元分析软件中建立有限元模型。其中将模型中材料考虑为连续、均质、各向同性的线弹性材料,将皮质骨和松质骨材料参数综合等效为弹性模量12 GPa,泊松比是0.3。模拟正常双足站立,股骨头上表面受到垂直向下的分力为500 N,执行计算。结果成功建立了有限元模型,最大位移发生在股骨头,最大应力发生在股骨体中下段,为14.2 MPa,股骨颈局部拉应力较大。验证了股骨骨折多发于股骨体中下段的理论;并证明了老年人多发股骨颈骨折,并且骨折难愈合的事实,从生物力学角度说明股骨颈骨折后应避免活动。 相似文献