鼻窦和鞍区结构三维可视化图像重建及其在经鼻蝶内镜手术中精确定位作用

目的 探讨三维可视化图像重建引导对窦腔内微小、变异结构及鞍底的精确定位的可行性.方法 对4个成人头颅标本行鼻窦、鞍区CT簿层扫描,对鼻腔内和鞍区重要解剖结构分别进行三维可视化"容积重建",通过多模数据的配准、三维容积图像的融合、拆分,以虚拟现实技术实现对鼻腔内部结构的个体化浏览、显示和精确定位;选取鼻腔内40个靶点结构...

Stereotatic image-guided accurately positioning in trans-nasal-sphenoidal endoscopic surgery with three-dimensional visualized image reconstruction of nasal sinuses and sella turcica structure

Objective To investigate the feasibility of three-dimensional （3D）visualized image reconstruction guided accurately positioning methods to tiny lesion of sinus cavity and sella turcica bottom or anatomical individual aberrance. Methods Stereotatic frame was installed on 4 adult eranio-cadavers with screws. Thln-slice CT scan acquired spatial localization data of nasal cavity and sella turcica structure. Aero-tech surgerical software assisted three-dimensional visualized ＂volume construction ＂of these structure. Through multi-modal image data match, 3D image fusion and dissection, individually browsing were realized. Forty intra-nasal target-structures （sphenoidal ostium, sellar floor etc） were chosen. Combining stereotaetic and image-guided, exect inserting path were designed to guide nasal endoscope to target region and carry out anatomic observation and measurements. The accurate of image-guided methods were validated （setting distance error 〈 5 mm as exact positioning）. Results The effect of 3D image reconstruction and virtual endoscope were fidelity. Spatial configuration were objective, The accurate rate of image-guided position was 92.5% and target mean error was 3 mm. The pre-operative plan ready average time was 20 minutes. The location of important intranasal structure （ sphenoidal ostium, sellar floor, sphenoid platform, optic nerve-carotid artery recess, optic prominence, carotid artery prominence, clivus umbilication antero- margin, cribriform foramina ect） were accurate under image-guided. Conclusion The 3D image reconstruction guided visual inserting path and virtual endoscopic maneuvering, combining stereotactic guided techinique, provides individual intuitionistie view and accurate position of intranasal structure, also provides the exact assist to trans-nasal-sphenoidal endoscopic surgery.