基于计算机建模的侧脑室额角垂直穿刺方法研究

目的研究垂直于颅骨钻孔点的侧脑室额角穿刺法的可行性及操作的最佳方法。方法利用204例颅脑CT数据,建立颅骨-侧脑室虚拟模型,取鼻根部沿矢状线向上9~11 cm,旁开2 cm、2.5 cm、3 cm、3.5 cm、4 cm作为钻孔点,分别进行垂直于该点的侧脑室模拟穿刺,统计各项穿刺成功率、测量偏置距离及穿刺深度。结果模拟侧脑室额角垂直穿刺方法成功率高;侧脑室占比越大,穿刺成功率越高;旁开距离的选取对穿刺成功率无明显影响,但各引流管到达侧脑室的位置存在差别。结论验证了侧脑室额角垂直穿刺法的可行性。侧脑室占比为20%~<60%者,手术前可在计算机上重建颅骨-侧脑室模型,实现个性化穿刺,也可取旁开距离2.5~3 cm作为穿刺点,穿刺点到侧脑室上表面的深度不超过5.3 cm。

Computer modeling of lateral ventricular frontal angle puncture

Objective To study the best feasibility and operation of puncturing the lateral ventricular frontal,which is perpendicular to the drilling point of skull.Methods Data of the 204 cases of brain CT was used to set up skull-lateral ventricle virtual model.The drilling points were located from the base of the nose,9-11cm upward along the sagittal line,then sideoffset of 2cm,2.5cm,3cm,3.5cm and 4cm respectively on the scalp to the destination points.Then virtual needles were made to respectively puncture perpendicular through the points,afterward the success rate of puncture was counted,the offset distance and puncture depth were measured.Results The success rate of vertical puncture of the lateral ventricle was high;the greater the proportion of the lateral ventricle,the higher the success rate;the selection of side offseton the scalpdistance had no obvious effect on the success rate of puncture,but a difference in the offset distance of the lateral ventricle,which each drainage tube got to.Conclusion The feasibility of vertical puncture of lateral ventricle was verified.For the people whose lateral ventricle just 20%-<60%,personalized puncture could be achieved by reconstructing skull-lateral ventricle model in the computer before surgery.It also recommended to use side offset of 2.5-3cm on the scalp as puncture point.The depth between puncture point and the surface of the lateral ventricle less than 5.3cm.