PDF(Pubmed)
Abstract：
Augmented reality (AR) is an emerging technology that can display three-dimensional patient anatomy in the surgeons\' field of view. The use of this technology has grown considerably for both presurgical and intraoperative guidance. A patient diagnosed with breast cancer started to experience numbness in the left hand, which progressed to weakness in the left hand and arm. An MRI was performed demonstrating a 2.9 cm X 1.8 cm lesion with extensive surrounding edema in the posterior fronto-parietal lobes. Surgery was recommended for presumed metastatic disease. Preoperatively, an AR system and Brainlab navigation were registered to the patient. AR, traditional navigation, and ultrasound were all used to localize the lesion and determine the craniotomy site and size. The tumor was removed along the direction of the lesion. Intraoperatively, we used AR to reexamine the tumor details and could appreciate that we had to redirect our surgical trajectory anteriorly and laterally in order to follow along the main axis of the tumor. In doing this, we were able to more confidently remain with the tumor, which by this time was poorly defined by 2D navigation and by direct vision. Postoperative MRI confirmed gross total removal of the tumor. The patient had an uneventful postoperative course with resolution of preoperative symptoms and the final surgical pathology was grade 4 glioblastoma. Here, we describe the valuable use of AR for the resection of a glioma. The system has a seamless registration process and provides the surgeon with a unique view of 3D anatomy overlaid onto the patient\'s head. This exciting technology can add tremendous value to complex cranial surgeries.
摘要：
增强现实（AR）是一种新兴技术，可以在外科医生的视野中显示三维患者解剖结构。这项技术的使用在术前和术中指导方面都有了很大的发展。一名被诊断患有乳腺癌的患者开始感到左手麻木，进展到左手和手臂的虚弱。进行MRI检查，显示后额顶叶有2.9cmX1.8cm的病变，周围有广泛的水肿。对于假定的转移性疾病，建议进行手术。术前,对患者注册了AR系统和Brainlab导航.AR,传统导航,和超声检查均用于定位病变并确定开颅部位和大小。沿病变方向切除肿瘤。术中,我们使用AR重新检查了肿瘤的细节，并且可以理解，我们必须将手术轨迹向前和横向重定向，以便沿着肿瘤的主轴。在这样做的时候，我们能够更自信地留在肿瘤中，到目前为止，2D导航和直视对其定义不佳。术后MRI证实肿瘤完全切除。患者术后病程顺利，术前症状缓解，最终手术病理为4级胶质母细胞瘤。这里,我们描述了AR在神经胶质瘤切除中的宝贵用途。该系统具有无缝配准过程，并为外科医生提供覆盖在患者头部的3D解剖结构的独特视图。这项令人兴奋的技术可以为复杂的颅骨手术增加巨大的价值。
