PDF(Pubmed)
Abstract：
Despite its broad use in cranial and spinal surgery, navigation support and microscope-based augmented reality (AR) have not yet found their way into posterior fossa surgery in the sitting position. While this position offers surgical benefits, navigation accuracy and thereof the use of navigation itself seems limited. Intraoperative ultrasound (iUS) can be applied at any time during surgery, delivering real-time images that can be used for accuracy verification and navigation updates. Within this study, its applicability in the sitting position was assessed. Data from 15 patients with lesions within the posterior fossa who underwent magnetic resonance imaging (MRI)-based navigation-supported surgery in the sitting position were retrospectively analyzed using the standard reference array and new rigid image-based MRI-iUS co-registration. The navigation accuracy was evaluated based on the spatial overlap of the outlined lesions and the distance between the corresponding landmarks in both data sets, respectively. Image-based co-registration significantly improved (p < 0.001) the spatial overlap of the outlined lesion (0.42 ± 0.30 vs. 0.65 ± 0.23) and significantly reduced (p < 0.001) the distance between the corresponding landmarks (8.69 ± 6.23 mm vs. 3.19 ± 2.73 mm), allowing for the sufficient use of navigation and AR support. Navigated iUS can therefore serve as an easy-to-use tool to enable navigation support for posterior fossa surgery in the sitting position.
摘要：
尽管它广泛用于颅骨和脊柱手术，导航支持和基于显微镜的增强现实（AR）尚未找到进入坐位后颅窝手术的方法。虽然这个位置提供了手术的好处，导航精度及其导航本身的使用似乎有限。术中超声（iUS）可以在手术过程中的任何时候应用，提供可用于准确性验证和导航更新的实时图像。在这项研究中，评估了其在坐姿中的适用性。使用标准参考阵列和新的基于刚性图像的MRI-iUS共配准，回顾性分析了15例后颅窝病变患者的数据，这些患者在坐位接受了基于磁共振成像（MRI）的导航支持手术。导航精度是根据轮廓病变的空间重叠和两个数据集中相应界标之间的距离进行评估的。分别。基于图像的共配准显着改善（p<0.001）轮廓病变的空间重叠（0.42±0.30vs.0.65±0.23），并显着减少（p<0.001）相应地标之间的距离（8.69±6.23mmvs.3.19±2.73mm),允许充分使用导航和AR支持。因此，导航iUS可以作为一种易于使用的工具，为坐姿的后颅窝手术提供导航支持。
