摘要
目的应用计算机导航系统,进行术前设计,探讨在术中精确评判骨肿瘤外科切除边界的意义和可行性。方法2007年11月至2008年6月,共施行红外线主动诱导计算机辅助三维导航下骨肿瘤外科手术30例,其中男性18例,女性12例。术前全部病例进行螺旋CT扫描,导入导航系统配置的工作站计算机,术前进行解剖重建,对比CT显示病变的骨窗、软组织窗和增强扫描窗影像,确定肿瘤范围;部分病例经计算机的CT和MR融合功能,显示的髓腔范围确定肿瘤边界;设计术中肿瘤外科边界,并标记。术中导航引导下,肿瘤切除,并精确评判外科切除边界。结果全部病例依照术前设计进行。18例在导航系统指引下,进行精确的切除,肿瘤标本显示了良好的外科切除边界;12例囊内切除,在导航的指引下,确认切刮边界足够。结论计算机导航技术已经被广泛应用于各个学科领域;术前设计肿瘤切除范围;术中依照计划进行手术;确认肿瘤切除边界,提高了手术的精确度。计算机导航技术的应用有助于骨肿瘤的精确切除,为重建创造条件。
Objective The aim was to report our experience for the precision tumor resection and reconstruction in musculoskeletal tumor surgery using image-guided computer navigation. Methods Between November 2007 and June 2008, 30 musculoskeletal tumor surgeries were performed with the assistance of the image-guided computer navigation. There were 12 females and 18 males. Pre-operative CT of each patient was performed. We made the pre-operation planning for each patient with the Navigation system software that included conforming the tumor surgical margin, designing resection and reconstruction according to the CT data and the CT fused images with MR in some cases. Intro-operatively, we carried out the process of registration and matched the operative anatomy to the virtual image generated by the Navigation System software. Then we performed these surgical processes according the pre-operative planning. Reults The tumor resections of all cases were done as pre-operation planning. In 10 patients with pelvic tumor, 5 cases were performed precision marginal resection and reconstruction and intralesional resection with adequate margin in 5 cases. 2 sacrum tumors were resected with intralesional margin. In 16 extremity cases, precision resection was performed in 9 patients and intralesioal resections in 7 cases and performed precision resection in 2 patients with spinal tumors. All the marginal resection specimens showed a safe and clear margin. For other patients with intralesional resection, the margin was excellent as confirmed by Navigation System. Conclusions An adequate surgical margin is quite important for tumor resection. Although the surgical process time may be increased, the navigation system is invaluable for precision tumor resection and reconstruction.
出处
《中国医药生物技术》
CSCD
2009年第2期114-118,共5页
Chinese Medicinal Biotechnology
关键词
骨肿瘤
外科手术
计算机辅助
图像处理
计算机辅助
Bone neoplasms
Surgery, computer-assisted
Image processing, computer-assisted
