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Model-Updated Image-Guided Neurosurgery: Preliminary Analysis Using Intraoperative MR

机译:模型更新的图像引导神经外科:使用术中MR的初步分析

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摘要

In this paper, initial clinical data from an intraoperative MR system are compared to calculations made by a three-dimensional finite element model of brain deformation. The preoperative and intraoperative MR data was collected on a patient undergoing a resection of an astrocytoma, grade 3 with non-enhancing and enhancing regions. The image volumes were co-registered and cortical displacements as well as subsurface structure movements were measured retrospectively. These data were then compared to model predictions undergoing intraoperative conditions of gravity and simulated tumor decompression. Computed results demonstrate that gravity and decompression effects account for approximately 40% and 30%, respectively, totaling a 70% recovery of shifting structures with the model. The results also suggest that a non-uniform decompressive stress distribution may be present during tumor resection. Based on this preliminary experience, model predictions constrained by intraoperative surface data appear to be a promising avenue for correcting brain shift during surgery. However, additional clinical cases where volumetric intraoperative MR data is available are needed to improve the understanding of tissue mechanics during resection.
机译:在本文中,将术中MR系统的初始临床数据与脑变形的三维有限元模型进行的计算进行了比较。术前和术中MR数据收集于接受星形细胞瘤3级切除,无增强区域和增强区域的患者。图像体积被共配准,并且回顾性地测量了皮质位移以及地下结构的运动。然后将这些数据与进行重力和模拟肿瘤减压术中条件的模型预测进行比较。计算结果表明,重力和减压效应分别约占40%和30%,该模型对移位结构的总回收率为70%。结果还表明,肿瘤切除过程中可能存在不均匀的减压应力分布。基于这一初步经验,受术中表面数据约束的模型预测似乎是矫正手术期间脑移位的有前途的途径。但是,需要更多的术中术中MR数据可用的临床病例,以提高对切除过程中组织力学的了解。

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