CAJ | 학술논문

目的：探讨虚拟现实（ Virtual reality）技术在蝶骨嵴脑膜瘤个体化手术入路中的应用。方法回顾性分析了2009年7月至2013年6月首都医科大学附属复兴医院41例拟采用手术治疗的蝶骨嵴脑膜瘤患者，将术前采集的CTA及MR数据输入Dextroscope虚拟现实系统进行三维重建，术前获得肿瘤，脑组织，骨质以及神经血管信息，并进行观察，测量、手术入路设计、模拟等操作，制定个体化手术规划。并与随机选取的常规手术的27例蝶骨嵴脑膜瘤病例进行比较：肿瘤切除时间，手术全切率，并发症发生率以及随访后的KPS预后评分。结果41例蝶骨嵴脑膜瘤均成功地实现了3D重建，与术中实际情况吻合，肿瘤切除时间（61±12） min，对照组为（80±14） min，两组比较P＜0．05；手术全切率及KPS评分两组差异无统计学意义（ P＞0．05）。结论 Dextroscope虚拟现实系统可以提供蝶骨嵴脑膜瘤及其毗邻结构的信息，为颅底病变个体化制定手术方案提供帮助，有助于提高了手术的安全性。
목적：탐토허의현실（ Virtual reality）기술재접골척뇌막류개체화수술입로중적응용。방법회고성분석료2009년7월지2013년6월수도의과대학부속복흥의원41례의채용수술치료적접골척뇌막류환자，장술전채집적CTA급MR수거수입Dextroscope허의현실계통진행삼유중건，술전획득종류，뇌조직，골질이급신경혈관신식，병진행관찰，측량、수술입로설계、모의등조작，제정개체화수술규화。병여수궤선취적상규수술적27례접골척뇌막류병례진행비교：종류절제시간，수술전절솔，병발증발생솔이급수방후적KPS예후평분。결과41례접골척뇌막류균성공지실현료3D중건，여술중실제정황문합，종류절제시간（61±12） min，대조조위（80±14） min，량조비교P＜0．05；수술전절솔급KPS평분량조차이무통계학의의（ P＞0．05）。결론 Dextroscope허의현실계통가이제공접골척뇌막류급기비린결구적신식，위로저병변개체화제정수술방안제공방조，유조우제고료수술적안전성。
Objective To evaluate the usefulness of virtual reality ( VR ) technique for individualized preoperative planning of sphenoidal ridge meningioma.Methods Multiple imaging data of CTA/MR were acquired from 41 surgical patients with sphenoidal ridge meningioma during the period from July 2009 to June 2013 were transferred into the Dextroscope system.A suite of built-in 3D tools enabled users to obtain measurement and simulated intraoperative viewpoint about the lesion and adjacent anatomic structures.A sophisticated preoperative plan was defined.Operative duration,total resection rate,complication rate and KPS scores were compared with control group undergoing routine operation (n=27).Results 3D stereoscopic VR images in accordance with reality were reconstructed for 41 cases.As compared with control group,VR preoperative plan could shorten operative duration and reduce complication rate ( P <0.05 ) . However,there was no improvement in total resection rate or KPS score ( P>0.50 ) .Conclusion VR technique of Dextroscope system offers comprehensive information of sphenoidal ridge and related neurovascular anatomical structure.Thus it may aid surgical planning and facilitate individualized operation.