Chinese Journal of Contemporary Neurology and Neurosurgery (Mar 2022)
Application of multi ⁃modal image fusion three ⁃dimensional reconstruction technology in operation of meningioma in the central area of the brain
Abstract
Objective To explore the application value of multi ⁃ modal image fusion three ⁃ dimensional (3D) reconstruction technology in operation of meningioma in the central area. Methods and Results Using multi⁃modal image fusion 3D reconstruction technology to study 46 patients admitted to The First Affiliated Hospital of University of Science and Technology of China from April 2019 to May 2021. 3D Slicer software was used to process the original imaging data to reconstruct 3D models of tumor, peritumoral vein, cerebral cortex, skull, scalp, etc., and intraoperatively Sina software was used for projection assisted incision design to verify the actual tumor position and its adjacency structures preoperatively. To reconstruct the effect before surgery, the tumor was removed under microscopy. All patients completed the preoperative reconstruction. The intraoperative verification showed that the tumor and its adjacency structures were in good agreement with the preoperative 3D model. All patients did not cause unnecessary injury due to insufficient preoperative exposure caused by improper preoperative planning. Forty⁃six cases of meningioma in the central area were completely removed under the microscopy, 32 cases had no limb dysfunction, 8 cases had significant improvement in limb function, and 6 cases had decreased muscle strength. None of the patients had epileptic seizures. One patient had postoperative infection, after active anti⁃infection, he was cured and discharged. There was no death. Conclusions The 3D Slicer reconstruction technology applied to meningioma in the central area can display the tumor adjacent structures in a intuitive, multi-dimensional and dynamic 3D manner, guide the maximum resection of the tumor and protect the peritumoral vein and cortex during the operation. Sina software has clinical and practical value in preoperative positioning of meningioma in the central area, such as accuracy, safety, non-invasiveness, and convenience, and it is worthy of further research and promotion.
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