多模态影像三维重建技术在功能区及其毗邻部位脑肿瘤手术中的应用
邱 俊 张朝贵 易 勇 江竟成 张 超 罗 鹏
宜宾市第二人民医院，四川 宜宾 644000
通信作者：张朝贵
【摘要】 目的 探讨基于多模态影像三维重建技术辅助功能区及其毗邻部位脑肿瘤手术中的作用。方法 回顾性分析 2019-04—2021-06 宜宾市第二人民医院神经外科收治的 21 例功能区及其毗邻部位脑肿瘤患者的临床资料。术前使用多模态影像三维重建技术，根据重建影像进行综合评估并实施手术，通过与术中所见与术后疗效综合评估有效性。结果 所有患者术中所见与术前重建影像均高度一致。其中 19 例患者术前均成功实现颅骨、脑组织、肿瘤、血管及白质纤维束走行的三维重建和融合，2 例患者无法辨认功能区脑回和肿瘤的关系。21 例患者中，肿瘤全切 17 例，次全切 1 例，3 例部分切除。术后出现 1 例一过性肢体活动障碍和 1 例一过性语言障碍，均恢复良好。结论 利用多模态影像三维重建技术有助于在术前对于肿瘤与功能区脑回、锥体束及脑血管之间的关系进行精确评估，制定完备的手术方案，最大程度保护神经功能，并能提高肿瘤的全切除率。
【关键词】 脑肿瘤；功能区；多模态；三维影像
【中图分类号】 R739.41 【文献标识码】 A 【文章编号】 1673-5110 （2022） 05-0583-04
基金项目：宜宾市卫健委科研课题（编号：2019YW020）
DOI：10.12083/SYSJ.220387
Application of multimodal image 3D reconstruction technique in the operation of brain tumors in functional areas and adjacent areas
QIU Jun，ZHANG Chaogui，YI Yong，JIANG Jingcheng，ZHANG Chao，LUO Peng
The Second People’s Hospital of Yibin，Yibin 644000，China
Corresponding author：ZHANG Chaogui
【Abstract】 Objective Explore 3d reconstruction based on multimodal image technology in the area and its adjacent to the site application effect of brain tumour surgery. Methods A retrospective analysis was performed on the clinical data of 21 patients with brain tumors in functional areas and adjacent areas admitted to the neurosurgery department of our hospital from April 2019 to June 2021. Preoperative case data of brain tumors in the auxiliary functional area and its adjacent areas were used for comprehensive evaluation and operation according to the reconstruction images，and the effectiveness was comprehensively evaluated by the intraoperative
observation and postoperative efficacy. Results The intraoperative findings of all patients were highly consistent with those of preoperative reconstruction. Among them，19 patients successfully achieved preoperative THREE-DIMENSIONAL reconstruction and fusion of the skull，brain tissue，tumor，blood vessels and white matter fiber bundles，and 2 patients could not identify the relationship between the functional area of the brain gyrus and the tumor. Total resection in 17 cases，subtotal resection in 1 case，partial resection in 3 cases. After operation，1 case had transient physical activity disorder and 1 case had transient speech disorder. Conclusion The use of multi-modal image three-dimensional reconstruction technology is helpful to accurately evaluate the relationship between the tumor and the functional areas of the gyrus，pyramidal tract and cerebrovascular before surgery，develop a complete surgical plan，protect the neural function to the greatest extent，and improve the total resection rate of the tumor.
【Key words】 Brain tumor；Functional areas；Multimodal；3D images
