Open intraoperative magnetic resonance imaging in neurosurgery is mediated by the last decade significant developments in the medical field, application of this technology can pinpoint the maximum lesion, a clear lesion boundary and to choose the best or the most secure person operation Road, the neurosurgeon treating tumors, vascular malformations and other brain lesions provides a very sophisticated way. the current image-mediated neurosurgery include frame (such as the Leksell, Cosman-Robets-Well, and Fisher, etc.) and non-framework (optical, electromagnetic and ultrasonic sensors three Tracing way navigation) 2 system technology. Application of these 2 systems are required to obtain preoperative imaging data to create the implementation of the guidance in the operation of the three-dimensional space. All these systems use preoperative imaging data is obtained, so it can not provide a surgical dynamic changes occurring in the information, because in the surgery due to loss of cerebrospinal fluid or brain edema, intracranial lesions after excision biopsy and the location of the structure solution will be cut will change, particularly hydrocephalus and brain atrophy in patients with the more obvious; these systems can not be found Oh intraoperative x is the complications (such as intracranial Sichuan blood); other surgery patients are sometimes difficult to determine tumor The size or extent of the scope and the importance of vascular lesions or peripheral nerve tissue, making it difficult to raise the quality of surgery: how to obtain real-time intraoperative imaging data of Hill and to guide surgery, neurosurgery technology development will become an important issue. surgery in CT and intraoperative MRI technology is one of the most important development of the content.
1 intraoperative MRI (Intraoperative MRI,) the concept and development: the use of imaging equipment in the operating room guiding the operation is not a new concept, since This X-ray imaging in clinical technology mediated applications in orthopedic surgery on; neurosurgeon already used in surgery or diagnostic imaging in the treatment of intracranial diseases; in recent years, intraoperative ultrasound has become a fairly routine operation; intraoperative CT guided neurosurgery in 1982, Professor Lunsford implemented by the main gun for the orientation activities, the heat boils and other skin interventional surgery. Because there are many CT and angiography shortcomings particularly vulnerable patients and doctors against the rays of the shortcomings of the emergence of MRI as people gradually move the surgery to look this potential advantage of MRI technology in the early .90 scientists, medical personnel and joint research and development engineers and technicians a palpable an open MRI scanner, which allows doctors to enter the resonance body, the image data in real time under the guidance of the surgery, the surgical imaging technology mediated real-time access to landmark stage. intraoperative MRI has gone through three stages: (1) closed (or closed) intervention framework NMR system: a surgeon can not directly contact with the patient the surgery; (2) of the open MRI system: often called C-shaped open-NMR resonance system, only through a horizontal clearance to allow doctors to operate part of the implementation of contact with patients, some simple medium human surgery; (3) the true sense of the intraoperative open MRI system: the basic design of the magnet and the scan is completely different from conventional MRI systems, magnets with similar double-donut (double doughnut) vertical design, 2 a vertical superconducting magnet between the entry and operation of space .1994 developed by GE, the first intraoperative MRI system (General Electric 0.5-T Signa SP). open intraoperative MRI system, design features: (1) 2 vertical distance between the magnet 58cm, surgery or medical personnel to enter and direct contact with patients; (2) The intake of the image space range is the range of surgical procedures, and thus no need for repeated surgery to promote the launch of the patients, while scanning bed are free to enter or completely out of magnet coils, dental chairs can also be placed between the magnets; (3) image monitor installed in the 2 the top of the vertical magnet gap, to facilitate real-time control of intraoperative medical information; (4) allows the operating microscope, stereotactic navigation, anesthesia machines, monitors and special surgical instruments, etc. to match. (5) requires a special operating room designed to meet the needs of intraoperative magnetic resonance imaging procedure.
2 intraoperative MRI system (Intraoperative MRI) and intraoperative CT (Intraoperative CT or Mobile CT) Comparison of intraoperative MRI system has its unique advantages: (1) open magnet design of the pituitary, the surgeon has enough room for maneuver, without repeatedly moving the patient; (2) intraoperative magnetic resonance imaging provided information on Dr. Yu Shu beyond the scope of naked eye, and can provide three-dimensional space to facilitate operation; (3) no CT or angiography irradiation caused suspicion; (4) magnetic resonance imaging is more sensitive than CT to distinguish between normal tissue and lesions, complete resection of lesions benefit; (5) surgery anatomical structures that occur in the displacement can be monitored in real time to prevent damage normal tissue; (6) MRI of the organization itself can change the temperature of the detectors can be used for hyperthermia monitoring operation. Disadvantages: (1) expensive, generally hospitals and patients is difficult to accept; (2) the surgical equipment used in the special requirements, limits the number of operations carried out; (3) the need to establish a special operating room, some requirements on the surrounding environment; (4 ) surgery room for maneuver is still subject to certain restrictions, is not conducive to the full range of surgery carried out. intraoperative CT advantages: (1) low cost, and patient treatment costs are low; (2) the area is small, removable strong; requirements of the work environment is low, can be applied to patients in need anywhere, very practical, disadvantages: (1) the ability to identify lesions than MRI, is limited in clinical application; (2) X Radiation protection issues have not reached the standard of protection for conventional CT room; (3) because they do not have the MRI scan which has a three-dimensional, temperature and blood flow in testability and other unique features, leading to some of the clinical treatment can not be.
No comments:
Post a Comment