数字化鞍区肿瘤模型的构建及在术前评估中的应用研究-外科学(神经外科学)专业论文.docx

system, tumor, brain, soft tissue and adjacent structures. There are more impressi ve than the other three- di mensional reconstruction image, and t hey can freel y observed the anat omi c landmarks for surgical approach i n any angl e and orient ati on.The models required that the image sequence must be thin sectional images. CT for skull and skin, CTA for cerebr al vascul ar, MRI- T1WI for t he brai n, opti c ne rve and t he ventr icular syst em, MRI-T1WI cont rast-enhanced sequences for t umor ti ssue, is better than the ot her sequences in the aspect of extracting images.Selecting anatomical landmarks and surgical gaps through virtual tool can simulate the operations of openi ng t he skull flap, removi ng t umor and ot hers, can al so simulate the exposure angle and t he rang of surgi cal fi el d, all the operations are for mastering the plan to protect the optic nerve, Willis ring, third ventricle, and the brain stem in t he r eal operati on.In the specific applications of pituitary adenoma models, we simulated the single nostril-transsphenoidal surgery. With the columella as a symbol, we measured the distance from the columella to nasal septum cartilage, sphenoid sinus opening and the dist ance from the mi dpoint of the anterior nostrils plane to the shallow point of anterior wall of the sphenoid sinus. To mark t he mi dpoint of sellar fl oor, t he distances were measur ed from here to the cavernous segment of ICA, optic canal, tuberculum sellae and dorsum sellae. The angle between the line of nasal columella-glabella and the direction of apporach were measured.In the VR environment, we observed the oriented anatomic landmarks through the approach angle, such as the nasal septum, the broken ends of vomer bone or lami na medi ana, apert ure of sphenoidal sinus, sphenoi dal cavi ty, sellar fl oor. We successfully simulated the approach thr ough the char act eri sti cs of individual anatomy and tumor, the intraoperative findings mai