J Neurol Surg B Skull Base 2021; 82(S 03): e321-e329
DOI: 10.1055/s-0040-1701603
Original Article

CT-MRI Image Fusion-Based Computer-Assisted Navigation Management of Communicative Tumors Involved the Infratemporal-Middle Cranial Fossa

Rong Yang
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Han Lu
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Yang Wang
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Xin Peng
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Chi Mao
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Zhiqiang Yi
5   Department of Neurosurgery, Peking University First Hospital, Beijing, P.R. China
,
Yuxing Guo
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
,
Chuanbin Guo
1   National Clinical Research Center for Oral Diseases, Beijing, P.R. China
2   National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, P.R. China
3   Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
4   Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
› Institutsangaben

Funding This work was supported by the Capital Featured Clinical Application Research Project of Beijing Municipal Science & Technology Commission (Z161100000516043); and the General Program of The National Natural Science Foundation of China (81672664).
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Abstract

Objective Computed tomography (CT) and magnetic resonance imaging (MRI) are crucial for preoperative assessment of the three-dimensional (3D) spatial position relationships of tumor, vital vessels, brain tissue, and craniomaxillofacial bones precisely. The value of CT-MRI-based image fusion was explored for the preoperative assessment, virtual planning, and navigation surgery application during the treatment of communicative tumors involved the infratemporal fossa (ITF) and middle cranial fossa.

Methods Eight patients with infratemporal-middle cranial fossa communicative tumors (ICFCTs) were enrolled in this retrospective study. Plain CT, contrast CT, and MRI image data were imported into a workstation for image fusion, which were used for 3D image reconstruction, virtual surgical planning, and intraoperative navigation sequentially. Therapeutic effect was evaluated through the clinical data analysis of ICFCT patients after CT-MRI image fusion-based navigation-guided biopsy or surgery.

Results High-quality CT-MRI image fusion and 3D reconstruction were obtained in all eight cases. Image fusion combined with 3D image reconstruction enhanced the preoperative assessment of ICFCT, and improved the surgical performance via virtual planning. Definite pathological diagnosis was obtained in all four navigation-guided core needle biopsies. Complete removal of the tumor was achieved with one exception among the seven navigation-guided operations. Postoperative cerebrospinal fluid leakage occurred in one patient with recurrent meningioma.

Conclusion CT-MRI image fusion combined with computer-assisted navigation management, optimized the accuracy, safety, and surgical results for core needle biopsy and surgery of ICFCTs.



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Eingereicht: 13. August 2019

Angenommen: 24. Dezember 2019

Artikel online veröffentlicht:
07. Februar 2020

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