报道了一种用于神经外科手术立体定向导航的原位同轴投影技术。该技术可以自动完成图像与患者位置的配准,并将术前重建的手术靶点和规划入路实时原位地投射到手术部位,指导术者按照预定靶点和入路进行精准手术。同轴标定实验表明该系统在工作距离下的平均投影仪重投影误差为0.4 mm,具有较高的摄影-投影同轴度。立体定向投影精度实验表明该系统在不同投射角度下的靶点平均投影误差为1.2 mm,具有较高的立体定向导航精度。仿体实验表明该系统在不同的模拟手术条件下可达到0.3 mm到3.1 mm的平均投影误差,具备良好的临床应用可行性。 跟其他立体定向导航系统相比,原位同轴投影技术摈弃了屏幕显示,可以避免术者视角在显示器和术野之间频繁切换带来的不便和操作误差,提升了手术效率,在脑肿瘤及脑血肿手术导航中具有广阔的临床应用前景。

In this study, we report a novel stereotactic neurosurgical navigation system based on orthotopic coaxial projective imaging (CPI). The proposed system facilitates automatic registration of the position of the patient, real-time projection of the preoperatively reconstructed surgical target and the planned approach in the surgical field, and precise intraoperative guidance with respect to the target and the approach. The average reprojection error of the system is 0.4 mm at its working distance via a coaxial calibration test, indicating a high photographic-projection coaxiality. The average projection error of the system in a stereotactic projection test is 1.2 mm at different projection angles, indicating a high stereotactic navigation accuracy. In a neurosurgery simulated by using a phantom model, the average projection error of the system is 0.3--3.1 mm in different operational conditions, indicating the technical feasibility of the system for neurosurgical navigation. Unlike the conventional stereotactic surgical navigation systems that require a display screen, the CPI system avoids frequent viewpoint changes between the screen and the surgical field, eliminates the possible operating errors, and improves the surgical efficiency. The proposed system may be applied to surgically treating many neurological diseases, including brain tumors and brain hematomas.