【摘要】 目的 探索术前多模态三维影像重建技术在岩斜区肿瘤手术中的应用价值。方法 连续选取2022年1月至2024年7月河北医科大学第二医院收治的17例岩斜区肿瘤患者作为观察组,使用3D Slicer和DSI Studio软件重建患者的肿瘤、颅骨、毗邻血管等重要结构,并根据重建影像制定个性化的手术方案;另选取医院2016年1月至2022年1月期间采用传统二维影像指导手术规划的20例患者作为对照组。比较两组患者的肿瘤切除率、术后并发症发生率、出入院KPS评分及术后住院时长的差异。结果 观察组所有患者成功完成术前影像三维重建指导下的手术,镜下结构与术前重建相符,重要结构保护良好。两组肿瘤全切率、新发脑神经功能障碍和术后肺炎症状比较差异无统计学意义(P> 0.05)。但观察组在术后神经功能障碍(P <0.05)和颅内感染发生率(P <0.05)上显著低于对照组。观察组KPS评分改善显著优于对照组(P <0.05),且术后平均住院时间显著缩短(P <0.05)。结论 多模态影像三维重建可直观呈现岩斜区肿瘤与周围重要结构的解剖毗邻关系,为术者制定个性化手术方案提供客观依据。本研究结果显示,应用该技术的患者术后KPS评分更高、住院时间更短,局灶神经功能损伤发生率更低,提示多模态影像三维重建在岩斜区肿瘤手术中具有一定的临床应用价值。更多还原

【Abstract】 Objective This study aimed to evaluate the clinical value of preoperative multimodal three-dimensional(3D) image reconstruction in the surgical management of petroclival region tumors.Methods Seventeen patients with petroclival region tumors who underwent preoperative multimodal imaging and three-dimensional reconstruction using software such as 3D Slicer and DSI Studio to guide surgical planning were randomly selected as the observation group in the Second Hospital of Hebei Medical University from January2022 to July 2024.Additionally,twenty patients who received conventional two-dimensional imaging-guided planning from January 2016 to January 2022 were randomly selected as the control group.The two groups were compared regarding tumor resection rate,incidence of postoperative complications,Karnofsky Performance Status(KPS) scores at admission and discharge,and length of postoperative hospital stay.Results All surgeries in the observation group were successfully performed with 3D reconstruction guidance,and intraoperative anatomical relationships were consistent with preoperative models.There were no significant differences in gross total resection rates,new cranial nerve deficits,or incidence of postoperative pneumonia between the two groups(P> 0.05).However,the observation group demonstrated significantly lower rates of postoperative neurological dysfunction(P <0.05) and intracranial infection(P <0.05).Additionally,the observation group had significantly higher KPS scores at discharge(P <0.05) and shorter postoperative hospital stays(P <0.05).Conclusion Multimodal 3D image reconstruction can intuitively demonstrate the anatomical relationship between petroclival tumors and surrounding vital structures,providing an objective basis for surgeons to formulate individualized surgical plans.The results of this study showed that patients treated with this technique had higher postoperative Karnofsky performance status(KPS) scores,shorter hospital stays,and a lower incidence of focal neurological deficits,suggesting that multimodal3D image reconstruction has certain clinical value in the surgery of petroclival tumors.更多还原