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论著:磁导航引导主动脉支架植入术的实验研究
Aorta Stent Implantation Guided by Magnetic Navigation System: an in Vitro Study
王肃 蔡俊锋 罗哲 顾力栩 王哲 赵强
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作者单位:上海交通大学附属瑞金医院心脏外科
中文关键字:磁导航系统;实时超声;介入治疗;主动脉支架;模型实验
英文关键字:Magnetic navigation system; Real time ultrasound; Interventional therapy; Aorta stent; Vitro experiment
中文摘要:目的:研究虚拟现实环境下应用磁导航引导对主动脉夹层进行支架植入术的可行性。方法:利用术前CT影像信息,通过计算机进行三维解剖结构重建,与模型完成术前配准,并通过融入实时超声图像,形成虚拟现实环境。对介入手术器械和主动脉支架植入物进行结构性能改造,应用NDI Aurora电磁导航系统,在体外实验模型中实现对器械和植入物的精确示踪和三维立体定位,参照支架前传感器完成支架释放,并以经胸超声和CT进行验证。记录操作时间(T),计算配准误差(E1),记录植入后支架实际位置与目标位置之间的误差即总实验误差(E2)。结果:所有主动脉支架植入操作均成功完成,平均操作时间为(38.4±3.9)min,平均配准误差为(0.59±0.27)mm,平均总实验误差为(1.94±1.15)mm。配准和操作精确度均满足临床要求。 结论:体外模型试验证明,虚拟现实环境下磁导航引导的主动脉支架植入术操作直观、简单、无辐射,具有较高的精确度和良好的重复性,可以作为新的介入示踪和定位方法。
英文摘要:Objective:To evaluate the feasibility, repeatability and accuracy of using magnetic navigation system to guide aorta stent implantation in virtual reality environment. Methods:Preoperative CT image information was loaded into the computer and reconstructed to a 3D anatomic structure. The next step was to complete preoperative registration with the model and to infuse the real time ultrasound images. After that, the virtual reality environment was established. The interventional devices were transformed so that in models they can be traced accurately and located in a 3D anatomic structure by using Aurora magnetic navigation system. The aorta stent was deployed according to the sensor coil in front of the stent. The accuracy was proved by real time ultrasound and postoperative CT. The operation time (T), registration error (E1), and the total operation error (E2) were recorded and calculated. Results: All aorta stents were successfully deployed in accurate positions. The average operation time was (38.4±3.9) min; the average registration error was (0.59±0.27) mm; the average total operation error was (1.94±1.15) mm. Registration and operation accuracy satisfied the clinical requirements. Conclusions: The experiment of in vitro models has proved that in virtual reality environment aorta stent implantation guided by magnetic navigation system is easy and repeatable. This method can be used as a new interventional tracing and positioning method.
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