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立體定向電極規(guī)劃中的神經(jīng)纖維束示蹤

Neural fiber tracking in the planning of stereotactic electrode

作者: 張文東  翟方文  丁輝王  廣志 
單位:清華大學(xué)醫(yī)學(xué)院生物醫(yī)學(xué)工程系(北京100084)
關(guān)鍵詞: 彌散張量成像;立體定向電極規(guī)劃;電極觸點(diǎn);纖維束可視化;3D  Slicer 
分類號(hào):R318.04
出版年·卷·期(頁碼):2017·36·6(551-557)
摘要:

目的 基于患者的彌散張量成像數(shù)據(jù)(diffusion tensor imaging,DTI),在立體定向電極手術(shù)置入規(guī)劃過程中提供電極觸點(diǎn)周圍神經(jīng)纖維束信息,以幫助醫(yī)生在更全面掌握腦解剖結(jié)構(gòu)和神經(jīng)連接情況的基礎(chǔ)上制定電極植入規(guī)劃方案。方法 基于3D Slicer的軟件框架和模塊化的設(shè)計(jì)思想,設(shè)計(jì)了一個(gè)可用于計(jì)算和呈現(xiàn)電極周圍神經(jīng)束的處理模塊。在模塊中根據(jù)手動(dòng)規(guī)劃的立體定向電極路徑計(jì)算各觸點(diǎn)位置的空間坐標(biāo),并呈現(xiàn)電極規(guī)劃方案中電極觸點(diǎn)周圍的神經(jīng)纖維束分布情況。結(jié)果 在T1加權(quán)像上手動(dòng)選擇電極路徑后,模塊可在影像結(jié)構(gòu)上呈現(xiàn)多支電極路徑周圍神經(jīng)纖維束的空間分布和連接情況;并依據(jù)電極路徑在二維影像上的投影位置及斜切面模式下的顯示結(jié)果,呈現(xiàn)電極與神經(jīng)纖維束和影像結(jié)構(gòu)之間的相對(duì)位置關(guān)系。結(jié)論 本文的處理模塊可在結(jié)構(gòu)像基礎(chǔ)上進(jìn)一步提供手動(dòng)選擇路徑中電極周圍纖維束的空間位置及分布范圍的信息,輔助醫(yī)生規(guī)劃與調(diào)整電極置入路徑。

Objective Based on patients’ diffusion tensor imaging(DTI),in the processing of planning stereotactic electrode insertion path,the information about neural fiber tracts surrounding the electrode contacts were presented to assist doctors to make plans for electrode insertion based on comprehensively grasping the knowledge about anatomic structure and neural connections in patients’ brain.Methods Based on the framework of 3D Slicer and idea of module design,we developed a scripted module in calculating and displaying fiber tracts around electrodes.The module could calculate contacts’ coordinates according to the manual planning of stereotactic electrode paths and present the distribution of fiber tracts around electrodes’ contacts in the planning scheme.Results After manually selected the electrode insertion paths in T1-weighted images,the distributions and connections of the neural fibers corresponding to the multiple electrode paths in the planning were revealed.According to paths’ projections in 2D slices and displaying in the pattern of the oblique plane,the relative positions of electrodes and their corresponding neural fibers were shown through the module.Conclusions On the basis of structure images,the module in this article could further provide information about the fibers’ positions and distributions around the contacts of electrodes in the manually planning,and assist doctors to plan and adjust the insertion paths of electrodes.

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