Preoperative surgical planning for intracranial meningioma resection by virtual reality / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The Dextroscope system by Volume Interactions (Singapore) had been applied to minimally invasive neurosurgery in many units. This system enables the neurosurgeon to interact intuitively with the three-dimensional graphics in a direct manner resembling the way one communicates with the real objects. In the paper, we explored its values in pre-operation surgical planning for intracranial meningiomas resection.</p><p><b>METHODS</b>Brain computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) were performed on 10 patients with parasagittal and falcine meningiomas located on central groove area; brain CT, MRI and magnetic resonance angiography (MRA) were performed on 10 patients with anterior skull base meningiomas and 10 patients with sphenoid ridge meningiomas. All these data were transferred to Dextroscope virtual reality system, and reconstructed. Then meningiomas, skull base, brain tissue, drainage vein and cerebral arteries were displayed within the system, and their anatomic relationships were evaluated. Also, the simulation operations were performed.</p><p><b>RESULTS</b>For parasagittal and falcine meningiomas, the relationships of tumor with drainage vein and superior sagittal sinus were clearly displayed in the Dextroscope system. For anterior skull base and sphenoid ridge meningiomas, the relationships of tumor with bilateral internal carotid arteries, anterior cerebral arteries, middle cerebral arteries and skull base were vividly displayed within the virtual reality system. Surgical planning and simulation operation of all cases were performed as well. The real operations of all patients were conducted according to the simulation with well outcomes.</p><p><b>CONCLUSIONS</b>According to the virtual reality planning, neurosurgeons could get more anatomic information about meningioma and its surrounding structures, especially important vessels, and choose the best approach for tumor resection, which would lead to better prognosis for patients.</p>

Stereoscopic virtual reality presurgical planning for cerebrospinal otorrhea

We present a complicated case of spontaneous cerebrospinal otorrhea, which had not been cured despite undergoing 5 surgical interventions in the past. The disability to identify the location of the fistula was the main crux of the past failures. On this occasion, stereoscopic virtual reality presurgical planning was applied to identify the exact location of the fistula and a surgical simulation was performed, and was later confirmed during the actual operation. Interactive manipulation in a stereoscopic virtual environment makes the decision making process easier in the treatment of cerebrospinal otorrhea

Application of virtual reality technique in preoperative planning of neurosurgery / 中华显微外科杂志

Objective To evaluate the usefulness of virtual reality technique in preoperative planning of neurosurgery.Methods Multiple medical imaging data including magnetic resonance imaging,magntic rsonanc angiograph,magnetic resonance venography and computed tomography collected from 26 patients who suffered craniocerebral diseases,were transfered to Dextroscope system.A stereoscopic 3-D object displayed after merging,extracting,dissecting the data with the Radiodexter software in virtual reality environment.A suite of 3-D tools accessible inside the Dextroscope workspace enabled users to obtain measurement and simu- lated intraoperative viewpoint about the lesion and adjacent anatomic structure.A preoperative plan was de- fined and compared with real operation.Results 3-D stereoscopic virtual reality images of 26 cases were re- constructed successfully,and of coincidence with real situation in operations.Conclusion VR technique in Dextroscope system can integrat multiple medical imaging data quickly,intuitively and overall,offer a compre- hensive information about the lesions and related local anatomy,give a hand to optimizing the operative project and might be possible potentially to increase the safety of operation and the resecting rate of the lesion.