Author/Editor		Matos, Boštjan; Prestor, Borut; Žele, Tilen; Knific, Jernej; Bajrović, Fajko F
Title		Računalniško podprto predoperativno interaktivno 3-D načrtovanje operativnega posega v nevrokirurgiji
Type		članek
Source		In: Tonin M, Repše S, Tomažič A, et al, editors. Zbornik predavanj 42. podiplomskega tečaja kirurgije; 2007 feb 2-3; Ljubljana. Ljubljana: Slovensko zdravniško društvo, Združenje kirurgov Slovenije,
Publication year		2007
Volume		str. 151-61
Language		slo
Abstract		Background. Present paper describes our experiences with the use of three-dimensional (3D) reconstruction of medical images for pre-operative planning and intra-operative navi- . gation in neurosurgery of cortical and sub-cortical tumors. Methods. In patients with cortical and sub-cortical tumors, before surgery 3D models of tumor, normal nearby brain tissue, liquor spaces and cortical veins were reconstructed from magnetic resonance images and in selected cases functional magnetic resonance images using the computer program "3D Slicer". Based on these models, the skin incision, trepanation opening and trans-cortical approach to the tumor were planned in virtual 3D computer space. Collected positional data were transferred from the 3D computer space to the operation field using distances from the artificial (fat tablets) and typical anatomical landmarks on skin (eg. ear) and cortical surface (eg. cortical veins). Results. Computer assisted 3D reconstruction provided a surgeon more accurate localization of tumor than conventional mental reconstruction of the 2D medical images. In all cases the position, size and shape of skin incision, trepanation opening, cortical veins, sulci and gyri visualized on computer screen before surgery matched the actual anatomy observed during surgical procedure. In all patients was the lesion precisely found and macroscopically totally resected. Conclusions. Precise pre-operative computer assisted 3D reconstruction of 2D medical images provides important additional information about spatial localization of cortical and sub-cortical tumors in comparison to mental reconstruction of 2D medical images. Therefore, it improves the accuracy of planning the surgical procedure and makes the surgical procedure less invasive and less risky.