摘要
目的探讨三维多模态影像重组技术在颅底手术教学中的应用效果。方法连续纳入2019年1—12月在首都医科大学宣武医院神经外科颅底和肿瘤中心轮转的培训人员60名作为研究对象,均为男性,其中博士研究生22名、硕士研究生8名、"专科医师规范化培训"医师10名、轮转进修医师(均为主治医师) 20名。通过简单随机方法,将60名培训人员平均分为对照组和观察组,各30名。对照组采用传统的方法,结合手术录像讲解术前影像;观察组在传统教学方法基础上增加三维可视化教学内容。使用三维Slicer软件将患者术前影像数据进行三维重组,模拟正常的颅脑解剖以及手术入路。每次教学活动结束后,对两组培训效果进行评价。评估指标分为客观(理论考试)及主观(能力的自我评价)两部分,理论考试分为笔试(占60%)、影像资料解读和病情分析(占40%)。主观评价项目为解剖基础、影像解读、手术入路制定、手术操作注意事项、手术并发症的预防等,分为显著提高、提高一般和无提高。结果 (1)观察组笔试、影像资料解读和病情分析成绩均优于对照组,差异均有统计学意义[笔试:(52.0±2.5)分比(48.8±3.2)分,t=4.359;影像资料解读和病情分析:(32.4±0.3)分比(27.4±0.6)分,t=7.122;均P <0.01]。(2)两组培训人员经培训后均认为能力有所提高。观察组解剖基础、影像解读、手术入路制定、手术操作注意事项及并发症预防方面显著提高比例均高于对照组,组间差异均有统计学意义[解剖基础:86.7%(26/30)比40.0%(12/30),χ~2=14.067;影像解读:80.0%(24/30)比33.3%(10/30),χ~2=13.030;手术入路制定:93.3%(28/30)比46.7%(14/30),χ~2=15.556;手术操作注意事项:93.3%(28/30)比33.3%(10/30),χ~2=23.254;并发症预防:86.7%(26/30)比36.7%(11/30),χ~2=15.864;均P <0.01]。结论利用术前影像对病变进行三维Slicer重组,可以准确了解病变周围的解剖结构。通过三维重�
Objective To explore the effect of teaching application of the three dimensional( 3 D)-Slicer image reconstruction in the skull base surgery.Methods A retrospective control study was performed involving 60 rotating trainees at the skull Base and Tumor Center of Department of Neurosurgery in Xuanwu Hospital from January 2019 to December 2019.All the trainees were divided into two groups randomly as the control group and the observation group,30 in each group.The traditional teaching model was carried out in the control group to explain the preoperative image combined the surgical video,while the observation group was added the 3 D visualization.Using the 3 D-Slicer software to construct the 3 D images of normal brain anatomy and according to the perioperative images to simulate the operative approach.The teaching effect was evaluated through theoretical examinations and self-evaluation at the end.Results The scores of theoretical exams of the observation group were higher than those of the control group,and the differences were statistically significant( written test: [52.0 ± 2.5]scores vs.[48.8 ± 3.2]scores,t = 4.359;image data interpretation and disease analysis: [32.4 ± 0.3]scores vs.[27.4 ±0.6]scores,t = 7.122;all P < 0.01).The ratio of significant improvement in all aspects in the observation group was higher than that in the control group,and the differences were statistically significant between the two groups( anatomical basis: 86.7 % [26/30] vs.40.0% [12/30],χ~2=14.067;the ability to interpret images: 80.0% [24/30] vs.33.3% [10/30],χ~2= 13.030;surgical approach: 93.3%[28/30] vs.46.7%[14/30],χ~2= 15.556;notes on operation: 93.3%[28/30] vs.33.3%[10/30],χ~2= 23.254;complication prevention: 86.7%[26/30] vs.36.7 % [11/30 ],χ~2=15.864;all P < 0.01).Conclusions The preoperative images were used to reconstruct the lesion with 3 D-Slicer,which can help trainees understand the anatomical structure around the lesion accurately.The 3 D reconstruction of simulated lesions is conducive to the teaching of atten
作者
宋刚
李梦君
张晓雨
王旭
梁建涛
郭宏川
肖新如
陈革
鲍遇海
李茗初
Song Gang;Li Mengjun;Zhang Xiaoyu;Wang Xu;Liang Jiantao;Guo Hongchuan;Xiao Xinru;Chen Ge;Bao Yuhai;Li Mingchu(Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2020年第8期455-458,496,共5页
Chinese Journal of Cerebrovascular Diseases
关键词
颅底
神经外科
肿瘤
三维Slicer
影像重组
Skull base
Neurosurgery
Tumor
Three dimensional Slicer
Image reconstruction
