Preoperative localization in patients with intracranial space-occupying lesions based on 3D reconstruction from MRI combined with scalp marking
HU Tao
ZHAO Yihan
CUI Jinglin
WANG Yanrong
ZHANG Tiantian
BAO Quan
Abstract：Objective To investigate the clinical application value of magnetic resonance three-dimensional reconstruction combined with scalp markers in the localization of intracranial space-occupying lesions before surgery.Methods A total of 20 patients diagnosed with intracranial space-occupying lesions preoperatively and planned for surgery from Hongqi Hospital Affiliated to Mudanjiang Medical College from June 2022 to April 2024 were prospectively enrolled,and the 3D slicer software was used to reconstruct the three-dimensional models of intracranial space-occupying lesions and scalp markers,and the lesion extent was outlined on the upper surface of the scalp according to the range of the lesion model in the vitamin E matrix.Observe whether the space-occupying lesion is exposed to the incision or bony window.During the operation,two neurosurgeons observed whether the accuracy of preoperative positioning,the measured depth,size and extent were consistent with the intraoperative results.The difference between the volume calculated by the two-dimensional formula,the volume calculated by the three-dimensional reconstruction,and the postoperative pathological volume was compared.Results All the 20 patients successfully completed the operation,of which 19 had accurate positioning and 1 had deviation.There were 2 cases of brain abscess,3 cases of glioma,11 cases of meningioma,2 cases of hemangiopericytoma,and 1 case of metastatic tumor.The Kappa coefficients of the two neurosurgeons were 0.613,0.835 and 0.701,respectively,in the evaluation of whether the preoperative positioning accuracy,depth and range were consistent with the intraoperative results.There was no significant difference between the two-dimensional formula and the three-dimensional reconstruction(P>0.05),the two-dimensional formula was not statistically significant(P>0.05),and the three-dimensional reconstruction was statistically significant(P<0.05).Among the 14 cases in the morphological regular group,there was no significant difference between the lesion volume calculated by the two-dimensional formula and the lesion volume calculated by the three-dimensional reconstruction(P>0.05),and in the 6 cases with irregular morphology,the lesion volume calculated by the two-dimensional formula was statistically significant compared with the lesion volume calculated by the three-dimensional reconstruction(P<0.05).Conclusion Magnetic resonance 3D reconstruction combined with scalp markers in the clinical application of preoperative intracranial space-occupying lesion localization is accurate,simple,convenient and practical,which is helpful for neurosurgeons to design surgical approaches,reduce the diameter of skull fenestration,reduce intracranial injury and improve patient prognosis.
Keywords：magnetic resonance3D reconstructionscalp markerintracranial space-occupying lesionpreoperative localization
Publication Date：2025-05-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 627-632 )