Objective: To explore the clinical and teaching application value of virtual reality technology in preoperative planning and intraoperative guide of glioma located in central sulcus region. Method: Ten patients with glioma in the central sulcus region were proposed to surgical treatment. The neuro-imaging data, including CT, CTA, DSA, MRI, fMRI were input to 3dgo sczhry workstation for image fusion and 3D reconstruction. Spatial relationships between the lesions and the surrounding structures on the virtual reality image were obtained. These images were applied to the operative approach design, operation process simulation, intraoperative auxiliary decision and the training of specialist physician. Results: Intraoperative founding of 10 patients were highly consistent with preoperative simulation with virtual reality technology. Preoperative 3D reconstruction virtual reality images improved the feasibility of operation planning and operation accuracy. This technology had not only shown the advantages for neurological function protection and lesion resection during surgery, but also improved the training efficiency and effectiveness of dedicated physician by turning the abstract comprehension to virtual reality. Conclusion: Image fusion and 3D reconstruction based virtual reality technology in glioma resection is helpful for formulating the operation plan, improving the operation safety, increasing the total resection rate, and facilitating the teaching and training of the specialist physician.
目的：探讨虚拟现实技术在神经外科中央区胶质瘤切除术术前计划和术中引导中的临床和教学应用价值。 方法： 2017年5月至2017年8月期间陆军军医大学西南医院神经外科，对拟采用手术治疗的中央区胶质瘤患者10例，采取其CT、CTA、DSA、MRI及fMRI等影像资料输入3dgo sczhry工作站进行图像融合处理和三维重建，术前及术中可在虚拟现实影像上观察病变与周围结构的空间关系，设计手术入路、模拟手术过程、术中辅助决策，并与实际术中所见进行比对，与传统术前、术中规划方式进行对照，并同时应用于专科医师手术教学培训。 结果： 10例患者术中情况与虚拟现实技术术前模拟高度吻合，提高了手术规划可行性，术中直观的3D引导提高了手术实施效率，降低了功能区保护同时全切病变的难度；该技术还降低了专陪医师的抽象理解难度，提高了培训效率和效果。 结论：虚拟现实技术在中央区胶质瘤切除术中的应用，有助于术前制定周详的手术计划、术中高效率辅助决策，提高手术安全性与病灶的全切除率，同时是专科医师教学和训练的有力工具。.
Keywords: Decision Support Techniques; Imaging, three-dimensional; Neurosurgical Procedures; Surgery computer-assisted; Teaching.