Application Of Multimodal Image Fusion Based On 3D Slicer Software In Neurosurgery

Part 1、Application of 3D slicer assisted minimally invasive surgery in the treatment of hypertensive intracerebral hemorrhage and analysis of factors affecting the prognosis of the patientsObjective to explore the application of minimally invasive surgery based on 3D slicer in the treatment of hypertensive intracerebral hemorrhage（hypertensive intracerebral hemorrhage,HICH）and to analyze the factors affecting the prognosis of the patients.Methods the clinical data of 60 patients with HICH were retrospectively analyzed and divided into two groups: 3D slicer assisted minimally invasive surgery group and simple minimally invasive surgery group.The hematoma clearance rate,intraoperative blood loss,operation time and prognosis were analyzed and compared between the two groups.The factors that may affect the recovery of neurological function in patients with HICH were screened by univariate and multivariate analysis.Results 3D slicer can be used to calculate hematoma volume more accurately;compared with minimally invasive surgery group,minimally invasive surgery based on 3D slicer can reduce intraoperative blood loss,increase hematoma clearance rate and improve prognosis;surgical methods and hematoma volume may be independent risk factors affecting the prognosis of patients.Conclusion 3D slicer-assisted minimally invasive surgery for HICH can achieve accurate preoperative location,simulate surgical approach,effectively remove intracranial hematoma,improve surgical efficacy and improve clinical prognosis;intracranial hematoma volume and 3D slicer-assisted minimally invasive surgery may be independent risk factors affecting the prognosis of patients with HICH;baseline NIHSS score,baseline GCS score and hematoma clearance rate have influence on the prognosis of patients with HICH treated by 3D slicer-assisted minimally invasive surgery.Part 2、Application of multimodal image fusion based on 3D slicer software in meningioma surgeryObjective simple MRI images can only show the situation of intracranial lesions,but there are some limitations in showing the relationship between lesions and skulls.In order to improve this deficiency,3D slicer software can be used to realize the multimodal image fusion of CT and MRI,and fully complement the advantages of different modal images.The purpose of this study is to explore the application value of multimodal image fusion based on 3D slicer software in patients with meningioma surgery.Methods the DCIOM imaging data of 18 inpatients with meningioma in the Department of Neurosurgery of the second affiliated Hospital of Bengbu Medical College from April 2020 to December 2021 were collected.The collected images were imported into 3D slicer software system,and multimodal image fusion was performed by neurosurgeons,then the three-dimensional model was reconstructed,and the three-dimensional anatomical relationship between meningioma and surrounding tissue was clarified.Results In all cases,the anatomical model of meningioma was reconstructed by the same neurosurgeon,and the three-dimensional model was used to design the size of bone flap before operation to reduce the injury of intracranial blood vessels.All operations were completed successfully under microscope.All the 18 patients achieved total or subtotal resection of the tumor tissue on the premise of avoiding vascular and nerve injury.among them,12 patients with meningioma underwent Simpson I resection and 6 patients with Simpson II grade meningioma.only one patient had a small amount of intracranial hemorrhage in the CT area of the skull after operation,and no obvious intracranial hemorrhage was found in the rest of the patients.No cranial nerve injury was found in all patients after operation,and the neurological defect was mild after operation.Conclusion The preoperative planning made by using 3D slicer for multimodal image fusion can make meningioma surgery more accurate,minimally invasive and safe,and has a good application prospect,which is a new direction of neurosurgery in the future.Using 3D slicer for multimodal image fusion and reconstructing the threedimensional model of tumor can be used to assist the design of individualized surgical approach,reduce surgical risks,reduce surgical complications,increase the resection rate of tumor tissue,and improve the prognosis of patients.