Application Of 3D-Slicer Software In Adjuvant Surgical Resection Of Medial Sphenoid Ridge Meningioma

Objective:The anatomical location of medial sphenoid ridge meningioma is deep,and it is difficult to expose the operative field.At the same time,it is adjacent to many important structures,so the operative risk is high,the operation is difficult,and complications are easy to occur.3D-Slicer software to three-dimensional structure model is established according to the basic imaging data,combined with the mixed reality technology,can more intuitive clear tumor location and with the blood vessels,nerves,and the location of the cavernous sinus and other important organization relationship,to develop a plan of operation,surgical approach,reduce the surgical complications,enhance the tumor cut rates.In this study,through the comparison of total tumor resection rate and bone flap area between the two groups,the significance of 3D-Slicer software in auxiliary surgical resection of medial sphenoid ridge meningioma was proved.Methods:A total of 28 patients with medial sphenoid ridge meningioma from the Neurosurgery Department of the Second Hospital of Hebei Medical University from October 2018 to March 2021 were selected and randomly divided into the control group and the experimental group.Brain CT,MRI scan,enhanced MRI,MRA or CTA or DSA imaging data were completed preoperatively in both groups.Control group using traditional method,after the tumor location and selection of appropriate surgical approach surgery,the experimental group by applying 3D-Slicer software to establish three-dimensional structure model,combined with the mixed reality devices,determine the location of the tumor in parts,and other organizations,assisted surgery plan formulation,choice of surgical approach after surgery.The data of tumor resection and bone flap area in the two groups were collected and statistically analyzed to evaluate the efficacy of 3D-Slicer software in assisting surgical resection of medial sphenoid ridge meningioma.Results:1.The application of 3D-Slicer software to establish three-dimensional model,can be more intuitive to determine the tumor location,tumor and surrounding important organization of space position relations,auxiliary operation plan,choice of surgical approach,intraoperative combined with mixed real equipment,to provide real-time data model,to enhance the tumor cut rate,reduce the operation risk,reduce bleeding and complications such as function of nerve damage,at the same time to explain to the patient and family condition is more convenient.2.The coincidence rate between the modeling results of the experimental group and the actual situation during the operation was 85.7%,among which the modeling results of 12 cases were consistent with the actual situation during the operation,and2 cases were not completely consistent.In these 2 cases,the deviation was caused by the large tumor volume,extrusion and wrapping around the internal carotid artery and its branches.3.Evaluate the difference between two groups of cases surgery cut all:all cases tumors cutting rate was 71.4%,the control operation all cut rate was 50%,the experimental surgery cut all rate was92.9%,the selection of chi-square Fisher’s exact probability method of statistical analysis,it is concluded that P=0.033<0.05,tumor cut all degree of difference between experimental group and control group have statistical significance.The results indicate that 3D-Slicer software can improve the total resection rate of medial sphenoid ridge meningioma.4.The difference in bone flap area between the two groups was evaluated:the control group(120.29±48.12)cm~2 and the experimental group(85.43±8.02)cm~2.The Wilcoxon rank sum test of the two independent samples was used for statistical analysis,and P=0.038<0.05 was obtained.The results indicated that 3D-Slicer software assisted resection of medial sphenoid ridge meningioma could reduce the area of bone flap and reduce surgical trauma.Conclusions:Type for medial sphenoid ridge meningiomas patients require surgical treatment,application of 3D-Slicer software to establish three-dimensional structure model,combined with the mixed reality device,can more intuitive clear tumor location and the space position relations,with important organization around the secondary surgery planning and choice of surgical approach,reduce operation trauma and complication,raise the whole cutting rate and so on has important and positive significance.