Research Of The Accuracy And Application In Neurosurgery Of DSA/MR 3D Image Fusion Technique

Objective:To explore the clinical factors that effect the accuracy of DSA/MR three-dimensional image fusion,then to improve and use them,and further explore the advantages and application value of DSA/MR three-dimensional image fusion technique used in different neurosurgical diseases.Methods:17 patients who need both DSA and MR examination in our department during January 2015 and October 2015 were chosen for this study.The patients were grouped to performed DSA and MR scan,then DSA,MRI or MRA images data were fused on Interventional tool post-processing workstation of Philips DSA machine(Allura Xper FD20).Each of the fused images were evaluated and graded by 2 neurosurgeons and 2 radiologists according to the ratings of subjective evaluation.Differences in assessment were resolved by consensus.To study the clinical factors that slice thickness of MR scan,correcting position between two examination and point method using different tissue markers how to effect the accuracy of DSA/MR three-dimensional image fusion.Then the advantages and application value of DSA/MR three-dimensional image fusion technique in evaluation preoperatively,intraoperative position,follow-up survey of different neurosurgical diseases were explored for further study.Results:Clinical factors that slice thickness of MR scan,correcting position between two examination and point method using different tissue markers are related to the accuracy of DSA/MR three-dimensional image fusion.The accuracy of the group that MR slice thickness is 1mm is higher than the group 3mm,6mm.In the DSA/MR image fusion about spinal cord,the accuracy of image fusion of the group that corrected position is higher than the group did not.In the DSA/MR image fusion about brain,the accuracy of image fusion the group that corrected position is similar to the group that did not but chose the vascular markers for point method,and the accuracy of two group are both higher than the group that did not correct position and chose the nonvascular tissue markers for point method.The fusion images clearly showed the angioarchitecture of cerebral and spinal vascular diseases and spatial relationship among cerebral and spinal vascular lesions,brain tissues(gyri or brain surface and functional areas)and other tissues,as well as the spatial relationship among intracranial space-occupying lesion,arterial and venous systems around.The information that fusion images showed was very useful for directing treatment planning and intraoperative lesion localization.Conclusions: When MR image pixels is in the same,slice thickness of MR scan are related to the accuracy of DSA/MR three-dimensional image fusion,a smaller thickness should be chosen.In the DSA/MR image fusion about spinal cord,correcting position between two examination effects the accuracy of image fusion directly and is the precondition of it.In the DSA/MR image fusion about brain,correcting position between two examination less effects the accuracy of image fusion.In addition,registration of choosing vascular markers for point method is more accurate,more time-saving and easier than the point method using nonvascular tissue markers.DSA/MR three-dimensional image fusion technique is useful for intracranial space-occupying lesion with rich blood supply and cerebral and spinal vascular lesions,especially for evaluation preoperatively,treatment planning,intraoperative position,follow-up survey of cerebral AVM,intracranial aneurysms and spinal vascular malformations.