arXiv:2510.16347eess.IVq-bio.QM2025-10

用MRI与AR实现无辐射脊柱手术导航,提升精准度。

Computer Navigated Spinal Surgery Using Magnetic Resonance Imaging and Augmented Reality

  • 结合MRI与双ArUco标记AR追踪患者实时位置
  • 双标记追踪使穿刺误差平均仅2毫米,媲美传统方法
  • 适合需减少辐射暴露的脊柱疼痛治疗场景

当前脊柱疼痛管理术如射频消融(RFA)和硬膜外类固醇注射(ESI)依赖荧光透视进行穿刺定位,导致患者与医生暴露于电离辐射。本文提出一种无辐射手术导航系统,融合磁共振成像(MRI)与基于ArUco标记的增强现实(AR)。对腰椎模拟体获取高分辨率MRI并构建表面网格,采用拉普拉斯平滑算法优化模型精度。使用商用立体相机(ZED2)追踪患者身上的单或双ArUco标记,实时确定患者姿态。定制化AR软件将MRI图像叠加至患者体表,使医生可同时观察体表及深层解剖结构。在3D打印的三椎体模拟体上进行穿刺实验显示,双标记追踪显著提升穿刺精度,平均偏差距离低于单标记方案。平均穿刺偏差达2毫米,与传统荧光透视技术相当。该无辐射系统展现出替代荧光透视、改进图像引导脊柱导航的潜力。

原文摘要 · Abstract (English)

Current spinal pain management procedures, such as radiofrequency ablation (RFA) and epidural steroid injection (ESI), rely on fluoroscopy for needle placement which exposes patients and physicians to ionizing radiation. In this paper, we investigate a radiation-free surgical navigation system for spinal pain management procedures that combines magnetic resonance imaging (MRI) with fiducial ArUco marker-based augmented reality (AR). High-resolution MRI scans of a lumbar spinal phantom were obtained and assembled as a surface mesh. Laplacian smoothing algorithms were then applied to smoothen the surface and improve the model fidelity. A commercially available stereo camera (ZED2) was used to track single or dual fiducial ArUco markers on the patient to determine the patient's real-time pose. Custom AR software was applied to overlay the MRI image onto the patient, allowing the physician to see not only the outer surface of the patient but also the complete anatomy of the patient below the surface. Needle-insertion trials on a 3D-printed 3-vertebra phantom showed that dual-ArUco marker tracking increased the accuracy of needle insertions and reduced the average needle misplacement distance compared to single-ArUco marker procedures. The average needle misplacement is comparable to the average deviation of 2 mm for conventional epidural techniques using fluoroscopy. Our radiation-free system demonstrates promise to serve as an alternative to fluoroscopy by improving image-guided spinal navigation.

脊柱手术无辐射导航增强现实MRI

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