Purpose

This work exploits virtual reality technique to analyse and optimize the preoperative planning of freehand external ventricular drain (EVD) insertion. Based on the three-dimensional (3D) virtual brain models, neurosurgeons can directly observe the anatomical landmarks and complete the simulated EVD insertion. Simulation data is used to optimize preoperative planning parameters to ensure the surgical performance.

Methods

We used the computed tomography (CT) scans to construct the 3D virtual brain models. A group of EVD insertions were simulated by inserting virtual catheters at different entry points. The key parameters including the location of entry point, the catheter orientation, the catheter tip position on lateral ventricles, and the insertion depth were recorded. A data analysis method was then applied to optimize these parameters, resulting in the optimal parameters for the EVD insertion.

Results

When the lateral distance of entry point ranged from 2.5 to 3 cm, the success rate of 204 cases was 97.79%, which was higher than that of the classic method (59.52%). The optimal insertion angle towards the sagittal plane ranged from 10.46° to 12.73°. To prevent penetrating the lateral ventricles, the insertion depth was optimized to be 3.28 to 4.58 cm.

Conclusions

The proposed data analysis method is helpful to optimize the key parameters of the preoperative planning, and provides useful references for neurosurgeons to perform the freehand EVD insertion. The EVD insertion experiments on 3D printing model had a success rate of 93.75%, which verified the effectiveness of the data analysis.

中文翻译：

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基于虚拟现实的数据分析，可优化徒手进行外部心室引流

目的

这项工作利用虚拟现实技术来分析和优化徒手外部心室引流（EVD）插入的术前计划。基于三维（3D）虚拟脑模型，神经外科医生可以直接观察解剖标志并完成模拟EVD插入。仿真数据用于优化术前计划参数，以确保手术性能。

方法

我们使用计算机断层扫描（CT）扫描来构建3D虚拟大脑模型。通过在不同的入口点插入虚拟导管来模拟一组EVD插入。记录关键参数，包括入口点的位置，导管方向，侧脑室上的导管尖端位置以及插入深度。然后应用数据分析方法来优化这些参数，从而为EVD插入提供最佳参数。

结果

当进入点的侧向距离在2.5至3 cm之间时，204例的成功率为97.79％，高于经典方法的59.52％。朝向矢状面的最佳插入角度为10.46°至12.73°。为防止穿透侧脑室，插入深度已优化为3.28至4.58 cm。

结论

所提出的数据分析方法有助于优化术前计划的关键参数，并为神经外科医生进行徒手EVD插入提供有用的参考。在3D打印模型上进行EVD插入实验的成功率为93.75％，这证明了数据分析的有效性。