摘要： 目的 探讨多模态影像融合三维重建技术在中央区脑膜瘤手术中的应用价值。方法与结果 纳入2019年4月至2021年5月中国科学技术大学附属第一医院收治的46例中央区脑膜瘤患者，采用3D Slicer软件处理原始影像学数据，重建出肿瘤、瘤周静脉、大脑皮质、颅骨、头皮等三维模型，术前采用手机Sina软件进行体表投影辅助皮瓣和骨窗设计，结合术中实际肿瘤部位及其毗邻结构，验证术前重建效果，于显微镜下切除肿瘤。所有患者均完成术前重建，术中验证肿瘤及其毗邻解剖结构与术前三维重建模型相吻合，均无因术前规划不当引起术中肿瘤显露不充分带来的损伤。46例患者均全切除肿瘤，32例未出现肢体功能障碍、8例肢体功能明显改善、6例肌力下降；均未发生癫发作，1例出现术后感染；无一例死亡。结论 3D Slicer三维重建技术应用于中央区脑膜瘤，可直观、多维度、动态、立体展示肿瘤及其毗邻解剖结构，指导术中最大程度地切除肿瘤及保护瘤周静脉和大脑皮质。手机Sina软件应用于中央区脑膜瘤术前定位具有精确、安全、无创性、方便等实用价值，值得进一步研究与推广。

关键词: 脑膜瘤, 多模态成像, 成像, 三维, 神经外科手术

Abstract: Objective To explore the application value of multi-modal image fusion three-dimensional (3D) reconstruction technology in operation of meningioma in the central area. Methods and Results Using multi-modal image fusion 3D reconstruction technology to study 46 patients admitted to The First Affiliated Hospital of University of Science and Technology of China from April 2019 to May 2021. 3D Slicer software was used to process the original imaging data to reconstruct 3D models of tumor, peritumoral vein, cerebral cortex, skull, scalp, etc., and intraoperatively Sina software was used for projection assisted incision design to verify the actual tumor position and its adjacency structures preoperatively. To reconstruct the effect before surgery, the tumor was removed under microscopy. All patients completed the preoperative reconstruction. The intraoperative verification showed that the tumor and its adjacency structures were in good agreement with the preoperative 3D model. All patients did not cause unnecessary injury due to insufficient preoperative exposure caused by improper preoperative planning. Forty-six cases of meningioma in the central area were completely removed under the microscopy, 32 cases had no limb dysfunction, 8 cases had significant improvement in limb function, and 6 cases had decreased muscle strength. None of the patients had epileptic seizures. One patient had postoperative infection, after active anti-infection, he was cured and discharged. There was no death. Conclusions The 3D Slicer reconstruction technology applied to meningioma in the central area can display the tumor and its adjacent structures in a intuitive, multi-dimensional and dynamic 3D manner, guide the maximum resection of the tumor and protect the peritumoral vein and cortex during the operation. Sina software has clinical and practical value in preoperative positioning of meningioma in the central area, such as accuracy, safety, non-invasiveness, and convenience, and it is worthy of further research and promotion.

Key words: Meningioma, Multimodal imaging, Imaging, three-dimensional, Neurosurgical procedures