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磁场导航智能定位系统引导穿刺准确性评估的实验研究

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R500 2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6磁 场 导 航 智 能 定 位 系 统 引 导 穿 刺 准 确 性评 估 的 实 验 研 究DOI:10.3877/cma.j.issn.1672-6448.2013.06.016:(30970837);(NCET-06-0723):200072:,Email:xuhuixiong@hotmail.com(IP)。鹌,,( <50mm)、( 50100mm)( >100mm), IP5。、,。、、,IP(1.881.18)、(1.560.56)、(3.991.10)cm,(4.522.23)、(4.491.73)、(3.932.19)cm。、,IP,(t -2.345,P 0.047;t -3.608,P 0.007);,IP(t 0.058,P 0.955)。IP,、,(t 1.073,P0.011;t -0.188,P 0.042);(t-1.927,P 0.501)。IP;、、, 2、1、2。、,IP,(U -2.372,P 0.018;U-2.390,P 0.032);,IP(U -1.000,P 0.690)。、、,IP(21.202.39)、(27.004.00)、(31.803.83)s,(45.209.68)、(26.804.21)、(54.6013.48)s。、,IP,(t -5.383,P 0.001;t -3.637,P0.007);,IP(t 0.077,P0.916)。IP,,、。;;;The accuracy of puncture guided by intelligent positioning system using magnetic naviga tion GUOLe-hang,XU Hui-xiong,WANG Shuai,HE Yong,LIU Chang,LIU Lin-na,ZHANG Yi-feng,XU Jun-mei,SUNLi-ping.Department of Medica l Ultrasound,Tenth People′s Hospita l of Tongji University,Shanghai TenthPeople′s Hospital,Shanghai 200072,ChinaCorresponding author:XU Hui-xiong,Email:xuhuixiong@hotmail.comAbstractObjectiveToasesstheacuracyofpunctureguidedbyinteligentpositioning(IP)systemusingmagneticnavigation.MethodsFivepreparedtargetedmodelsatthreecertaindepth(<50mm,samldepth;50-100mm,mediumdepth;>100mm,largedepth)underwentpunctureguidedbyinteligentpositioningsystemusingIPandconventionalultrasound(US),respectively.Punctureerors,thenumberofatemptandspenttimewererecordedandcompared.ResultsForthetargetsatsmal,mediumandlargedepth,theerorsofIPwas(1.881.18),(1.560.56)and(3.991.10)cm,andtheerorsofconventionalUSwas(4.522.23),(4.491.73)and(3.932.19)cmrespectively.TheerorsofIPweresignificantlylesthanthoseofconventionalUSatsmal(t -2.345,P 0.047)andmedium(t-3.608,2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6 R501P 0.007)depth,buttherewasnostatisticalysignificantdiferenceatlargedepth(t 0.058,P 0.955).IntheIPgroup,therewerestatisticalysignificantdiferencesforpunctureerorsbetweenthesmalandlargedepth,aswelasbetweenmedium andlargedepth(F 8.923,P 0.010).TherewasnostatisticalysignificantdiferencefortheerorsofIPbetweenthesmalandmediumdepth(t -1.927,P 0.501).Forthetargetsatsmal,mediumandlargedepth,eachpuncturewasperformedinsingleatemptwhenguidedbyIPandin2,1and2atemptwhenguidedbyconventionalUS.Atsmalandlargedepth,thenumbersofatemptofIPweresignificantlylessthanthoseofconventionalUS(U -2.372,P 0.018;U -2.39,P 0.032).Whereasatmediumdepth,therewasnosignificantdiference(U-1.000,P 0.690).Forthetargetsatsmal,mediumandlargedepth,eachpuncturespent(21.202.39)s,(27.004.00)sand(31.803.83)swhenguidedbyIP,and(45.209.68),(26.804.21)and(54.6013.48)swhenguidedbyconventionalUS.ThespenttimeofIPwaslessthanthatwithconventionalUSforsmalandlargedepthtargets(t -5.383,P 0.001;t -3.637,P 0.007).Whereasnostatisticalysignificantdiferencewasfoundforthemediumdepthtarget(t 0.077,P 0.916).ConclusionIncomparisonwithconventionalUS,IPsystemguidedpunctureismoreaccurateandthenumberofatemptandspenttimeisles.Key wordsUltrasonography;Magneticnavigation;Inteligencepositioning;Punctures、、,、、(、、)、[1-3],、、、[4-6]。,,致。(inteligentpositioning,IP),,。, IP、, IP。、鹌,,。,,鹌,耦,。鹌,,( 1)。鹌。( <50mm)、( 50100mm)( >100mm)。 IP、 5。 2,。、 EsaoteMyLabTMTwice,、、1。,(Sensor2); LA332, 311MHz。 CIVCOeTRAXTM,14G,(Sensor1),、,、、,; 18G。、1.IP( 2,3):,。(Sensor1)(Sensor2)(50cm),(High)。,10mm,,至,。,,3,,,,;-, , R502 2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6;, 0180,(90)。 2,3IP。2 IP,3。,,,:(1),;(2):,;(3),。,。-, 3,;( /)2.:,,,,。、1.:。[7](4)。, 2A B, 2 A 、B AP BP, O PO,:PO (AP2BP2):O ;MN4。, 2AB, 2 A、B AP、BP, O PO2.:。,,,至。3.:,。IP、,。、 SPSS17.0。、 珋x s , M。 t IP、; IP、,LSD-t; Mann-WhitneyUIP。P <0.05。1.( 1):、、,IP 0.53.2、1.02.5、2.85.5cm,2.28.1、2.86.8、0.76.1cm。、,IP,2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6 R503 1IP(mm,珋xs) (<50mm) (50100mm) (>100mm)F PIP 5 1.881.18 1 ゥ.560.56 3.991.10a 8 I.923 0.010 5 4.522.23 4 ゥ.491.73 3.932.19 1 I.070 0.375t -2 [.345 -3 .608 0 >.058P 0 [.047 0 .007 0 >.955:a、,(t 1.073,P 0.011;t -0.188,P 0.042);,IP。,,IP。,IP,、,;(t -1.927,P 0.501)。2.( 2):IP;、、, 13、12、13。、,IP,;,IP。 2IP(,M)(<50mm)(50100mm)(>100mm)IP 5 Y1 1 1 铑 5 Y2 1 2 铑U -2 .372 -1.000 -2.390P 0 .018 0.690 0.0323.( 3):、、,IP 1925、2232、2938s, 3055、2232、3266s。、,IP,;,IP。IP(55.0022.30)s。3IP(s,珋x s)(<50mm)(50100mm)(>100mm)IP 5 y21.202.39 27 u.004.00 31 l.803.83 5 y45.209.68 26 u.804.21 54 l.6013.48t -5 .383 0.077 -3.637P 0 .001 0.916 0.007,、。 MRICT,,[8-9],,,。 CT,[10],。,、,[11]。IP,,。:(1)、、。,,,,至。(2)。-,,。(3),,。, IP、,。[12], R504 2013 6 10 6ChinJMedUltrasound(ElectronicEdition),June2013,Vol.10,No.6。 IP,。、。、,IP,, IP。,,IP、,,。,,,210min,, CT MRI[11-13]。IP,,。,,,,、。 IP,,、,[14]。 IP、,,、。,:(1)、,致。(2),。(3),,。(4) IP, IP。。 IP,IP:(1)。(2), ,。(3),。(4)、、,,,,。 1SchmidtRL,HalBJ,LayfieldLJ.Asystematicreviewandmeta-analysisofthediagnosticaccuracyofultrasound-guidedcoreneedlebiopsyforsalivaryglandlesions.AmJClinPathol,2011,136(4):516-526.2SamirAE,VijA,SealeMK,etal.Ultrasound-guidedpercutaneousthyroidnodulecorebiopsy:clinicalutilityin patientswith priornondiagnosticfine-needleaspirate.Thyroid,2012,22(5):461-467.3JohnsonSJ,HuntCM,WoolnoughHM,etal.Virtualreality,ultrasound-guidedliverbiopsysimulator:developmentandperformancediscrimination.BrJRadiol,2012,85(1013):555-561.4LorentzenT,NolsoeCS,kjoldbyeB.Ultrasound-guideddrainageofdeeppelvicabscesses:experiencewith33cases.UltrasoundMedBiol,2011,37(5):723-728.5StoneMB,MoonC,SutijonoD,etal.Needletipvisualizationduringultrasound-guidedvascularaccess:short-axisvslong-axisapproach.Am JEmergMed,2010,28(3):343-347.6XuHX,WangY,LuMD,etal.Percutaneousultrasound-guidedthermalablationforintrahepaticcholangiocarcinoma.BrJRadiol,2012,85(1016):1078-1084.7,,. : .,2010,14(4):625-628.8LuY,LiuM,LiC,etal.MRI-guidedbiopsyandaspirationintheheadandneck:evaluationof77patients.EurRadiol,2012,22(2):404-410.9StatausJ,KuehlH,LaddS,etal.CT-guidedbiopsyofsmalliverlesions:visibility,artifacts,andcorrespondingdiagnosticaccuracy.CardiovascInterventRadiol,2007,30(5):928-935.10Kim GR,HurJ,LeeSM,etal.CTfluoroscopy-guidedlungbiopsyversusconventionalCT-guidedlungbiopsy:aprospectivecontroledstudytoassessradiation dosesand diagnosticperformance.EurRadiol,2011,21(2):232-239.11XuHX,LuMD,LiuLN,etal.Magneticnavigationinultrasound-guidedinterventionalradiologyprocedures.ClinRadiol,2012,67(5):447-454.12SugimotoK,MoriyasuF,ShiraishiJ,etal.Aphantom studycomparingultrasound-guidedlivertumorpuncture using new real-time3Dultrasoundandconventional2Dultrasound.AJRAmJRoentgenol,2011,196(6):W753-W757.13,,,.[J/CD].:,2011,8(3):571-576.14RossCJ,RennertJ,SchachererD,etal.Imagefusionwithvolumenavigationofcontrastenhancedultrasound(CEUS)withcomputedtomography(CT)or magnetic resonance imaging(MRI) forpost-interventionalfolow-upaftertranscatheterarterialchemoembolization(TACE)ofhepatocelularcarcinomas(HCC):Preliminaryresults.ClinHemorheolMicrocirc,2010,46(2-3):101-115.(:2012-09-22)(:),,,.[J/CD].:,2013,10(6):500-504.

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