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Modélisation Biomécanique des Tissus Mous du Cerveau et Développement d'un Neuronavigateur Permettant la Prise en Compte Per-Opératoire du Brain-Shift

Abstract : Accurate localization of the target is essential to reduce morbidity during a brain tumor removal intervention. In the case of large skull openings, a deformation of brain tissues can occur in the course of surgery. As a consequence of this `brain-shift', the preoperatively acquired images no longer correspond to reality and therefore neuronavigation is strongly compromised. In order to compensate for this deformation and recover the preoperative data during surgery, we propose to use a neuronavigation system which offers passive help to the surgeon by displaying the position of the guided tools with respect to the corrected location of the brain anatomical features. Before the intervention, a magnetic resonance angiography (MRA) of the patient's brain is acquired. Once the patient has been installed on the operating table, the MRA volume defining the initial vascular tree configuration is rigidly registered with the patient's head. During the intervention, whenever a large deformation occurs, the surgeon performs a Doppler ultrasound sweep of the region of interest. The initial vascular tree is elastically registered to its deformed configuration, segmented from the localized US images, and the resulting displacement field is further extended to the whole brain volume using a patient specific biomechanical model. The computed organ deformation is then used to update the preoperative data as well as the initial surgical planning. Our system gives the surgeon a quick, robust and accurate response and, moreover, enables him to check the relevance of the computed brain deformation prior to any alteration of the planning.
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https://tel.archives-ouvertes.fr/tel-00351417
Contributor : Marek Bucki <>
Submitted on : Friday, January 9, 2009 - 11:20:16 AM
Last modification on : Thursday, November 19, 2020 - 3:56:07 PM
Long-term archiving on: : Tuesday, June 8, 2010 - 5:33:31 PM

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  • HAL Id : tel-00351417, version 1

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Marek Bucki. Modélisation Biomécanique des Tissus Mous du Cerveau et Développement d'un Neuronavigateur Permettant la Prise en Compte Per-Opératoire du Brain-Shift. Sciences du Vivant [q-bio]. Université Joseph-Fourier - Grenoble I, 2008. Français. ⟨tel-00351417⟩

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