ICS 11.060.01 C05 T/CHSA 004—2018 “导航引导下颅底肿瘤穿刺活检技术流程 及操作”的专家共识 Expert consensus on “Processes and operations of navigation -guided needle biopsy techniques in skull base tumors” 2018 - 12 - 07发布 2018 - 12 - 07实施 中华口腔医学会 发布 团 体 标 准 T/CHSA 004 —2018 I 目 次 前言 ................................ ................................ ................ IV 引言 ................................ ................................ ................. V 1 范围 ................................ ................................ .............. 1 1.1 适应证 ................................ ................................ ........ 1 1.2 禁忌证 ................................ ................................ ........ 1 2 术语及定义 ................................ ................................ ........ 1 2.1 颅底外科 Skull base surgery ................................ .................. 1 2.2 穿刺活检 Needle biopsy ................................ ....................... 1 2.3 计算机断层扫描 Computed Tomography, CT ................................ ........ 1 2.4 外科手术导航系统 Surgical navigation system ................................ .. 1 2.5 磁共振成像 Magnetic resonance imaging (MRI) ................................ .. 2 2.6 三维重建 3D reconstruction ................................ .................... 2 2.7 图像分割 Image segmentation ................................ ................... 2 2.8 医学数字图像和通讯格式 Digital imaging and communication in medicine, DICOM .... 2 2.9 图像配准 Image registration ................................ .................. 2 2.10 图像融合 Image fusion ................................ ....................... 2 2.11 细针吸活检 Fine needle biopsy ................................ ............... 2 2.12 粗针穿刺活检 Core needle biopsy ................................ ............. 2 2.13 冰冻组织病理诊断 Frozen tissue pathological diagnosis ....................... 2 3 技术使用所需设备 ................................ ................................ .. 3 3.1 数据采集设备 ................................ ................................ .. 3 3.2 数字化软件 ................................ ................................ .... 3 3.3 外科手术导航系统 ................................ .............................. 3 4 术前数据采集及手术设计 ................................ ............................ 3 4.1 术前数据采集 ................................ ................................ .. 3 4.2 术前设计 ................................ ................................ ...... 3 4.2.1 导入数据和三维重建 ................................ ........................ 3 4.2.2 分割、配准融合 ................................ ............................ 3 4.2.3 穿刺针直径的选择 ................................ .......................... 4 4.2.4 虚拟设计穿刺路径 ................................ .......................... 4 5 导航的安装和注册 ................................ ................................ .. 5 5.1 头带式头架安装 ................................ ................................ 5 5.2 患者注册 ................................ ................................ ...... 5 5.3 穿刺针注册 ................................ ................................ .... 5 T/CHSA 004 —2018 II 6 穿刺手术 ................................ ................................ .......... 6 6.1 穿刺前准备 ................................ ................................ .... 6 6.2 穿刺过程 ................................ ................................ ...... 6 6.3 术中冰冻病理 ................................ ................................ .. 6 7 效果评价 ................................ ................................ .......... 6 8 风险与并发症 ................................ ................................ ...... 6 参考文献 ................................ ................................ ............. 7 图1 分割及显示肿瘤（绿色） 、动脉（红色） 、静脉（蓝色） ................................ 4 图2 设计穿刺路径（蓝色为穿刺路径、黄色为弹射距离） ................................ .. 5 T/CHSA 004 —2018 III T/CHSA 004 —2018 IV 前 言 本标准按照 GB/