摘要
目的:探讨三维可视化技术辅助复杂性肝切除术的应用价值。方法:收集2015年8月到2016年3月的21例肝肿瘤患者资料,行上腹部CT扫描,获取1 mm DICOM格式的CT数据,采用三维可视化分析系统进行三维重建和三维可视化分析,并制定手术策略、指导手术操作。观察指标包括手术时间、术中出血量、实际切除肝体积、术后住院时间和术后并发症。结果:21例患者均构建了三维可视化图像模型,并进行虚拟肝切除术,虚拟切除肝体积为(1 030±279)mL。采用三维可视化技术指导复杂性肝切除术,21例患者的手术均取得成功,手术时间(350±78)min,术中出血量(497±381)mL,术后住院时间(12.5±2.9)d,术后并发症率14.3%,围手术期无患者死亡,实际切除肝体积(1 028±258)mL。实际切除肝体积与虚拟切除肝体积在统计学上具有相关性(r=0.945,P<0.001),两者均值无统计学差异(t=0.022,P=0.983)。结论:三维可视化分析有助于熟悉肝脏解剖,虚拟肝切除术有助于精确定量分析和制定准确的手术方案。采用三维可视化技术间接指导手术操作,可提高复杂性肝切除术的精准性和安全性。
Objective To study on the application value of three-dimensional（3D） visualization technique in complex liver resection for liver tumors. Methods From August 2015 to March 2016, 21 patients with liver tumors were treated by abdominal CT scan,obtaining 1 mm thin- slice CT images in DICOM format. The medical image 3D visualization system was applied for 3D reconstruction, 3D visualization analysis, planning a surgical strategy, and assisting operative procedure in real time. The observe indexes included operation time, intraoperative blood loss, actual liver resection volume, postoperative hospitalization duration and postoperative complications. Results The 3D visualization models were successfully constructed for 21 patients. In virtual liver resection, the virtual liver resection volume was（1 030±279） mL. The complex liver resections with the assistance of 3D visualization technique for 21 patients were successful. The operation time was（350±78） min, and the intraoperative blood loss was（497±381） m L, and the postoperative hospitalization duration was（12.5±2.9） d, and the postoperative morbidity was 14.3%.No patient was dead in the perioperative period. The actual liver resection volume was（1 028±258） mL, which was significantly correlated with the virtual liver resection volume（r=0.945, P0.001）. No significant differences were found between the volumes of actual and virtual liver resection（t=0.022, P=0.983）. Conclusion The 3D visualization technique improves the familiarity with liver anatomy, and the virtual liver resection is helpful in precise quantitative analysis and surgical strategy planning. The 3D visualization technique indirectly navigates the operative procedure in real time, which improves the safety and accuracy of complex liver resection.
出处
《中国医学物理学杂志》
CSCD
2016年第8期793-798,共6页
Chinese Journal of Medical Physics
基金
广东省自然科学基金(2014A030310393)
南宁市普通外科腔镜微创中心建设项目(20153012)
关键词
肝肿瘤
三维可视化
复杂性肝切除术
虚拟肝切除术
liver tumor
three-dimensional visualization
complex liver resection
virtual liver resection
