Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reporte...Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery. Methods Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.Results The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.Conclusions Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.展开更多
BACKGROUND: At present, imaging is used not only to show the form of images, but also to make three-dimensional (3D) reconstructions and visual simulations based on original data to guide clinical surgery. This study ...BACKGROUND: At present, imaging is used not only to show the form of images, but also to make three-dimensional (3D) reconstructions and visual simulations based on original data to guide clinical surgery. This study aimed to assess the use of a medical image-processing system in liver transplantation surgery. METHODS: The data of abdominal 64-slice spiral CT scan were collected from 200 healthy volunteers and 37 liver cancer patients in terms of hepatic arterial phase, portal phase, and hepatic venous phase. A 3D model of abdominal blood vessels including the abdominal aorta system, portal vein system, and inferior vena cava system was reconstructed by an abdominal image processing system to identify vascular variations. Then, a 3D model of the liver was reconstructed in terms of hepatic segmentation and liver volume was calculated. The Free Form modeling system with a PHANTOM force feedback device was used to simulate the real liver transplantation environment, in which the total process of liver transplantation was completed. RESULTS: The reconstructed model of the abdominal blood vessels and the liver was clearly demonstrated to be three-dimensionally consistent with the anatomy of the liver, in which the variations of abdominal blood vessels were identified and liver segmentation was performed digitally. In the model, liver transplantation was simulated subsequently, and different modus operandi were selected successfully. CONCLUSION: The digitized medical image processing system may be valuable for liver transplantation.展开更多
目的研究数字化医学技术在肝胆管结石诊断及治疗中的应用价值。方法收集2008年2月至9月南方医科大学珠江医院肝胆一科收治的14例肝胆管结石患者的64排螺旋cT扫描数据，其中男性3例，女性11例，年龄37～65岁，平均48岁。将收集的数据导...目的研究数字化医学技术在肝胆管结石诊断及治疗中的应用价值。方法收集2008年2月至9月南方医科大学珠江医院肝胆一科收治的14例肝胆管结石患者的64排螺旋cT扫描数据，其中男性3例，女性11例，年龄37～65岁，平均48岁。将收集的数据导人医学图像处理软件进行程序分割、三维重建。重建后的模型再导人到Free Form Modeling System，并利用自主研发的仿真器械进行仿真手术研究。术前根据三维重建及仿真手术的结果选择合适的手术方式，并与术中所见相比较，术后通过逆行T管造影检查结石是否有残余，评价三维重建及仿真手术的价值。结果14例肝胆管结石三维重建模型中显示左肝胆管结石7例，右肝胆管结石2例，左右肝胆管结石5例。其中6例合并肝外胆管结石；胆管绝对狭窄6例，相对狭窄8例。三维模型诊断与临床诊断一致。术前仿真多种手术方式，仿真手术过程使用的仿真器械有力反馈的感觉。结论数字医学技术有助于诊断结石的分布、胆道狭窄部位及程度。仿真手术可指导手术方式的选择，从而降低手术风险。展开更多
基金This research was funded by the National Hlgh-Tech Research and Development Program of China （863 Program） （No. 2006AA2Z346）, Guangdong Province Science Foundation Group Program （No. 6200171）, National Nature Science Foundation of China （No. 30470493）, and Science and Technology Projects of Guangdong Province （No. 2003C34303）.
文摘Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery. Methods Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.Results The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.Conclusions Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.
基金supported by a grant from the National High Technology Research and Development Program of China(863 Program) (No. 2006AA02Z346)
文摘BACKGROUND: At present, imaging is used not only to show the form of images, but also to make three-dimensional (3D) reconstructions and visual simulations based on original data to guide clinical surgery. This study aimed to assess the use of a medical image-processing system in liver transplantation surgery. METHODS: The data of abdominal 64-slice spiral CT scan were collected from 200 healthy volunteers and 37 liver cancer patients in terms of hepatic arterial phase, portal phase, and hepatic venous phase. A 3D model of abdominal blood vessels including the abdominal aorta system, portal vein system, and inferior vena cava system was reconstructed by an abdominal image processing system to identify vascular variations. Then, a 3D model of the liver was reconstructed in terms of hepatic segmentation and liver volume was calculated. The Free Form modeling system with a PHANTOM force feedback device was used to simulate the real liver transplantation environment, in which the total process of liver transplantation was completed. RESULTS: The reconstructed model of the abdominal blood vessels and the liver was clearly demonstrated to be three-dimensionally consistent with the anatomy of the liver, in which the variations of abdominal blood vessels were identified and liver segmentation was performed digitally. In the model, liver transplantation was simulated subsequently, and different modus operandi were selected successfully. CONCLUSION: The digitized medical image processing system may be valuable for liver transplantation.
文摘目的研究数字化医学技术在肝胆管结石诊断及治疗中的应用价值。方法收集2008年2月至9月南方医科大学珠江医院肝胆一科收治的14例肝胆管结石患者的64排螺旋cT扫描数据，其中男性3例，女性11例，年龄37～65岁，平均48岁。将收集的数据导人医学图像处理软件进行程序分割、三维重建。重建后的模型再导人到Free Form Modeling System，并利用自主研发的仿真器械进行仿真手术研究。术前根据三维重建及仿真手术的结果选择合适的手术方式，并与术中所见相比较，术后通过逆行T管造影检查结石是否有残余，评价三维重建及仿真手术的价值。结果14例肝胆管结石三维重建模型中显示左肝胆管结石7例，右肝胆管结石2例，左右肝胆管结石5例。其中6例合并肝外胆管结石；胆管绝对狭窄6例，相对狭窄8例。三维模型诊断与临床诊断一致。术前仿真多种手术方式，仿真手术过程使用的仿真器械有力反馈的感觉。结论数字医学技术有助于诊断结石的分布、胆道狭窄部位及程度。仿真手术可指导手术方式的选择，从而降低手术风险。
