3D可视化在胰腺肿瘤精准手术的应用
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摘要
目的探讨3D可视化模型在胰腺肿瘤精准手术中的应用价值。方法 5例胰腺肿瘤患者行CT多期扫描获取DICOM格式的原始数据,将这些数据导入Visual Volume医学图像三维系统重建三维可视化模型,用于术前医患沟通、医疗方案的制订。结果 5例患者的CT影像数据均成功重建出三维模型,医疗团队通过仔细阅读三维可视化模型,确认肿瘤与毗邻的器官、组织,尤其是血管的位置关系,制定合理详细的手术方案,术中完全按照手术方案进行操作,切除肿瘤并最大化减少周围正常组织的损伤,取得较好的疗效。结论基于多期CT原始数据构建的胰腺肿瘤三维可视化模型具有较高的真实度和精确度,准确反映肿瘤的位置、结构、血供和周围毗邻情况,用于术前疾病评估、手术方案制订与模拟、医患沟通,具有非常广泛的的前景。
Objective To explore the application value of 3 D visualization model in precise surgery of pancreatic neoplasms.Methods Five patients with pancreatic tumor underwent CT multi-phase scanning to obtain the raw data in DICOM format. Thesedata were imported into medical imaging system named Visual Volume to reconstruct 3 D visualization models,which were used forpreoperative communication between doctors and patients and formulation of medical plan. Results The 3 D model of five patientswas successfully reconstructed based on CT raw data. By carefully reading the 3 D visualization model,the medical team confirmedthe tumor,adjacent organs or tissues,blood vessels,so that they worked out a reasonable and detailed surgical plan and operatedin accordance with it. Conclusion The 3 D visualization model of pancreatic neoplasm based on raw data of multi-phase CT ishighly accurate,which can accurately reflect the location,structure,blood supply of pancreatic neoplasm. It has a very bright prospect in preoperative disease assessment,surgical planning and simulation,doctor-patient communication.
Objective To explore the application value of 3 D visualization model in precise surgery of pancreatic neoplasms.Methods Five patients with pancreatic tumor underwent CT multi-phase scanning to obtain the raw data in DICOM format. Thesedata were imported into medical imaging system named Visual Volume to reconstruct 3 D visualization models,which were used forpreoperative communication between doctors and patients and formulation of medical plan. Results The 3 D model of five patientswas successfully reconstructed based on CT raw data. By carefully reading the 3 D visualization model,the medical team confirmedthe tumor,adjacent organs or tissues,blood vessels,so that they worked out a reasonable and detailed surgical plan and operatedin accordance with it. Conclusion The 3 D visualization model of pancreatic neoplasm based on raw data of multi-phase CT ishighly accurate,which can accurately reflect the location,structure,blood supply of pancreatic neoplasm. It has a very bright prospect in preoperative disease assessment,surgical planning and simulation,doctor-patient communication.
引文
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[15]朱广远,韩从辉. 3D打印技术在泌尿外科的研究及应用进展[J].医学研究生学报,2017,30(8):884-888.
[16]丁宁,何惠斌,宣自俊,等.基于肾血管肾集合系统同步显影技术的高清3D打印研究[J].中华腔镜泌尿外科杂志(电子版),2017,11(4):224-228.
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[19]王峻峰,孙志为,王罡,等.肝右前叶肿瘤切除手术中3D打印模型的临床应用报道[J].重庆医学,2017,46(10):1438-1439.
[20]程万里,刘光华,韩希年.多层螺旋CT血管造影对胰腺癌侵犯胰周血管的判断[J].医学影像学杂志,2007,17(7):695-699.
[21]刘彦平,章伟,朱应合,等. 128层螺旋CT双期增强扫描对胰腺癌诊断价值的分析[J].医学影像学杂志,2011,21(12):1856-1858.
[22]董孙根,张汉良. 16层螺旋CT兼容性血管成像对胰腺癌胰周主要血管侵犯的诊断价值[J].医学影像学杂志,2015,25(2):358-361.
[23]刘允怡,张绍祥,姜洪池,等.肝门部胆管癌三维可视化精准诊治专家共识[J].中国实用外科杂志,2017,37(1):48-52.
[24]刘允怡,张绍祥,姜洪池,等.复杂性肝脏肿瘤三维可视化精准诊治专家共识[J].中国实用外科杂志,2017,37(1):53-59.
[2] Long J,Luo GP,Xiao ZW,et al. Cancer statistics:current di-agnosis and treatment of pancreatic cancer in Shanghai,China[J]. Cancer Lett,2014,346(2):273-277.
[3]王威巍,李靖,张宇,等.胰腺血管的3D解剖结构研究[J].重庆医学,2017,46(15):2075-2077.
[4]晋云,陈刚,张绍祥,等.胰腺及其周围结构的多方位断层解剖研究[J].第三军医大学学报,2007,29(23):2271-2273.
[5]林钢,李鹏,彭国瑞,等.数字化结合3D打印技术辅助复杂骨盆骨折的手术设计[J].中国临床解剖学杂志,2016,34(3):293-297.
[6]柳鑫,曾参军,卢键森,等. 3D打印计算机虚拟辅助技术在髋臼骨折术前规划中的应用[J].南方医科大学学报,2017,37(3):378-382.
[7]王志标,伯宇,马腾,等. 3D打印技术在骶骨骨折手术中的应用[J].宁夏医科大学学报,2017,39(4):479-481+360.
[8]王蒙,郑冬,白克文,等.基于CT薄层扫描数据的3D打印技术在跟骨关节内骨折手术治疗中的应用[J].创伤外科杂志,2017,19(6):421-425.
[9]胡敏,谭新颖,鄢荣曾,等. 3D打印技术在口腔颌面外科领域中的应用进展[J].中国实用口腔科杂志,2014,7(6):335-339.
[10]时佳子,王杰,王志向,等. 3D打印在泌尿外科个体化治疗中的应用[J].实用医学杂志,2015,31(23):3957-3959.
[11]王锋,赵淼,马静. 3D打印技术在肾肿瘤治疗的应用[J].中国继续医学教育,2016,8(10):108-109.
[12]胡立伟,孙杰,钟玉敏,等.基于CT多期图像融合构建3D打印重复肾模型的应用[J].中国医疗设备,2017,32(3):29-31.
[13]朱陈辉,余刚,杨水华,等. 3D打印快速成型技术在泌尿外科领域中的应用进展[J].安徽医药,2017,21(7):1176-1179.
[14]丘捷文,李春,文博,等. 3D打印技术在经皮肾镜取石术中的应用[J].临床泌尿外科杂志,2017,32(7):524-528.
[15]朱广远,韩从辉. 3D打印技术在泌尿外科的研究及应用进展[J].医学研究生学报,2017,30(8):884-888.
[16]丁宁,何惠斌,宣自俊,等.基于肾血管肾集合系统同步显影技术的高清3D打印研究[J].中华腔镜泌尿外科杂志(电子版),2017,11(4):224-228.
[17]钟世镇,方驰华.三维打印技术的临床应用[J].中华外科杂志,2016,54(9):658-660.
[18]张朋飞,于松宁,雷鹏,等. 3D打印技术在精准肝切除术前评估的应用[J].中国普通外科杂志,2017,26(7):831-837.
[19]王峻峰,孙志为,王罡,等.肝右前叶肿瘤切除手术中3D打印模型的临床应用报道[J].重庆医学,2017,46(10):1438-1439.
[20]程万里,刘光华,韩希年.多层螺旋CT血管造影对胰腺癌侵犯胰周血管的判断[J].医学影像学杂志,2007,17(7):695-699.
[21]刘彦平,章伟,朱应合,等. 128层螺旋CT双期增强扫描对胰腺癌诊断价值的分析[J].医学影像学杂志,2011,21(12):1856-1858.
[22]董孙根,张汉良. 16层螺旋CT兼容性血管成像对胰腺癌胰周主要血管侵犯的诊断价值[J].医学影像学杂志,2015,25(2):358-361.
[23]刘允怡,张绍祥,姜洪池,等.肝门部胆管癌三维可视化精准诊治专家共识[J].中国实用外科杂志,2017,37(1):48-52.
[24]刘允怡,张绍祥,姜洪池,等.复杂性肝脏肿瘤三维可视化精准诊治专家共识[J].中国实用外科杂志,2017,37(1):53-59.