混合现实技术远程诊治乳腺肿瘤患者的价值研究
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摘要
目的初步探讨混合现实技术在乳腺肿瘤患者远程诊治中的价值。方法 1例42岁女性患者以"无明显原因发现右侧乳房肿块两周"入院,完善多排CT胸部平扫与乳腺3.0T MRI平扫+增强检查,获取DICOM原始影像数据输入至Visual Volume系统进行重构,三维可视化模型用于远程手术术前方案规划、医患沟通、实时手术指导。结果患者按照要求顺利完成影像学检查,数据符合三维重建要求,三维可视化模型清晰显示患者右侧乳头后方有一强化明显结节,边界光滑,使抽象的人体结构具体化,手术方案规划与医患沟通高效、流畅,在专家远程指导下,手术时间短、出血少,患者恢复快,家属满意。结论混合现实技术能提供个性化三维可视化模型,用于手术方案规划、医患沟通、远程手术指导,部分改变了临床诊疗模式,不但可能符合未来外科发展方向,又部分解决当下医疗资源分布不平衡的难题,应该有广阔的发展空间。
Objective To explore the value of mixed reality technology for the remote diagnosis and treatment of patients with breast cancer. Methods A 42-year-old female patient presenting as "right breast mass without obvious cause for two weeks" was admitted to the hospital. Multi-slice CT and 3.0 T MRI examination were performed. The raw DICOM data were obtained and input into the Visual Volume System of VISUAL Company for reconstruction. The three-dimensional visualization model was used for preoperative planning, doctor-patient communication and real-time operation. Results The patient completed imaging examination smoothly and whose data were suitable for three-dimensional model reconstruction. The model showed clearly that there was an obvious nodule with smooth boundary behind the right nipple. The human anatomical structure was presented clearly, which made the surgical planning and doctor-patient communication more effective. The whole operation had less bleeding, shorter time, faster recovery. Conclusions Mixed reality technology can provide individualized three-dimensional visualization model for surgical planning, doctor-patient communication, remote operation guidance which changes the mode of clinical diagnosis and treatment. It may be not only suitable to development trends of surgery, but also resolves partly the current problem of uneven distribution of medical resources. Which has broad space for development.
Objective To explore the value of mixed reality technology for the remote diagnosis and treatment of patients with breast cancer. Methods A 42-year-old female patient presenting as "right breast mass without obvious cause for two weeks" was admitted to the hospital. Multi-slice CT and 3.0 T MRI examination were performed. The raw DICOM data were obtained and input into the Visual Volume System of VISUAL Company for reconstruction. The three-dimensional visualization model was used for preoperative planning, doctor-patient communication and real-time operation. Results The patient completed imaging examination smoothly and whose data were suitable for three-dimensional model reconstruction. The model showed clearly that there was an obvious nodule with smooth boundary behind the right nipple. The human anatomical structure was presented clearly, which made the surgical planning and doctor-patient communication more effective. The whole operation had less bleeding, shorter time, faster recovery. Conclusions Mixed reality technology can provide individualized three-dimensional visualization model for surgical planning, doctor-patient communication, remote operation guidance which changes the mode of clinical diagnosis and treatment. It may be not only suitable to development trends of surgery, but also resolves partly the current problem of uneven distribution of medical resources. Which has broad space for development.
引文
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[2] 卢清君.远程医疗的管理与分级体系建设原则[J].皮肤科学通报,2016,33(1):12-16.
[3] 徐挺玉,王文明,朱甬倩,等.现行远程医疗系统的建设与思考[J].中国数字医学,2017,12(1):41-43,102.
[4] 冯亚坤,刘玉佳,刚晓坤,等.远程医疗模式在2型糖尿病综合管理中的应用[J].中国糖尿病杂志,2016,24(5):439-442.
[5] 赵禹,李峥.远程医疗在双相情感障碍患者中的应用研究进展[J].中华护理杂志,2018,53(7):872-877.
[6] 魏涛,谌永毅,李星凤,等.远程医疗在肿瘤化疗间歇期相关并发症管理的应用进展[J].护理学杂志,2018,33(7):97-100.
[7] 杜超,张梅奎.远程医疗在居家养老健康服务中的应用研究[J].转化医学杂志,2018,7(4):237-239.
[8] 杨华瑜,廖文俊,桑新亭,等.3D打印技术在医学和肝胆外科中的应用[J].肝胆外科杂志,2016,24(1):66-68.
[9] 宋宏宁,郭瑞强.基于医学影像学的3D打印技术在心血管疾病诊疗中的应用现状及研究进展[J].中国医学影像技术,2017,33(3):375-380.
[10] 刘瑞,董乐乐,左强,等.3D打印定位导向模板在脊柱外科中的应用进展[J].中国数字医学,2015,9(7):33-35.
[11] 高强,庄建,岑坚正,等.3D打印技术在复杂先天性心脏病外科诊疗中的应用[J].中国胸心血管外科临床杂志,2018,28(8):654-658.
[12] 姜雨晨,陈雁西.3D打印技术在足踝外科的应用价值[J].国际骨科学杂志,2015,52(1):15-17.
[13] 程传东.3D打印技术在神经外科颅底手术临床教学中的应用[J].安徽卫生职业技术学院学报,2018,17(5):111-112,115.
[14] 张敏,王玮,李庆元,等.3D打印在泌尿外科手术中的应用[J].泌尿外科杂志(电子版),2017,9(1):58-60.
[15] 王子罡,唐泽圣,王田苗,等.基于虚拟现实的计算机辅助立体定向神经外科手术系统[J].计算机学报,2000,23(9):931-937.
[16] 职康康,蒋庆君,吴鉴今,等.VR教学系统在血管外科领域中的应用研究[J].中国医学教育技术,2018,32(5):545-547.
[17] 王晓龙,丁新民.增强现实在神经外科中的应用[J].中国药物与临床,2018,18(4):547-549.
[18] 刘书中,张海龙,余可谊,等.增强现实技术在脊柱外科中的应用研究进展[J].中国实验诊断学,2018,22(7):1291-1296.
[19] 郝万静,万永,牟怡平,等.三维重建及3D打印技术在腹部外科临床带教中的应用研究[J].中国医学教育技术,2018,32(4):430-433.
[20] 陈康,熊力,郑砚文.3D打印技术在肝脏外科应用现状及展望[J].中国普通外科杂志,2017,26(1):90-95.
[21] 方驰华,方兆山,范应方,等.三维可视化、3D打印及3D腹腔镜在肝肿瘤外科诊治中的应用[J].南方医科大学学报,2015,35(5):639-645.
[22] 孙涛,韩善清.三维(3D)可视化技术在复杂骶骨肿瘤精准手术治疗中的价值初探[J].中国医学装备,2018,15(5):97-101.
[23] 孙涛,韩善清.基于3D可视化技术的肾脏肿瘤精准手术[J].中国医疗设备,2017,32(9):71-73,86.
[24] 王艺霖,张才铭,黄文华.3D打印技术在乳腺外科的应用及展望[J].中国医学物理学杂志,2018,35(11):1351-1354.
[25] 孙涛,张鹤达,李建,等.个案报道:基于3D打印技术的乳腺肿瘤精准手术治疗2例[J].中国肿瘤外科杂志,2016,8(4):235-239.
[26] 孙涛,邓飞,李建,等.混合现实技术在乳腺肿瘤精准手术中的应用初探[J].中国肿瘤外科杂志,2017,9(3):145-148.
[27] Tepper OM,Rudy HL,Lefkowitz A.et al.Mixed Reality withHoloLens:Where virtual reality meets augmented reality in the operating room[J].Plast Reconstr Surg,2017,140(5):1066-1070.
[28] Chen L,Day T W,Tang W,et al.Recent developments and future challenges in medical mixed reality[C].16th IEEE International Symposium on Mixed and Augmented Reality (ISMAR).IEEE,2017.
[29] Lee SC,Fuerst B,Tateno K,et al.Multi-modal imaging,model-basedtracking,and mixed reality visualisation for orthopaedicsurgery[J].Healthc Technol Lett.2017,4(5):168-173.