[1]杨兴业,王林俊,陈曦,等.术前三维重建在肝癌大范围肝切除中的应用[J].中国医学物理学杂志,2020,37(5):625-628.[doi:10.3969/j.issn.1005-202X.2020.05.018]
　YANG Xingye,WANG Linjun,CHEN Xi,et al.Application of three-dimensional reconstruction in preoperative assessment of extensivehepatectomy for hepatocellular carcinoma[J].Chinese Journal of Medical Physics,2020,37(5):625-628.[doi:10.3969/j.issn.1005-202X.2020.05.018]
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术前三维重建在肝癌大范围肝切除中的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第5期
页码:
625-628
栏目:
医学影像物理
出版日期:
2020-05-25

文章信息/Info

Title:
Application of three-dimensional reconstruction in preoperative assessment of extensive hepatectomy for hepatocellular carcinoma
文章编号:
1005-202X（2020）05-0625-04
作者:
杨兴业1; 王林俊2; 陈曦1; 周红兵1; 袁寅1
1. 泰州市人民医院总院肝胆胰外科，江苏泰州225300；2. 江苏省人民医院普通外科，江苏南京210029
Author(s):
YANG Xingye1;  WANG Linjun2;  CHEN Xi1;  ZHOU Hongbing1;  YUAN Yin1
1. Department of Hepatobiliary and Pancreatic Surgery, Jiangsu Taizhou Peoples Hospital, Taizhou 225300, China 2. Department of General Surgery, Jiangsu Province Hospital, Nanjing 210029, China
关键词:
肝癌; 三维重建; 大范围肝切除; 肝脏体积; 手术切缘
Keywords:
hepatocellular carcinoma three-dimensional reconstruction extensive hepatectomy liver volume surgical margin
分类号:
R735.7
DOI:
10.3969/j.issn.1005-202X.2020.05.018
文献标志码:
A
摘要:
目的：探讨术前三维重建技术在大范围肝切除中的应用价值。方法：回顾性分析2016年1月~2018年6月泰州市人 民医院总院收治的45例行大范围肝切除（≥4个肝段）肝癌患者的临床资料，所有患者术前均行薄层CT检查，应用三维重建 系统（IQQA-Liver）进行术前评估，充分显示肿瘤与肝脏血管的关系，并行手术模拟规划，分别计算肝脏体积、模拟手术肝切 除体积、剩余肝脏体积、手术切缘等。并与手术中实际切除肝脏体积及切缘对比。结果：45例患者三维重建后均能清晰显 示肝脏、肝内外血管、肿瘤、肿瘤与肝脏血管关系。患者术前模拟切除肝脏体积（845.2+285.5）mL，实际切除肝脏体积 （826.3±268.1）mL，两者比较差异无统计学意义（t=0.425, P>0.05）。模拟手术切缘（11.2±3.4）mm，实际切缘（10.6±2.8）mm， 两者比较差异无统计学意义（t=0.471, P>0.05）。此两项指标术前模拟与手术实际均呈正相关性（r=0.95, P<0.01；r=0.83, P<0.01）。结论：三维重建技术能够清晰显示肝脏肿瘤与肝脏脉管的关系，准确评估肝切除的体积及手术切缘，在大范围肝 切除术中具有一定的临床应用价值。
Abstract:
Objective To explore the value of three-dimensional reconstruction technology in the preoperative assessment of hepatocellular carcinoma (HCC) patients treated with extensive hepatectomy. Methods The clinical data of 45 HCC patients undergoing extensive hepatectomy (≥4 segments) in Jiangsu Taizhou Peoples Hospital between January 2016 and June 2018 were analyzed retrospectively. All the patients underwent thin-slice CT examination before operation, and three-dimensional reconstruction system (IQQA-Liver) was used for preoperative assessment. The relationship between tumor and hepatic blood vessels was fully displayed in preoperative assessment and then the operation procedure was simulated for calculating liver volume, removed liver volume, residual liver volume and surgical margin. The simulated liver volume and surgical margin were then compared with the actual surgical results. Results The liver tissues, hepatic vessels, tumor, and the adjacent relationship of tumor and hepatic vessels of 45 patients were clearly displayed after three-dimensional reconstruction. There was no significant difference between the removed liver volume in simulation and the actually removed liver volume［(845.2+285.5) mL vs (826.3± 268.1) mL t=0.425, P>0.05］, between simulated surgical margin and actual margin［(11.2±3.4) mm vs (10.6±2.8) mm t=0.471, P>0.05)］. Both the two above-mentioned indexes in simulation were positively correlated with the actual operation (r=0.95, P<0.01 r=0.83, P<0.01). Conclusion Three-dimensional reconstruction technology can clearly show the relationship between hepatic tumor and hepatic vessels, accurately evaluate the hepatic volume and surgical margin of liver resection, with certain clinical value in extensive hepatectomy.

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备注/Memo

备注/Memo:
【收稿日期】2019-12-14 【作者简介】杨兴业，副主任医师，研究方向：肝胆胰肿瘤外科治疗、腹 腔镜外科，E-mail: doctsyq@163.com
更新日期/Last Update: 2020-06-03