基于64排螺旋CT扫描数据三维肝脏手术仿真的研究

Study on the three dimensional hepatic virtual operation based on the data of 64-sliee helical CT scanning

目的研究基于64排螺旋CT扫描数据的三维肝脏虚拟手术的设计和仿真效果，以及基于自由设计模型系统（FreeForm Modeling System）的虚拟手术的可行性。方法采集正常人肝脏64排薄层扫描数据集，利用医学三维重建软件（MIMICS软件）进行肝脏及其肝内血管三维重建，并将重建的肝脏及其管道模型、人工绘制肝脏肿瘤模拟物导入FreeForm Modeling System，利用力反馈设备（PHANTOM），对肝脏模型进行手术切割。结果通过旋转和放大目标物体，肿瘤与肝内血管的立体关系能清晰展示。根据手术原则，使用PHANTOM操纵“手术刀”，仿真左外叶切除，术中肝内管道结构容易识别，其过程基本符合临床肝脏肿瘤切除的手术过程并可调节目标物体的强度，感受切割时力反馈的大小。结论利用FreeForm Modeling System虚拟手术系统仿真肝脏手术切割，可以制定合理的个体化手术方案，减少并发症发生，提高手术成功率。

Objective To study the surgery plan and simulation effect of the three dimensional （3D） hepatic virtual operation based on the data of 64-slice helical CT scanning and to probe the feasibility of the virtual operation based on the FreeForm Modeling System. Methods The volunteer liver was scanned to collect two dimensional （2D） DICOM data of 64-slice helical CT scanning and the 3D hepatic and intrahepatic vessels model were reconstructed by MIMICS software. The reconstructed liver, the intrahepatic vessels model and the artificial tumor models were outputted into the FreeForm Modeling System in the STL format. The device PHANTOM with the characterization of dynamo-feedback was applied to make the operation on the 3D hepatic. Results The spatial relationship between the tumour and the intrahepatic vessels were clearly observed by rotation and enlargement of the target. According to the operation principle, the left lobe of liver resection was simulated by manipulating the device PHANTOM. Through the liver transparence surface, the intrahepatic vessels were easily distinguished. The operation procedure was accord with the clinic hepatic surgery. Meanwhile, during the operation ,by adjusting the incision objective intensity, the dynamo-feedback intensity was definitely touched. Conclusions By using the FreeForm Modeling System, the hepatic operation procedure can be simulated ahead of time. The operation complication in the practical surgery can be anticipated and the individualization operation schema can be reasonable instituted.