胆道系统CT扫描的三维重建研究

Human biliary system three-dimensional model on perfused cadaveric liver by Computed Tomography

目的:通过CT扫描获取胆道系统容积数据,确立人体胆道系统三维重建的方法。方法:7例正常成人新鲜尸肝,以羧甲基纤维素(carboxymethylcellulose,CMC)/氧化铅(leadoxide,LO)混合物、牙托粉和明胶分别对应经胆道、门静脉和肝静脉灌注显影和固形,16排CT机扫描获取断层数据,在工作站用Mimics软件处理,建立胆系三维图像并进行评估。结果:7例标本6例灌注满意;6例满意者胆管连续、光滑、无伪影,空间感强烈、可任意度旋转;肝脏Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ、Ⅶ、Ⅷ各段胆管显示级数分别为5.8±0.75,10.1±1.05,10.2±0.98,7.8±0.75,11.8±0.75,11.7±0.82,13.2±0.75,11.7±1.63,相应各肝段胆管三维图像质量平均优秀率依次为98.14、97.78、97.82、98.68、97.05、96.22、95.02和95.31%;6例肝胆道图像平均优秀率(97.01±1.35)%。结论:本法建立的人体胆道系统三维模型胆道连续性好、图像空间感强烈,胆管显示级数多,图像质量高,是一种优秀的胆系三维重建方法。

Objective： To investigate a three-dimensional modeling method of human biliary system on perfused cadaveric liver by Computed Tomography. Methods： 7 isolated livers, which were selectively filled the bile ducts with mixtures of carboxymethylcellulose and lead oxide for visualization, the portal vein with dental base acrylic resin powder and the hepatic vein with gelatin for keeping shape of livers, were scanned to obtain respective volumetric dataset of biliary tract by Medical System Brilliance CT. The three-dimensional images of human biliary system obtained by applying Mimics software with the data above and assessed in self-designed standard for image quality analysis. Resluts： 6 of 7 cases were perfused satisfactively. Established images were of great continuity, smooth and glossy, and intense perception of space without defect. The stage numbers of bile duct representing in I, II ,III, IV, V ,VI,VII,Ⅷ liver segments were respectively 5.8±0.75, I 0.1 ± 1.05,10.2±0.98,7.8±0.75,11.8±0.75, 11.7±0.82,13.2±0.75,11.7±1.63 .The average image superiority rate of bile duct in corresponding segments revealed 98.14%, 97.78%, 97.82%, 98.68%, 97.05%, 96.22%, 95.02%, 95.31% by turns. The total average image superiority rate in 6 livers was （97.01 ±1.35 ）%. Conclusions： The three-dimensional modeling method of human biliary system, by which the established images are of high continuity, intense perception of space, and more branches display of bile duct, is a superior one.