基于医学影像的虚拟膀胱镜技术

A Review on Virtual Cystoscopy Techniques

目的:虚拟膀胱镜技术是利用医学影像和计算机技术相结合来替代现有光学膀胱镜一种行之有效方法。该技术与光学膀胱镜一样,可以作为常用的一种膀胱癌早期检查和定位的手段,同时也可以避免费光学膀胱镜的费用昂贵、有创、容易造成出血、尿道感染、甚至还有可能造成膀胱洞穿的危险等问题。方法:虚拟膀胱镜技术首选CT或者MRI作为其成像模态,得到清晰的膀胱结构或(和)功能图像信息,对膀胱进行手动或自动分割,并在此图像分割的基础上,对膀胱进行三维重建,进行面绘制,实现对膀胱原始形状的还原和表达。另外,通过对图像进行有效特征的提取,并将特征在重建后的三维膀胱上进行表达,更直观地为医生提供更多的诊断信息。结果:虚拟膀胱镜技术的应用可以解决光学膀胱镜检查有创的这一问题,并且能够为医生提供更多有效的诊断信息和更便利、灵活的检查方式。结论:虚拟膀胱镜对膀胱癌进行早期筛查和复查有着很大的临床价值和广阔的应用前景。而其研究正处于起步阶段,距离临床应用仍有距离。其临床意义和商业价值有待进一步挖掘。

Objective： Bladder cancer is the ninth cause of cancer deaths and has high recurrence rate after resection of the tumors. Cystoscopy is the current most accurate method for investigating the bladder abnormalities. However, it is expensive, uncomfortable and invasive. It is possible to induce bleeding, urinary-tract infection and even puncture of bladder. Advances in medical imaging and computer technologies make virtual cystoscopy a potential alternative. Methods： Computed tomography （CT） and magnetic resonance imaging （MRI） are the preferred imaging modalities for virtual cystoscopy to get clear structural images or （and） functional images of the bladder. The boundary of bladder is segmented manually or automatically, and then the bladder is reconstructed and displayed by surface rendering. Useful features are extracted from the images and expressed on the reconstructed bladder to provide more valuable diagnosis information for doctors. Results： Comparing with conventional cystoscopy, virtual cystoscopy is noninvasive, more convenient, flexible and can provide more useful diagnosis information as well. Conclusions： Virtual cystoscopy is a promising method of detection and reexamination of bladder cancer. So far, more researches are needed for the virtual cystoscopy before clinical application. It clinical and commercial value are under investigation.