腹部医学图像三维可视化系统用于腹主动脉瘤诊治临床研究

Clinical research on the diagnosis and treatment of abdominal aortic aneurysm by the Abdominal Medical Image Three-dimensional Visualization System

目的研究腹部医学图像三维可视化系统在腹主动脉瘤诊断及治疗中的应用价值。方法 2008年1月至2010年1月南方医科大学珠江医院收集13例腹主动脉瘤病人64排螺旋CTA数据,利用DICOM Viewer进行重建前处理,导入自主开发的腹部医学图像三维可视化系统进行图像分割及三维重建,然后对13例病人腹主动脉瘤重建模型进行数字化分型、分级,测量各项参数,选择合适的手术方式,最后将重建模型导入Free Form Modeling System仿真手术平台进行腹主动脉瘤仿真人工血管置换及腔内隔绝手术研究,评估腹部医学图像三维可视化系统的应用价值。结果 13例病人腹腔三维模型形态逼真,立体感强,相互关系明晰;腹主动脉瘤分型、分级准确;仿真手术符合临床开放及腔内手术过程。结论腹部医学图像三维可视化系统有利于腹主动脉瘤术前的评估及手术方式的选择;可视化仿真开放及腔内手术可让术者熟悉手术过程,缩短手术时间,提高手术者的操作技能;加强医患沟通。

Objective To explore the clinical value of the abdominal medical Image three-dimensional visualization system（MI-3DVS） in the diagnosis and treatment of abdominal aortic aneurysm（AAA）.Methods The data of 13 cases with AAA provided by 64-slice spiral computerized tomography（CT） is collected and adjusted by DICOM Viewer before reconstructed.Then the adjusted datum are segmented and reconstructed in three-dimensional（3D） models by the MI-3DVS which has been exploited ourselves.The 3D models are classified and measured to select the preferable operation.Finally,the 3D models are imported into the Freeform Modeling System to study on virtual surgery of vascular prosthesis replacement and endovascular exclusion for AAA and to assess the clinical value of the MI-3DVS.Results The 3D models of 13 cases have characteristic of realistic,stereoscopic and clear in interrelationship.They are helpful to classification accurately.It is showed that the effect of the management of the virtual surgery on AAA is the same as that of the surgical interference.Conclusion The MI-3DVS contribute to preoperative evaluation and selecting preferable surgical interference.Furthermore,we can also get more familiar with the procedure of the surgical interference,save our time and improve our surgical skills.At the same time,the virtual surgery can strengthen the doctor-patient communication.