3D成像系统在肝门部胆管癌诊断及可切除性评估中的应用

Application of the three-dimensional evaluation system in the diagnosis and resectability for hilar cholangiocarcinoma

目的 探讨3D成像系统在肝门部胆管癌可切除性评估中的应用.方法 回顾性分析2012年10月至2013年8月在我科行3D评估的35例肝门部胆管癌患者的临床资料,在CT及MRCP基础上进行三维重建,获得3D图像,显示肿瘤与血管、胆道的三维关系,并进行虚拟的手术方式规划及可切除性评估.结果 35例患者均成功获得3D图像,除l例外其余患者均可行手术治疗,预测肿瘤可切除的准确性为97.1％,虚拟手术规划与实际大体一致.结论 3D成像对于判断肝门部胆管癌与血管、胆管的关系具有较高的准确性,有助于作出准确的可切除性评估.

Objective To discuss the application of the three-dimensional（3D）imaging system in the assessment of respectability for hilar cholangiocarcinoma. Methods The clinical data of 12 cases of hilar cholangiocarcinoma that evaluated by the 3D evaluation system from October 2012 to May 2013 were analysed retrospectively. All of the cases got the reconstructed 3D-image based on the results of computed tomography（CT） and magnetic resonance cholangiopancreatography （MRCP）, and the 3D relations of tumor, vessels and bile duct were revealed. Surgical procedures were planned and simulated, and its reseet- ability was evaluated. Results The 3D-images of all 12 cases were successfully obtained and all opera- tions were performed except for 1 patient. The prediction of tumor respectability was with great accuracy （91.7%）, and the virtual surgical planning was quite consistent with the actuals. Conclusion The 3 D e- valuation system is with high accuracy for the judgment of relationship among hilar cholangiocarcinoma, blood vessels and bile ducts ,which is valuable to predict the resectability of the carcinoma.