三维可视化技术在腹膜后肿瘤术前评估中应用价值(附15例报告)

Application of a three-dimensional visualization technology for precise before retroperitoneal tumor surgery(Report of 15 cases)

目的探讨三维可视化技术在腹膜后肿瘤术前评估中的应用价值。方法回顾性分析2011年3月至2013年12月厦门大学附属成功医院收治的15例腹膜后肿瘤病人的临床资料,应用三维可视化技术将病人术前二维CT图像进行三维可视化重建,通过观察肿瘤与腹腔脏器、腹部大血管之间的关系及测量肿瘤体积、手术模拟进行术前评估。对实施手术的病人,比较重建结果与实际手术的区别,对模拟切除肿瘤体积与实际切除肿瘤体积进行相关性分析。结果 15例病人三维可视化重建后图像清晰立体地显示肿瘤组织、腹腔实质脏器、腹腔大血管的解剖结构及毗邻关系,12例评估后行腹膜后肿瘤切除术,三维重建肿瘤的解剖关系与术中大致相符。12例手术病人术前模拟切除肿瘤体积(1117.50±690.35)m L,实际切除肿瘤体积(1189.92±737.74)m L,两者比较差异无统计学意义(t=0.25,P>0.05),具有相关性(r=0.81,P<0.05)。结论三维可视化技术能够对腹膜后肿瘤术前进行精准评估,具有一定的临床应用价值。

Objective Explore the value of three-dimensional visualization technology in the precise before retroperitoneal tumor surgery. Methods The clinical data of fifteen patients with retroperitoneal tumor who were admitted to the ChengGong Hospital from March 2011 to December 2013 were retrospectively analyzed. Based on three-dimensional visualization technology, converted the two-dimensional images of CT into three-dimensional images, observed the relationship between tumor and abdominal viscera, major abdominal vascular,measured the volume of tumor and Simulated operation to evaluate the preoperative. Both volumes of the predicted resected tumor and the results of the actual operations tumor resection were calculated, and had a correlation test analysis.Results The tumor tissue, abdominal organs and blood vessel were reconstructed three-dimensionally using the three-dimensional reconstruction software.Twelve of fifteen patients were operated underwent accurate assessment. Assessment of the anatomical situation were broadly consistent with actual situation before operation.The volume of twelve patients simulated resected tumor were（1117.50±690.35）mL, while the actual operations tumor resection volumes were（1189.92±737.74）mL. There was no significant different between the predicted and the actual values（t=0.25,P〉0.05）. The actual liver resection volume was positively correlated with the predicted liver resection volume （r=0.81, P〈0.05）. Conclusions The three-dimensional visualization technology has a certain degree of clinical value in the precise before retroperitoneal tumor surgery.