三维可视化技术在终末期肝多房棘球蚴病自体肝移植术前评估中的应用价值

Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis

目的探讨三维可视化技术在终末期肝多房棘球蚴病患者行自体肝移植术前评估中的应用价值。方法收集2013年5月至2017年7月在青海省人民医院接受自体肝移植术的8例终末期肝多房棘球蚴病患者。对8例患者术前行腹部CT平扫及三期动态增强扫描,将患者CT原始数据传输至人体三维可视化虚拟手术系统,通过三维可视化重建测定多房棘球绦虫体积、预切肝体积,并观察病灶与周围组织的关系。对比术中实际所见,评估三维可视化技术对终末期肝多房棘球蚴病行自体肝移植术的应用价值。结果三维可视化重建模型能清晰显示终末期肝多房棘球蚴病病灶与周围组织毗邻关系,三维可视化重建模型术前测得预切肝体积与术中实际切除的肝体积差异无统计学意义(t=1.083,P>0.05)。结论三维可视化技术可用于终末期肝多房棘球蚴病行自体肝移植术前制定合理的肝脏切除及血管吻合方案,提高手术成功率、改善患者预后。

Objective To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver aulotransplantation for end-stage hepatic alveolar echinococcosis. Methods A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People's Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT seanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. Results The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t= 1.083, P > 0.05). Conclusions 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echi no coccosis prior to liver autotransplantation , which may increase the success of surgery and improve the prognosis.