三维可视化技术在肝占位性病变精准手术中的应用效果观察

Application of Three-dimensional Visualization Technology in Accurate Operation of Liver Occupying Lesions

目的观察三维可视化技术用于肝占位性病变精准手术中的效果。方法选择2018年10月—2019年11月收治的35例肝占位性病变患者(10例肿瘤,25例肝包虫),所有患者术前均接受64排CT扫描,提取毫米扫描数据,将其整合至三维可视化软件MI-3DVS内,分别予以切割图像、三维重建、肝脏分段、体积测算、规划虚拟摘除平面、拟定手术方案。结果所有患者经三维可视化技术处理后,均能清晰的呈现出肝脏中各血管形态、分段及病变部位、规格大小及具体数目。术中所观察到的肿瘤情况和术前规划相符率达到100%(10/10)。依照三维重建结果拟定术前计划,现实手术操作和术前规划相符率为100%(10/10),手术切除工作顺利进行,围手术期未出现死亡病例,2例患者术后出现胸腔积液,经引流处理后符合临床治愈标准。对于25例肝包虫病患者,虚拟手术设计欲切除的肝脏体积为(762.12±504.17)mL,在全肝体积中所占比例为(39.22±18.74)%,术中实际切除肝脏体积为(755.84±501.86)mL。在全肝体积中占(38.97±16.97)%,经统计学软件分析,虚拟手术欲切除肝脏体积和术中实际切除体积差异无统计学意义(t=0.044,0.039,P均>0.05)。结论针对肝占位性病变患者,采用三维可视化技术能提升术前诊断的精确性,术前对手术方案作出规划,以进一步提升术中操作准确度,优化临床治疗效果。

Objective To observe the effect of three-dimensional visualization technology in the precise operation of liver occupying lesions.Methods From October 2018 to November 2019,35 patients(10 tumors,25 hydatidosis)with hepatic space occupying lesions were selected.All patients received 64 rows of CT scan before operation.Millimeter scan data were extracted and integrated into 3D visualization software in MI-3DVS,images were cut,three-dimensional reconstruction,liver segmentation,volume measurement,virtual extraction plane planning,and operation plan were made.Results After three-dimensional visualization,all patients could clearly show the shape,segment,pathological position,size and number of blood vessels in the liver.The coincidence rate of tumor observation and preoperative planning was 100%(10/10).According to the results of three-dimensional reconstruction,the preoperative plan was drawn up.The coincidence rate between the actual operation and the preoperative plan was 100%(10/10).The operation was carried out smoothly.There were no death cases in the perioperative period.Two patients developed pleural effusion after operation.After drainage,the plan met the clinical cure standard.For 25 patients with hydatidosis,the volume of the liver to be resected was(762.12±504.17)mL,accounting for(39.22±18.74)%of the total liver volume,and the actual volume of the liver to be resected was(755.84±501.86)mL.It accounted for(38.97±16.97)%of the total liver volume.Through statistical software analysis,there was no significant difference between the volume of virtual surgery to be removed and the actual volume to be removed during the operation(t=0.044,0.039,P>0.05).Conclusion For patients with liver occupying lesions,3D visualization technology can improve the accuracy of preoperative diagnosis,preoperative planning of the operation plan,in order to further improve the accuracy of the operation and optimize the clinical treatment effect.