利用CT薄层计算机三维重建对宫颈癌根治术保留子宫动脉输尿管支价值的评估

Evaluation of the value of preserving ureteral branch of uterine artery in radical hysterectomy for cervical cancer by CT thin-layer computer three-dimensional reconstruction

目的探讨利用CT薄层扫描数据,构建宫颈癌术前、术后子宫动脉及子宫动脉输尿管支的三维重建模型,查验术中子宫动脉输尿管支保留情况,并结合术后输尿管并发症发生情况,评估宫颈癌根治术保留子宫动脉输尿管支的价值。方法利用CT薄层扫描技术,获取34例宫颈癌患者术前、术后的断层图像数据集,借助Mimics软件在术前、术后对患者的子宫动脉及子宫动脉输尿管支进行三维重建,检测术中子宫动脉输尿管支保留情况及术后子宫动脉和子宫动脉输尿管支的变化情况。结果术前三维重建所见的63支子宫动脉输尿管支均保留成功。经测量,术前子宫动脉输尿管支粗细平均值为(0.69±0.11)mm,术后子宫动脉输尿管支粗细平均值为(1.21±0.13)mm。保留子宫动脉输尿管支后,子宫动脉输尿管支较术前明显增粗,且术后患者均未出现泌尿系统并发症。结论利用CT三维重建技术,在检验术中保留子宫动脉输尿管支是否成功的同时,发现保留子宫动脉输尿管支可以代偿性增加子宫动脉输尿管支的血供,有效减少了患者术后输尿管并发症的发生。

Objective To explore the three-dimensional reconstruction model of uterine artery and ureteral branch of uterine artery before and after cervical cancer operation by using CT thin-layer scanning data,to check the retention of ureteral branch of uterine artery during operation,and to evaluate the value of retaining ureteral branch of uterine artery after radical cervical cancer operation.Methods CT thin-layer scanning technology was used to obtain the tomographic image data sets of 34 patients with cervical cancer before and after operation.The uterine artery and ureteral branch of uterine artery were reconstructed by Mimics software before and after operation,and the retention of ureteral branch of uterine artery during operation and the changes of uterine artery and ureteral branch of uterine artery after operation were detected.Results All the 63 ureteral branches of uterine artery were successfully preserved.After measurement,the average thickness of ureteral branch of uterine artery was(0.69±0.11)mm before operation and(1.21±0.13)mm after operation.After retaining the ureteral branch of uterine artery,the ureteral branch of uterine artery was significantly thicker than that before operation,and no urinary complications occurred in patients after operation.Conclusion Using CT three-dimensional reconstruction technology,while checking the success of preserving uterine artery and ureter branch during operation,it is found that preserving uterine artery and ureter branch can increase the blood supply of uterine artery and ureter branch compensatively,and effectively reduce the occurrence of postoperative ureteral complications.