三维可视化技术引导肝切除联合胆道镜取石术治疗肝内胆管结石

目的 研究三维可视化技术(three-dimensional visualization technology,3DVT)在肝切除联合胆道镜探查取石术治疗肝内胆管结石的应用效果。方法 回顾性分析2018年1月至2020年12月南华大学附属第一医院肝胆胰外科收治的132例肝内胆管结石患者的临床资料,根据术前是否采用3DVT指导分为试验组(n=74)和对照组(n=58),比较两组结石清除的疗效。结果 与对照组比,试验组具有较短的术后住院时间[(15.1±6.9)d vs (19.6±10.9)d,P=0.01]、较高的结石清除率(94.59% vs 82.76%,P=0.028)及较低的结石复发率(6.76% vs 18.97%,P=0.033)。结论 3DVT引导肝切除联合胆道镜探查取石术治疗肝内胆管结石是可行的,对有效清除肝内结石具有较大的优势。

Adaptive tracking algorithm based on 3D variable turn model

Satisfactory results cannot be obtained when three-dimensional (3D) targets with complex maneuvering characteristics are tracked by the commonly used two-dimensional coordinated turn (2DCT) model. To address the problem of 3D target tracking with strong maneuverability, on the basis of the modified three-dimensional variable turn (3DVT) model, an adaptive tracking algorithm is proposed by combining with the cubature Kalman filter (CKF) in this paper. Through ideology of real-time identification, the parameters of the model are changed to adjust the state transition matrix and the state noise covariance matrix. Therefore, states of the target are matched in real-time to achieve the purpose of adaptive tracking. Finally, four simulations are analyzed in different settings by the Monte Carlo method. All results show that the proposed algorithm can update parameters of the model and identify motion characteristics in real-time when targets tracking also has a better tracking accuracy.

基于三维可视化技术的脾门区脾动脉三维分型

目的探讨基于三维可视化技术(3DVT)的脾门区脾动脉(SA)三维分型。方法本研究对象为2018年6月至2021年6月在安徽医科大学第一附属医院及皖南医学院附属弋矶山医院诊治的100例患者CT检查影像学资料。患者均签署知情同意书,符合医学伦理学规定。其中男61例,女39例;年龄49~88岁,中位年龄63岁。所有患者行薄层增强CT扫描,提取数据导入三维可视化系统进行三维重建。观察SA分支数目、分布范围、立体走行,与胰尾末端及脾门的空间位置关系,进行三维可视化分型。结果100例脾门区SA、脾脏、胰腺三维模型重建成功率均为100%(100/100)。SA一级分支数目为1支者4例(4%),2支76例(76%),3支15例(15%),多支(≥4支)5例(5%)。SA总分支点与脾门的距离为0~68 mm,中位数为19 mm。SA总分支点与胰尾末端的距离为0~127 mm,中位数为16 mm。脾门与胰尾的距离为0~138 mm,中位数为21 mm。SA分为5型:A型4例(4%),B型76例(76%),C型16例(16%),D型2例(2%),E型2例(2%)。结论脾门区解剖结构复杂多变,术前采用3DVT可对SA末端分支观察和个体化分型,该分型对临床实施精准个体化脾脏和胰腺手术具有一定指导意义。