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基于VTK实现三维重建在胆囊管变异中的诊断价值

发布时间:2017-12-31 16:10

  本文关键词:基于VTK实现三维重建在胆囊管变异中的诊断价值 出处:《山东大学学报(医学版)》2017年07期  论文类型:期刊论文


  更多相关文章: 胆囊管 解剖变异 磁共振胰胆管成像 VTK 医学三维可视化


【摘要】:目的探讨利用VTK实现三维可视化系统对胆囊管变异的诊断价值及临床意义。方法回顾性分析经临床确诊的160例胆石症患者,分别采用传统最大密度投影(MIP)及三维可视化系统辅助,对磁共振胰胆管水成像(MRCP)进行胆囊管变异的诊断,并与手术结果进行比较。结果以手术结果为金标准,在三维可视化系统辅助下检出胆囊管变异81例,与手术结果一致且差异无统计学意义(κ=0.950,P=1.000);而单纯采用MIP结合薄层图像检出则为51例,与手术结果存在差异且具有统计学意义(κ=0.477,P0.001)。对难以明确诊断的39例胆囊管旋前或旋后汇入肝总管的变异,在三维可视化系统的辅助下分别检出12例及27例,与手术结果一致且差异无统计学意义(κ=0.880,P=1.000);而单纯采用MIP结合薄层图像则分别检出24例及15例,与手术结果的差异具有统计学意义(κ=0.246,P=0.004)。结论利用VTK实现的三维可视化系统可以提高对胆囊管变异诊断的准确性,不仅弥补了MIP对于空间比邻关系显示欠确切的不足,更有助于临床术前了解胆囊管解剖变异的情况,避免胆囊切除术中所引起的胆道损伤。
[Abstract]:Objective to explore the diagnostic value and clinical significance of three-dimensional visualization system (VTK) for cystic duct variation. Methods 160 cases of cholelithiasis diagnosed by clinical diagnosis were analyzed retrospectively. Mr cholangiopancreatography (MRCP) was used to diagnose the variation of the cystic duct with the help of traditional maximum density projection (MIP) and 3D visualization system. Results 81 cases of cholecystic duct variation were detected under the aid of 3D visualization system, which were consistent with the results of operation and had no statistical significance (魏 0.950). Pu 1.000; However, 51 cases were detected by MIP combined with thin-layer image alone, which was significantly different from the results of operation (魏 0.477). In 39 cases of cholecystic duct pronation or convolution into the common hepatic duct, 12 cases and 27 cases were detected respectively with the aid of 3D visualization system. There was no significant difference between the results of the operation and that of the operation (魏 0. 880, P < 1. 000). However, 24 cases and 15 cases were detected by MIP and thin-layer images respectively, and the difference was statistically significant compared with the results of operation (魏 0.246). Conclusion the 3D visualization system based on VTK can improve the accuracy of diagnosis of cystic duct variation, which not only makes up for the deficiency of MIP in displaying spatial neighbor relationship. It is helpful to understand the anatomic variation of gallbladder duct before operation and to avoid bile duct injury caused by cholecystectomy.
【作者单位】: 天津市南开医院放射科;
【分类号】:R445.2;R575.6
【正文快照】: 胆石症是目前普外临床的多发病,开腹或腹腔镜胆囊切除术仍是治疗胆石症的基本术式[1],术中对胆囊管的处理是胆囊切除术的关键,而胆囊管变异则增加了手术难度[2]。随着磁共振胰胆管成像(magnetic resonance cholangiopancreatography,MRCP)检查的逐渐普及,通过最大密度投影(max

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