数字医学在门静脉分型、肝脏体积测量研究及小儿巨大肝间叶性错构瘤手术指导中的应用
发布时间：2019-03-12 09:12
【摘要】：目的应用海信计算机辅助手术系统(海信CAS)对不同年龄组人群(新生儿至成年人)进行肝脏及血管三维重建,建立人类数字肝脏数据库,对肝内血管变异及肝脏体积进行分析统计,寻找肝脏解剖学变异规律。方法本院及外院搜集正常肝脏上腹部增强CT数据664例,记录年龄、性别、肝脏体积,并行三维重建。将其中106例儿童上腹部增强CT进行肝脏及血管三维重建,分析小儿肝脏门静脉解剖变异并进行分型,按照年龄分组,自动测量右前叶、右后叶及左叶的流域体积。结果海信CAS能够快速准确测量肝脏体积,立体、清晰的显示小儿肝脏门静脉主干的解剖走形,并自动测量各流域体积。门静脉分型:a型82例(77.36%),b型12例(11.32%),c型8例(7.55%),d型2例(1.89%),e型1例(0.94%),f型1例(0.94%)。根据门静脉右前支、右后支及左支供血区域实现个体化肝段划分。各年龄段组间肝脏体积差异有统计学意义(P0.05)。肝脏总体积与年龄、身高、体重、体表面积均呈正相关(年龄:R=0.889,P0.05;身高:R=0.914,P0.05;体重:R=0.919,P0.05;体表面积:R=0.931,P0.05)。结论肝脏总体积随年龄、身高、体重、体表面积变化而变化,小儿肝脏门静脉解剖变异复杂多样。海信CAS能准确立体的显示出肝内血管走形并自动测量流域体积,为小儿门静脉分型及个体化肝段划分提供可靠依据,对小儿精准肝切除术的实施具有重要意义。目的获取肝间叶性错构瘤患儿影像学检查数据,使用海信计算机辅助手术系统(Hisense CAS)数字化重建出可视化立体患肝模型,探讨计算机辅助手术系统在小儿巨大肝间叶性错构瘤(HMH)诊断治疗中的价值。方法自2010年9月至2015年10月,我院收治5例HMH患儿,术前均行上腹部增强CT检查,3例(2013年7月至2015年10月)应用海信CAS对患儿CT资料行三维重建及模拟肝切除,制定手术计划,术中实施精准肝切除术。结果2例(2010年9月至2013年5月)根据术前CT检查分别实施肝右叶切除术及肝左叶切除术。3例(2013年7月至2015年10月)应用海信CAS系统成功进行肝脏及肿瘤的三维重建,并进行模拟肝切除,根据术前制定的手术计划分别成功实施:肝Ⅱ、Ⅲ、Ⅴ、Ⅷ部分及IV全部切除术,肝Ⅴ段切除术,右半肝切除术。术后恢复好,病理检查证实为HMH。随访3月~5年未见并发症及复发。结论HMH影像学检查与肝囊肿相似,易误诊。海信CAS能清晰、直观显示HMH的位置、形态及其与肝内管道系统的关系,其术前规划功能利于术者制定最佳手术方案,实施个体化精准肝脏肿瘤切除。
[Abstract]:Objective to establish a human digital liver database by using Hisense computer aided surgery system (Hisense CAS) to reconstruct the liver and blood vessels in different age groups (from newborn to adult). The variation of hepatic vessels and the volume of liver were analyzed and analyzed to find out the regularity of hepatic anatomical variation. Methods six hundred and sixty-four patients with normal liver and abdomen enhanced CT were collected. Age, sex, liver volume and three-dimensional reconstruction were recorded. Three-dimensional reconstruction of liver and blood vessels was performed with enhanced CT in children's upper abdomen. The anatomical variation of hepatic portal vein in children was analyzed and classified. The watershed volumes of right anterior lobe, right posterior lobe and Zuo Ye were measured automatically according to age. Results Hisense CAS can quickly and accurately measure the liver volume, stereoscopic, clearly display the anatomy of the portal vein trunk of the liver in children, and automatically measure the volume of each watershed. There were 82 cases of type a (77.36%), 12 cases of type b (11.32%), 8 cases of type c (7.55%), 2 cases of type d (1.89%), 1 case of type e (0.94%) and 1 case of type f (0.94%). According to the right anterior branch, right posterior branch and left branch of portal vein, the individual hepatic segments were divided. There was significant difference in liver volume among different age groups (P0.05). The total liver volume was positively correlated with age, height, weight and body surface area (age: r = 0.889, P 0.05; height: r = 0.914, P 0.05; body weight: r = 0.919, P 0.05; body surface area: r = 0.931, P 0.05). Conclusion the total volume of liver varies with age, height, body weight and body surface area. The anatomic variation of hepatic portal vein in children is complicated and varied. Hisense CAS can accurately display the intrahepatic vessel shape and automatically measure the watershed volume, which provides a reliable basis for the classification of the portal vein and individual hepatic segments in children. It is of great significance for the implementation of accurate hepatectomy in children. Objective to obtain the imaging data of children with hepatic mesenchymal hamartoma, and to reconstruct the visual stereoscopic liver model using Hisense computer aided surgery system (Hisense CAS). To evaluate the value of computer-assisted surgery system in the diagnosis and treatment of giant hepatic stromal hamartoma (HMH) in children. Methods from September 2010 to October 2015, 5 patients with HMH were treated in our hospital. All patients underwent enhanced CT examination in upper abdomen before operation. Three patients (from July 2013 to October 2015) underwent three-dimensional reconstruction and simulated hepatectomy of CT data with Hisense CAS. The operative plan was made and the precise hepatectomy was performed during the operation. Results from September 2010 to May 2013, right lobectomy and Zuo Ye's resection of liver were performed in 2 cases (from September 2010 to May 2013), respectively. Three cases (July 2013 to October 2015) underwent three-dimensional reconstruction of liver and tumor with Hisense CAS system. The simulated hepatectomy was performed successfully according to the preoperative operation plan: total resection of liver 鈪，
本文编号：2438647
[Abstract]:Objective to establish a human digital liver database by using Hisense computer aided surgery system (Hisense CAS) to reconstruct the liver and blood vessels in different age groups (from newborn to adult). The variation of hepatic vessels and the volume of liver were analyzed and analyzed to find out the regularity of hepatic anatomical variation. Methods six hundred and sixty-four patients with normal liver and abdomen enhanced CT were collected. Age, sex, liver volume and three-dimensional reconstruction were recorded. Three-dimensional reconstruction of liver and blood vessels was performed with enhanced CT in children's upper abdomen. The anatomical variation of hepatic portal vein in children was analyzed and classified. The watershed volumes of right anterior lobe, right posterior lobe and Zuo Ye were measured automatically according to age. Results Hisense CAS can quickly and accurately measure the liver volume, stereoscopic, clearly display the anatomy of the portal vein trunk of the liver in children, and automatically measure the volume of each watershed. There were 82 cases of type a (77.36%), 12 cases of type b (11.32%), 8 cases of type c (7.55%), 2 cases of type d (1.89%), 1 case of type e (0.94%) and 1 case of type f (0.94%). According to the right anterior branch, right posterior branch and left branch of portal vein, the individual hepatic segments were divided. There was significant difference in liver volume among different age groups (P0.05). The total liver volume was positively correlated with age, height, weight and body surface area (age: r = 0.889, P 0.05; height: r = 0.914, P 0.05; body weight: r = 0.919, P 0.05; body surface area: r = 0.931, P 0.05). Conclusion the total volume of liver varies with age, height, body weight and body surface area. The anatomic variation of hepatic portal vein in children is complicated and varied. Hisense CAS can accurately display the intrahepatic vessel shape and automatically measure the watershed volume, which provides a reliable basis for the classification of the portal vein and individual hepatic segments in children. It is of great significance for the implementation of accurate hepatectomy in children. Objective to obtain the imaging data of children with hepatic mesenchymal hamartoma, and to reconstruct the visual stereoscopic liver model using Hisense computer aided surgery system (Hisense CAS). To evaluate the value of computer-assisted surgery system in the diagnosis and treatment of giant hepatic stromal hamartoma (HMH) in children. Methods from September 2010 to October 2015, 5 patients with HMH were treated in our hospital. All patients underwent enhanced CT examination in upper abdomen before operation. Three patients (from July 2013 to October 2015) underwent three-dimensional reconstruction and simulated hepatectomy of CT data with Hisense CAS. The operative plan was made and the precise hepatectomy was performed during the operation. Results from September 2010 to May 2013, right lobectomy and Zuo Ye's resection of liver were performed in 2 cases (from September 2010 to May 2013), respectively. Three cases (July 2013 to October 2015) underwent three-dimensional reconstruction of liver and tumor with Hisense CAS system. The simulated hepatectomy was performed successfully according to the preoperative operation plan: total resection of liver 鈪，
本文编号：2438647
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