瘢痕妊娠动脉血管网数字化三维模型重建及意义

发布时间：2018-06-23 05:28

本文选题：瘢痕妊娠 + CTA　；参考：《现代妇产科进展》2017年09期

【摘要】：目的:探讨剖宫产瘢痕妊娠(CSP)数字化三维模型的构建方法及其在患者行子宫动脉栓塞术(UAE)中的应用和意义。方法:将10例CSP患者随机分为实验组和对照组,各5例。实验组:UAE术前行双源CTA扫描,获取CTA原始图像后利用Mimics10.01软件对盆腔动脉系统进行三维重建,将构建的CSP数字化三维模型用于指导UAE手术操作;对照组:常规行UAE手术。比较两组的手术时间、辐射时间、术后止血时间和副反应发生率。结果:5例CSP数字化三维模型重建特点:2例患者的病灶由双侧子宫动脉和卵巢动脉共同供血,3例仅由双侧子宫动脉供血;患者均双侧血供不均衡,其中3例以左侧为主,2例右侧为主。三维模型与DSA图形结果对比:DSA可显示病灶的血供来源,但1例有卵巢动脉供血的患者DSA图像未见卵巢动脉显影。三维重建可清晰显示动脉的开口角度和走行特点。10例患者UAE术后均无明显并发症发生。实验组的平均手术时间、辐射时间为(39.54±3.12)min和(9.41±0.83)min,显著小于对照组的(46.01±3.65)min和(11.75±1.63)min,差异均有统计学意义(P0.05)。两组的术后止血时间无统计学差异。结论:CSP的数字化三维模型可用于UAE的术前和术中指导,缩短CSP-UAE的手术时间和辐射剂量,并为模拟手术平台的建立提供基础。
[Abstract]:Objective: to investigate the method of constructing digital 3D model of cesarean scar pregnancy (CSP) and its application in uterine artery embolization (UAE). Methods: 10 patients with CSP were randomly divided into experimental group and control group, 5 cases each. The experimental group underwent dual-source CTA scan before operation, and the original CTA images were obtained. The three-dimensional reconstruction of pelvic artery system was carried out by using Mimics10.01 software. The constructed CSP digital three-dimensional model was used to guide the UAE operation, while the control group was routinely performed UAE operation. The operative time, radiation time, hemostasis time and incidence of side effects were compared between the two groups. Results the reconstruction characteristics of 5 cases of CSP digital 3D model showed that the lesions of 2 cases were supplied by bilateral uterine artery and ovarian artery in 3 cases only by bilateral uterine artery, and the bilateral blood supply was not balanced in all the patients. Among them, 3 cases were mainly left side and 2 cases were right side. Compared with the results of DSA, the 3D model could show the origin of the blood supply of the lesion, but no development of the ovarian artery was found in the DSA image of one patient with ovarian artery supply. Three-dimensional reconstruction could clearly show the opening angle and the characteristics of the artery. There were no obvious complications after UAE in 10 patients. The mean operation time and radiation time in the experimental group were (39.54 卤3.12) min and (9.41 卤0.83) min, respectively, which were significantly lower than those in the control group (46.01 卤3.65) min and (11.75 卤1.63) mins (P0.05). There was no significant difference in hemostasis time between the two groups. Conclusion the three dimensional digital model of CSP can be used to guide UAE before and during operation, shorten the operative time and radiation dose of CSP-UAE, and provide the foundation for the establishment of simulated surgical platform.
【作者单位】：潍坊市人民医院产科;南方医科大学南方医院;
【分类号】：R714.22

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