中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2010年
4期
249-252
,共4页
黄从云%孟志华%陈振松%吴青松%朱剑华%张小龙%赵家锋%万志方%潘高升%黎丽%卢雨零
黃從雲%孟誌華%陳振鬆%吳青鬆%硃劍華%張小龍%趙傢鋒%萬誌方%潘高升%黎麗%盧雨零
황종운%맹지화%진진송%오청송%주검화%장소룡%조가봉%만지방%반고승%려려%로우령
癌,肝细胞%虚拟肝切除%磁共振扫描
癌,肝細胞%虛擬肝切除%磁共振掃描
암,간세포%허의간절제%자공진소묘
Carcinoma hepatocellular%Virtual hepatectomy%Magnetic resonance image
目的 探讨虚拟肝切除技术在肝癌切除中的价值.方法 2007年9月至2008年9月对13例肝癌病人术前行常规Flash3D增强扫描,用3D-Doctor软件行包括下腔静脉、门静脉、肝静脉和肝短静脉的三维影像重建,测量全肝体积、肿瘤体积、拟切除的肝脏体积、余肝体积和余肝体积/标准肝体积(SFLVR).结果 7例行右半肝切除,6例肝段/叶切除.肝脏三维重建后均能从各个角度显示肝内静脉走向及与肿瘤的空间关系,肿瘤体积为(348±214)ml,拟切除肝体积为(676±375)ml,余肝体积为(714±261)ml,SFLVR为62%±19%.术后并发症包括肺1例肺部感染,中等量腹水6例,大量腹水2例,其中1例肝功能不全.结论 虚拟肝切除技术能直观显示肝脏静脉以及与肿瘤的关系,预测肝切除量,对制定肝脏手术方案具有实用价值.
目的 探討虛擬肝切除技術在肝癌切除中的價值.方法 2007年9月至2008年9月對13例肝癌病人術前行常規Flash3D增彊掃描,用3D-Doctor軟件行包括下腔靜脈、門靜脈、肝靜脈和肝短靜脈的三維影像重建,測量全肝體積、腫瘤體積、擬切除的肝髒體積、餘肝體積和餘肝體積/標準肝體積(SFLVR).結果 7例行右半肝切除,6例肝段/葉切除.肝髒三維重建後均能從各箇角度顯示肝內靜脈走嚮及與腫瘤的空間關繫,腫瘤體積為(348±214)ml,擬切除肝體積為(676±375)ml,餘肝體積為(714±261)ml,SFLVR為62%±19%.術後併髮癥包括肺1例肺部感染,中等量腹水6例,大量腹水2例,其中1例肝功能不全.結論 虛擬肝切除技術能直觀顯示肝髒靜脈以及與腫瘤的關繫,預測肝切除量,對製定肝髒手術方案具有實用價值.
목적 탐토허의간절제기술재간암절제중적개치.방법 2007년9월지2008년9월대13례간암병인술전행상규Flash3D증강소묘,용3D-Doctor연건행포괄하강정맥、문정맥、간정맥화간단정맥적삼유영상중건,측량전간체적、종류체적、의절제적간장체적、여간체적화여간체적/표준간체적(SFLVR).결과 7례행우반간절제,6례간단/협절제.간장삼유중건후균능종각개각도현시간내정맥주향급여종류적공간관계,종류체적위(348±214)ml,의절제간체적위(676±375)ml,여간체적위(714±261)ml,SFLVR위62%±19%.술후병발증포괄폐1례폐부감염,중등량복수6례,대량복수2례,기중1례간공능불전.결론 허의간절제기술능직관현시간장정맥이급여종류적관계,예측간절제량,대제정간장수술방안구유실용개치.
Objective To assess the feasibility of virtual hepatectomy in the treatment of primary hepatocellular carcinom(PHCC).Methods From September 2007 to September 2008,three-dimensional(3D)models from MR images were constructed by 3D-Doctor software in 13 patients with PHCC scheduled for liver resection.From these 3D models,the images of vena cava,portal vein,hepatic vein and short hepatic vein were reconstructed and total liver volume,tumor volume,functional liver volume and SFLVR(ratio of functional liver volume to standard liver volume)were calculated.Results Of the 13 patients with PHCC,7 received right hemihepatectomy and 6 bisegmentectomy.The anatomic detail of liver veins and its relation to the tumor could be displayed clearly in liver 3D models.By the 3D models,tumor volume was calculated as(348±214)ml,total liver volume(676±375)ml,functional liver volume(714 ± 261)ml and SFLVR(62±19)%.Postoperative complications included pulmonary infection in 1,moderate ascites in 6 and massive ascites in 2.Conclusion Virtual hepatectomy provides an accurate picture of liver vein anatomy and its relationship with the tumor.It can predict the liver volume to be removed and functional liver volume,and may be used for the preoperative planning of safe hepatectomy.
