CAJ | 학술논문

目的应用数字医学技术,利用患者已有的外院CT胶片构建腹膜后腔三维数字模型,探讨医疗资源共享与再利用的可行方法及应用价值. 方法携外院CT胶片并拟在我院接受后腹腔镜手术治疗的患者85例,扫描CT胶片(含动脉、静脉及延迟期),经计算机图像处理,最终生成含病灶的腹膜后腔三维数字模型,术时全程验证并参与个性化导引.同时对其中53例肾肿瘤病例根据层厚分为A组34例(层厚5 mm),B组19例(层厚＞5 mm),观察肾蒂动、静脉显示符合率,并进行比较. 结果 85例个体化腹膜后腔三维数字模型均成功建立,可自由地进行观察,病灶与周围重要解剖结构的大体形态及空间位置符合术中所见,较好地参与及实现了术中个性化导引.A、B组肾蒂血管符合率分别为82.4％ (28/34)、52.6％ (10/19),差异有统计学意义(x2=5.306,P=0.021).结论基于5 mm层厚的常见CT胶片可重建出具有一定精细度与准确度的腹膜后腔三维数字模型.该方法不仅有效避免了不必要的重复检查,为医学影像资源共享和再利用的实现提供了新思路,更将CT所含信息呈现为三维形式以便参与术前规划与术中导引,具有一定的临床应用价值.
목적 응용수자의학기술,이용환자이유적외원CT효편구건복막후강삼유수자모형,탐토의료자원공향여재이용적가행방법급응용개치. 방법 휴외원CT효편병의재아원접수후복강경수술치료적환자85례,소묘CT효편(함동맥、정맥급연지기),경계산궤도상처리,최종생성함병조적복막후강삼유수자모형,술시전정험증병삼여개성화도인.동시대기중53례신종류병례근거층후분위A조34례(층후5 mm),B조19례(층후＞5 mm),관찰신체동、정맥현시부합솔,병진행비교. 결과 85례개체화복막후강삼유수자모형균성공건립,가자유지진행관찰,병조여주위중요해부결구적대체형태급공간위치부합술중소견,교호지삼여급실현료술중개성화도인.A、B조신체혈관부합솔분별위82.4％ (28/34)、52.6％ (10/19),차이유통계학의의(x2=5.306,P=0.021).결론 기우5 mm층후적상견CT효편가중건출구유일정정세도여준학도적복막후강삼유수자모형.해방법불부유효피면료불필요적중복검사,위의학영상자원공향화재이용적실현제공료신사로,경장CT소함신식정현위삼유형식이편삼여술전규화여술중도인,구유일정적림상응용개치.
Objective To explore the feasibilities and clinical applications for sharing the medical resources and recycles by applying digital medicine technology and making the most of medical CT films from other hospitals.Methods Based on scanning data of medical CT films from other hospitals,which were in 85 cases of undergo retroperitoneal laparoscopic surgery,the 3D models were reconstructed in the computer,then were verified and navigated during operations.Meanwhile,coincidence rates were compaired between group A (slice thickness =5 mm) and group B (slice thickness ＞5 mm) in 53 cases whose renal pedicle blood vessels were exposed during the operations.Results All the 85 procedures were successfully completed.The 3D models,which could be observed freely,were consistent with intraoperative screenshots and participated in intraoperative guidance.Coincidence rates were 82.4％ (28/34) in group A and 52.6％(10/19) in group B (x2 =5.306,P =0.021).Conclusions Based on medical CT films of 5 mm slice thickness,the 3D models which are verified to have some accuration and fineness can be successfully reconstructed.The method not only can effectively avoid unnecessary repeated inspection,but also directly render in 3D form to participate in preoperative planning and intraoperative guidance.