活体部分肝移植可视化仿真手术的研究  

Study on visualized virtual surgery of living-related donor liver transplantation

作　　者：方驰华[1] 吴东波[1] 黄燕鹏[1] 鲍苏苏[2] 鲁朝敏[1] 廖其光[2] 潘家辉[2] 

机构地区：[1]南方医科大学珠江医院肝胆外科,广州510282 [2]广东华南师范大学计算机学院

出　　处：《中华外科杂志》2009年第3期187-189,共3页Chinese Journal of Surgery

基　　金：国家高科技研究发展（863）计划资助项目（2006AA022346）;广东省自然科学基金团队资助项目（6200171）;国家自然科学基金资助项目（30470493）

摘　　要：目的研究三维可视化仿真手术技术在活体部分肝移植外科中的应用价值。方法利用2例胆道结石患者的肝脏64排螺旋CT扫描数据集，将所收集的数据导人自主研发的医学图像处理软件进行程序分割、配准和三维重建，重建出的肝脏及其管道模型均以STL格式输出，然后导入到FreeForm Modeling System进行修饰和平滑。利用系统的力反馈设备PHANTOM进行活体部分肝移植手术的仿真研究。结果重建的肝脏模型具有肝脏、肝动脉、肝静脉、门静脉和胆道系统，形态逼真，立体感强；肝脏可视化后，肝脏内部管道空间立体感强，肝动脉、肝静脉、门静脉和肝胆管的分布、行程以及相互关系明晰。在可视化手术系统中，使用力反馈设备PHANTOM操纵手术刀，仿真活体部分肝移植的手术过程，其结果符合临床手术的效果。结论可视化的肝脏重建模型立体、逼真，有利于肝移植手术方案的合理设计；肝移植术前的手术设计和可视化演示可提高手术效果、降低手术风险及减少手术并发症。Objective To investigate the significance of three dimensional visualization and virtual surgery system in living related donor liver transplantation surgery. Methods Two patients suffered biliary calculi were scanned by 64 slice helical computer tomography （CT） on livers and the data were imported into medical image proceeding system （MIPS） for sequence. Man-made segmentation and true-up on the image from the data were carried out. Three dimensional（3 D） models of the liver and the intrabepatic vessels were reconstructed by VTK software respectively. The models were exported with format STL from it and then were imported into the FreeForm Modeling System for smoothing and modifying. At last,living related donor liver transplantation were simulated with the force-feedback equipment （PHANTOM）. Results It had great verisimilar image for the reconstructed 3D liver models with artery, hepatic vein, portal vein and bile duct. By seeing through liver,it had high fidelity and strong 3D effect for the intrahepatic artery, hepatic vein, portal vein and bile duct, and their spatial disposition and course and co-relationship were shown clearly. In the virtual surgery system, the virtual scalpel could be manipulated on 3D liver model with PHANTOM. The simulating effect was the same as the clinic operation for living related donor liver transplantation. Conclusions The visualized liver model reconstructed is 3D and verisimilar, and it is helpful to design reasonable scheme for liver transplantation. It can improve the surgical effect, decrease the surgical risk, reduce the complication, enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery.

关 键 词：肝移植 成像 三维 仿真手术 

分 类 号：R686[医药卫生—骨科学]