数字化三维重建技术在盆腔包块诊断中的意义  

Significance of digital three-dimensional reconstruction techniques in the diagnosis of pelvic mass

作　　者：陈兰[1] 陈春林[2] 刘萍[2] 唐雷[1] 段慧[2] 王俊[2] 陈若兰[2] 陈斌[3] 王建平[3] 李维丽[2] 钟世镇[1] 

机构地区：[1]南方医科大学解剖学教研室,广州510515 [2]南方医科大学南方医院妇产科 [3]南方医科大学南方医院影像科

出　　处：《中华妇产科杂志》2014年第2期94-99,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金（81272585、61190120、61190122）;广东省自然科学基金（10151051501000102、S2011010003830）

摘　　要：目的 探讨数字化三维重建技术在盆腔包块诊断中的意义.方法 采用单盲法,收集2009年10月至2012年10月期间,在南方医科大学南方医院住院且入院诊断为“盆腔包块”的患者72例,患者于术前均行B超和CT血管成像术（CTA）检查,并获取CTA原始数据集,采用三维重建软件Mimics 10.01对其骨盆、腹盆腔动脉血管网、盆腔包块及盆腔主要器官进行三维重建,构建盆腔数字化三维模型,由两位妇产科医师在不知CTA诊断结果的前提下通过多方位、多角度对该模型共同进行观察,依据盆腔包块的供血来源及其与毗邻器官之间的关系,得出诊断.以术后病理诊断为标准,对不同术前诊断方法（包括B超、CTA检查的诊断和基于盆腔数字化三维模型的诊断）与术后病理诊断的符合率进行比较.结果 本研究成功构建了72例患者的盆腔数字化三维模型,清楚地显示了骨盆结构、各级腹盆腔动脉分支的走行以及盆腔包块与盆腔主要器官之间的解剖学关系.在72例患者中,B超检查的诊断结果与术后病理诊断一致者56例,符合率为78％；术前CTA检查的诊断结果与术后病理诊断一致者58例,符合率为81％；基于盆腔数字化三维模型供血特点的诊断结果与术后病理诊断一致者66例,符合率为92％.盆腔数字化三维模型的诊断符合率与术前B超检查比较,差异有统计学意义（P=0.021）,而与术前CTA检查比较,差异无统计学意义（P=0.054）.结论 运用数字化三维重建技术构建的盆腔数字化三维模型可以直观地显示盆腔占位性病变的供血来源及其与盆腔主要器官的毗邻关系,具有较大的术前诊断和评估的意义.Objective To explore the significance of digital three-dimensional reconstruction techniques in the diagnosis of female pelvic mass.Methods Original computed tomographic angiography （CTA） datasets of 72 patients with pelvic mass who were hospitalized in Southern Hospital of Southern Medical University from October 2009 to October 2012 were collected.All cases were undergone the B-mode ultrasound and CTA examination,the datasets were input into the Mimics Version 10.01 software respectively to construct digital three-dimensional models of pelvic,arterial blood network,pelvic mass and organs.On the basis of without knowing the diagnosis of the disease on CTA,two gynecologists gave the final diagnosis of the disease after observing and analyzing the supply blood vessels and the relationship between the adjacent organs of pelvic mass through rotate the three-dimensional model by single-blind method.Define the postoperative pathological diagnosis as the standard,and compare the coincidence rate between the postoperative pathological diagnosis with diagnosis results on different inspections （including B ultrasound results,CTA results or the diagnosis on the three-dimensional model of pelvic mass）.Results We successfully reconstructed 72 patients＇ three-dimensional model which could clearly display anatomic structure of pelvic bone,abdomen and pelvic arterial branches at different levels and the anatomic relationship between the mass and main organs in the pelvis.In all cases,56 of them preoperative B-mode ultrasound examination were consistency with the postoperative pathological diagnosis,the coincidence rate was 78％,the preoperative CTA inspection results of 58 patients were consistency with the postoperative pathological diagnosis,the coincidence rate was 81％.While the diagnosis rate of 66 patients on the basis of digital three-dimensional model were consistency with that of the postoperative pathological diagnosis,the coincidence rate was 92％.Compared the compliance rate between diagnosis of pelvic

关 键 词：生殖器疾病 女(雌)性 体层摄影术 X线计算机 血管造影术 数字减影 成像 三维 

分 类 号：R816.91[医药卫生—放射医学]