三维可视化技术在肝血管瘤个体化诊治中的应用研究  

Applications of three-dimensional visualization technology in individualized diagnosis and treatment oh hepatic hemangioma

作　　者：项楠[1] 方驰华[1] 范应方[1] 杨剑[1] 祝文[1] 曾宁[1] 蔡伟[1] 

机构地区：[1]南方医科大学珠江医院肝胆一科,广州市510282

出　　处：《实用医学杂志》2014年第20期3299-3301,共3页The Journal of Practical Medicine

基　　金：国家高技术研究发展计划(863计划)项目(编号:2012AA022305);国家自然科学基金项目(编号:81170458);广东省重大科技专项(编号:2012A080203013);广东省科技计划项目(编号:2011B031800088);广东省医学科研基金(编号:A2011376)

摘　　要：目的:探讨三维可视化技术在肝血管瘤诊治中的应用价值。方法:2010年7月至2014年1月我院收治32例肝血管瘤,术前通过增强CT扫描获取亚毫米CT数据,采用腹部医学图像三维可视化系统(MI-3DVS)三维重建进行诊断和手术规划。术中在3D模型辅助下,选择最佳肝切除手术方案,保护临近血管瘤的重要血管,最大限度保留正常肝脏组织,实施手术。结果:三维重建真实显示肝血管瘤的部位、大小、形态,血管变异,血管瘤与肝内血管的空间关系。所有病例术前评估均为可切除,术前规划和实际手术符合率100%。术中在3D模型指导下完成腹腔镜肝血管瘤切除术14例,开腹肝血管瘤切除术18例。第一肝门阻断18例,阻断时间(15.32±7.12)min。术中出血(188.63±66.37)m L。术后胸腔积液5例,切口感染1例。结论:三维可视化技术辅助肝血管瘤个体化的诊断和外科治疗,有利于减少手术创伤,降低手术并发症。Objective To investigate the values of three-dimensional visualization technology in the diagnosis and surgical treatment of hepatic hemangioma. Methods Thirty two patients with hepatic hemangioma who had been hospitalized during the period from July 2010 to January 2014 in our hospital were scanned by 64-slice spiral computerized tomography （CT） before surgical treatment. Three-dimensional （3D） reconstruction based on the CT data was carried out to achieve dignosis and surgical planning. Assisted with the 3D model , we chose the best surgical procedure for liver resection, protecting the major blood vessels near hemangioma and retaining normal liver tissue as far as possible. Results The location, size and shape of hepatic hemangioma, vascular variation, and spatial relationship with intrahepatic vessel were shown factually by three-dimensional reconstruction. All the hemangiomas were preoperatively assessed to be resectable. The compliance rate for preoperative surgical planning to actual surgery was 100%. Under assistance of the 3D model during surgery , 14 patients received laparoscopic hepatectomy and 18 underwent hepatectomy. Pringle′s maneuver was applied in 18 patients , with blocking time of （15.32 ± 7.12） min and blood loss of （188.63 ± 66.37） mL. The postoperative complications included pleural effusion in 5 patients and incision infection in one patients. Conclusions Three-dimensional visualization technology for the individualized diagnosis and treatment of hepatic hemangioma helps reduce surgical trauma and incidence of postoperative complications.

关 键 词：肝血管瘤 三维重建 微创手术 

分 类 号：R735.7[医药卫生—肿瘤]