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作 者:印磊[1] 陈佳慧[2] 邵贤[1] 王胤达 王斐然[1] 陈钟[1]
机构地区:[1]南通大学附属医院肝胆外科,江苏省226001 [2]复旦大学附属中山医院心内科
出 处:《中华普通外科杂志》2016年第7期545-548,共4页Chinese Journal of General Surgery
基 金:江苏省“科教兴卫工程”医学领军人才和创新团队基金资助项目(LJ201134);江苏省科技厅临床医学科技专项基金资助项目(BL2014060)
摘 要:目的研究三维重建系统(IQQA.Liver)评估肝癌切除体积和切缘的效果。方法回顾性分析2014年3月至2015年10月收治的51例肝细胞肝癌患者肝切除的临床资料。术前对所有患者行B超、cT和(或)MRI检查,应用三维重建系统(IQQA—Liver)进行术前评估,分别重建肿瘤形态和位置、肿瘤与血管及胆管的毗邻关系,计算肝脏总体积、模拟切肝体积、剩余肝脏体积和手术切缘,并与实际术中切除肝脏体积和实际手术切缘比较。结果术前运用三维重建系统(IQQA—Liver)所重建的图像准确,清晰,直观。在肝脏切除体积和切缘方面,模拟结果和实际结果差异均无统计学意义[切肝体积:(412.93±471.26)m3。比(487.02±529.01)cm3,t=0.75,P=0.46];手术切缘[(13.72±4.58)mm比(13.92±4.21)mm,t=0.23,P=0.82],模拟切除肝脏体积与实际肝脏切除体积具有相关性(r=0.91,P〈0.01),模拟手术切缘和实际手术切缘也具有相关性(r=0.89,P〈0.01)。结论三维重建系统(IOOA.Liver)可以准确评估肝癌切除体积及手术切缘。Objective To study three-dimensional reconstruction system (IQQA-Liver) in evaluation of resection volume and margin of hepatocellular carcinoma. Method Data of 51 hepatocellular carcinoma patients undergoing hepatectomy from March 2014 to October 2015 were analyzed retrospectively. All patients received preoperative ultrasound and CT/MIR evaluation. Three-dimensional reconstruction system (IQQA-Liver) was used to reconstruct tumor shape and location, the relationship between tumor and adjacent vessels or bile ducts. Then liver volume, liver resection volume, residual liver volume and surgical margin were calculated and compared with the actual resection liver values and actual margin. Results hnages of three-dimensional reconstruction system (IQQA-Liver) were accurate, clear and directly perceived. In terms of the resection liver volume and resection margin, there was no significant difference between the predicted results and actual results [ resection liver volume: (412.93±471.26)cm3 vs. (487.02 ±529. 01 )cm3 , t =0. 75, P =0. 46, resection margin: ( 13.72 ±4. 58) mm vs. ( 13.92 ±4. 21 ) mm, t = 0. 23, P = 0. 82 l- The predicted resection liver volume was significantly correlated with the actual resection volume ( r = 0. 91, P 〈 0. 01 ), the predicted resection margin was also correlated with the actual resection margin ( r = 0. 89, P 〈 0. 01 ). Conclusion Three-dimensional reconstruction system ( IQQA- Liver) could accuratelv assess the resection volume volume and margin of hepatocellular carcinoma.
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