电磁导航系统在3D打印模型胆道镜探查中的应用探索  

Prospection of electromagnetic navigation for hepatic ducts exploration by choledochoscope based on a three-dimensional printing model

作　　者：汤睿[1] 马龙飞[2] 曾建平[1] 赵文萍[1] 王学栋[1] 王良[1] 廖洪恩[2] 董家鸿[1] 

机构地区：[1]清华大学医学中心北京清华长庚医院肝胆胰医学中心,102218 [2]清华大学医学院生物医学工程系,北京100084

出　　处：《中华消化外科杂志》2017年第4期433-436,共4页Chinese Journal of Digestive Surgery

基　　金：国家科技支撑计划（2012BA106801）;北京市医院管理局“使命”计划（SML20152201）;北京清华长庚医院研究基金（12015C1039）

摘　　要：目的探讨电磁导航系统在3D打印模型胆道镜探查中应用的可行性。方法采用回顾性描述性研究方法。选取2016年4月北京清华长庚医院收治的1例梗阻性黄疸合并肝内外胆管继发性扩张患者的临床资料。获取患者行增强CT扫描检查的医学数字成像和通信标准格式数据，对肝脏和胆道行三维重建，将结果进行3D打印，获得胆道中空模型。胆道镜器械通道内置磁探头，进镜后选取左、右肝管及肝总管内4个解剖标志点为基准点进行配准。结果配准后，胆道镜进入右前、左肝管分支时可被实时追踪导航，配准效果良好。结论电磁导航系统应用于3D打印模型胆道镜探查可获得较准确的追踪效果。Objective To explore the feasibility of electromagnetic navigation for hepatic ducts explora- tion by choledochoscope based on a three-dimensional （3D） printing model. Methods The retrospective descriptive study was conducted. The clinical data of 1 patient with obstructive jaundice combined with secondary biliary tract dilation who was admitted to the Beijing Tsinghua Changgung Hospital in April 2016 were collected. Digital imaging and standardized format data of enhanced computed tomography （CT） scan were collected, 3D reconstruc- tion of liver and bile duct were done under a 3D printing model, and then a hollow model of bile duct was achieved. Choledochoscope with internal electromagnetic probe was inserted into the printed hepatic ducts. Four points of anatomical markers in left and right hepatic ducts and common hepatic duct were chosen as fiducial markers for calibration and registration. Results After registration, the scope can be tracked in main hepatic segmental bile ducts. The locations of choledochoscope matched precisely the navigation results. Conclusion Electromagnetic navigation may bring accurate tracking effectiveness for choledochoscopic examination.

关 键 词：梗阻性黄疸 肝胆管结石病 电磁导航 胆道镜检查 三维重建 3D打印 

分 类 号：R657.4[医药卫生—外科学]