头面部神经纤维瘤切除术的数字化评估初步研究  

Priliminary Exploration of Digital Evaluation in Craniofacial Neurofibroma Reduction

作　　者：马大梦 郭呈瑞 陈良波[1] 胡晓洁[1] 陈丹丹[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科杂志》2017年第4期188-192,共5页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨三维激光扫描技术,结合MRI、CT在头面部神经纤维瘤体积测量中的应用。方法 2015年5月至2016年9月,对11例神经纤维瘤患者行头面部三维激光扫描,结合MRI和CT影像学数据,应用Mimics18.0软件进行计算,预估切除肿瘤的体积。术后3个月,再次行头面部三维激光扫描,评价手术效果。结果(1)术前根据MRI影像学数据,预估可切除肿瘤体积(61.8±67.5)cm^3。术中实际切除(47.0±55.4)cm3,达到术前预估的(79.0%±16.4%)。(2)三维激光扫描显示,患侧半侧头颅(以正中线为界)体积平均缩小(54.4±60.5)cm3,缩小率为(9.4%±6.4%);术中检测实际体积缩小率为(9.3%±5.8%),两者无显著性差异(P=0.977)。(3)根据三维激光扫描数据,术前头颅两侧(以正中线为界)对称度为(72.7%±1.1%),术后为(79.9%±9.3%),提高了(10.6%±8.1%),差异显著(P=0.000 4)。结论三维激光扫描技术是MRI、CT等影像技术的良好补充手段,用于测量神经纤维瘤的瘤体体积,具有低成本、便捷、直接客观、精准的特点,可在手术指导、监测、评估疗效和观察肿瘤生长规律等方面发挥积极作用。Objective To investigate the application of three-dimensional(3D) laser scan technology combined with MRI and CT examination in the measurement of craniofacial neurofibroma 's volume.Methods From May 2015 to September2016,11 patients with craniofacial neurofibroma were scanned by 3-D laser,MRI and CT.Mimics 18.0 software was used to reconstruct 3-D model of tumor and face,analyze and calculate 3-D model volume.All patients underwent 3-D laser scan again to evaluate the effects of the operation 3 months after operation.Results(1) Volume of planned resection part was(61.8±67.5) cm3 according to MRI pre-operation.Volume of resected tumor was(47.0±55.4) cm^3 during operation,accounting for(79.0%±16.4%) of the MRI volume.(2) The volume of the surgical head(bounded by the median line) was reduced to(54.4±60.5) cm3 scanned by 3-D laser,of which the reduction rate was(9.4%±6.4%).The actual volume reduction rate was(9.3%±5.8%) in terms of estimated in operation.There is no statistical significance(P=0.977) between two calculate methods.(3) Based on the 3-D laser scan technology,the symmetry of the preoperative area(bounded by the median line) was(72.7%±1.1%),while it turned out to become(79.9%±9.3%) after operation.The degree of symmetry increased(10.6%±8.1%)with statistical significance(P=0.000 4).Conclusion 3-D laser scan technology is an effective supplement to MRI and CT.It would probably become a low-cost,convenient,direct,objective and accurate method to measure the volume of craniofacial neurofibroma,which can be used in guiding the operation,assessing the results,and monitoring tumor variation after operation.

关 键 词：神经纤维瘤 三维激光扫描 数字医学 

分 类 号：R730.264[医药卫生—肿瘤]