基于三维可视化技术的颈椎神经鞘瘤精准手术治疗一例报告及分析  

Precise surgery for cervical vertebra neurilemmoma based on 3D visualization technique:a case report and analysis

作　　者：孙涛[1] 韩善清[2] 王建伟[1] 陈爱萍[1] SUN Tao;HAN Shan-qing;WANG Jian-wei(Department of Radiotherapy, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]南京医科大学第一附属医院信息中心,江苏南京210029

出　　处：《中国医学装备》2017年第11期102-105,共4页China Medical Equipment

基　　金：江苏高校优势学科建设工程资助(JX10231801)"临床医学"

摘　　要：目的:探讨三维(3D)可视化技术在颈椎神经鞘瘤精准手术治疗中的意义。方法:选取1例因触摸发现右侧颈部肿大而在医院就诊的患者,通过多排CT和MR颈部平扫加增强检查发现右侧颈椎旁有占位性病变,将CT和MR的原始医学数字成像及通信(DICOM)数据,输入计算机进行立体3D建模,并根据实际情况规划手术方案。结果:基于3D可视化技术的重建模型可以清晰地显示占位周围的组织、器官的解剖结构,尤其是其与血管的关系,通过重建模型的指导,在尽可能保全正常周围组织的情况下,占位被完整切除,出血量和手术时间大为减少。结论:3D可视化技术可以清晰显示颈部各种组织、器官的解剖结构,通过增强成像,可以明确辨识占位性病变毗邻的血管;通过重建模型进行术前规划和模拟手术,在尽可能保全正常组织的同时,可减少出血量,提高手术速度,在肿瘤外科精准手术治疗方面具有极大的应用前景。Objective:To explore the significance of3D visualization technique in precise surgery of cervical vertebra neurilemmoma.Methods:To select a male patient who there was swelling on the right side of neck by touch,and he was found a space occupying lesion on his right side of cervical vertebra through multi-slice CT and MR plain scan combined with enhanced examination on neck.And the original digital imaging and communications in medicine(DICOM)of CT and MR were input computer to construct3D model.And then the operation plan was programmed according to actual situation.Results:The reconstructed model based on3-dimensional visualization technique can clearly display the anatomical structures of the tissues and organs around space occupying lesion,especially the relationship between them and vessel.Through the guidance of reconstructed model,the space occupying lesion was completely excised and the normal tissues around lesion were retained as far as possible.And the amount of bleeding and operation time were greatly reduced.Conclusion:The3D visualization technology can clearly show the anatomical structure of various tissues and organs of neck,and the vessel adjacent to space occupying lesion can be clearly identified through enhanced imaging.Through reconstructed model to implement preoperative program and simulated operation can reduce amount of bleeding and increase speed of operation,and the normal tissues can be remained as far as possible.Therefore,it has enormous application prospect on the aspect of precise operative treatment of surgical oncology.

关 键 词：三维可视化 精准手术 神经鞘瘤 

分 类 号：R-058[医药卫生]