三维可视化技术在外科诊治Mirizzi综合征中的应用  

Application of three-dimensional visualization in surgical diagnosis and treatment for Mirizzi syndrome

作　　者：喻海波[1] 黄海锋[1] 张二勇[1] YU Hai-bo;HUANG Hai-feng;ZHANG Er-yong(Department of Hepatobiliary Surgery,Shengzhou People’s Hospital/the First Affiliated Hospital of Zhejiang University Shengzhou Branch/Shaoxing University Shengzhou Branch,Shaoxing,Zhejiang 312400,China)

机构地区：[1]嵊州市人民医院/浙江大学第一附属医院嵊州分院/绍兴文理学院附属嵊州分院肝胆外科,浙江绍兴312400

出　　处：《肝胆胰外科杂志》2020年第8期479-483,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的应用三维可视化技术,探讨三维成像对Mirizzi综合征外科诊治的指导意义。方法选取嵊州市人民医院2015年9月1日至2019年10月31日7例Mirizzi综合征患者的原始腹部增强CT扫描数据,导入Mimics软件,对胆管、胆囊、结石、门静脉、肝静脉、肝固有动脉、左右肝动脉、肝脏及胰腺等组织器官进行三维重建,并进行术前规划。结果 7例Mirizzi综合征患者均完成三维重建和术前规划,并顺利进行手术治疗。重建的三维图像清晰逼真,立体感强,可从任意角度、任意方位观察周围各组织器官的解剖关系。结论三维可视化技术可在术前了解胆道情况,评估胆管缺损,模拟胆管成形,避免损伤血管,规划手术路径,指导手术操作,在Mirizzi综合征的外科诊治中具有较高的临床实用价值。Objective To investigate the guiding significance of three-dimensional visualization in surgical diagnosis and treatment for Mirizzi syndrome. Methods The original abdominal enhanced CT scan data of 7 patients with Mirizzi syndrome were collected in Shengzhou People’s Hospital from Sep.1, 2015 to Oct.31, 2019. Mimics software was employed to reconstruct the three-dimensional tissues and organs such as bile duct, gallbladder, stone, portal vein, hepatic vein, proper hepatic artery, left and right hepatic arteries, liver, and pancreas, and to carry out preoperative planning. Results All 7 patients with Mirizzi syndrome completed the three-dimensional reconstruction and preoperative planning, whose surgical treatments were also successfully performed. The reconstructed three-dimensional images were clear and realistic, with strong three-dimensional sense, and the anatomical relationship of surrounding tissues and organs could be observed from any angle and any position. Conclusion Three-dimensional visualization can be used to understand the situation of biliary tract, evaluate the defect of bile duct, simulate the formation of bile duct, avoid vascular injury, plan surgical path, and guide the surgical procedure, which has high practical and clinical value in surgical diagnosis and treatment of Mirizzi syndrome.

关 键 词：三维可视化 MIRIZZI综合征 胆囊胆管瘘 胆囊结石 

分 类 号：R657.42[医药卫生—外科学]