在体女性盆腔淋巴结数字化三维模型构建及测量  

Construction and Measurement of the Digital Three-dimensional Model of Pelvic Lymph Nodes in Vivo in Women

作　　者：贾鹏欢 刘晓云 宋小磊 陈春林[3] 杨伟 JIA Peng-huan;LIU Xiao-yun;SONG Xiao-lei(The Third Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,P.R.C.;不详)

机构地区：[1]遵义医科大学第三附属医院,贵州省遵义市563000 [2]深圳市中西医结合医院,广东省深圳市518104 [3]南方医科大学附属南方医院,广东省广州市510515

出　　处：《中国数字医学》2021年第5期91-96,共6页China Digital Medicine

基　　金：新疆维吾尔自治区卫生厅青年基金资助项目(编号:2014Y11);乌鲁木齐市科学技术局基金资助项目(编号:Y151310020);广东省临床教学基地教学改革研究项目(编号:2019JD079)。

摘　　要：目的:探讨利用数字化三维重建技术构建在体盆腔淋巴结数字化三维模型并测量相关数据,对早期宫颈癌淋巴结转移做出准确判断的标准,同时探索淋巴结转移的一-般规律。方法:选取2019年6-12月因初诊宫颈癌IA2-IIA1期入院的患者25例,以CT扫描的方式获得患者DICOM原始数据,并导入相应的三维重建软件中,完成骨盆、盆腔血管、淋巴结重建。随后对淋巴结所在平面最大时的径线值进行测量,将最短径线以dmin表示,最长径线以Dmax表示,并计算获得径线比,用字母R表示,和术后病检结果进行比较。结果:以淋巴结最短径值≥6.32mm对淋巴结转移进行评估,可获得敏感度为0.868,特异度为0.779,相较于Dmax及R具有更高的诊断价值:早期宫颈癌淋巴结总淋巴结转移率为48.00%(12/25),总淋巴结转移度为6.80%(50/735)。其中淋巴结转移率和转移度最高的分组为闭孔淋巴结。结论:借助数字化三维重建技术重建盆腔淋巴结三维模型,并精确测量相关解剖参数,初步得出以淋巴结最短径值≥6.32 mm、最长径线≥10.15 mm作为判断淋巴结转移的诊断标准具有较高的诊断效能。Objective: To explore the standard of accurate judgment of lymph node metastasis of early cervical cancer by using digital 3 D reconstruction technology to construct digital 3 D model of pelvic lymph node in vivo and measure relevant data, and to explore the general rule of lymph node metastasis. Methods: A total of 25 patients admitted to hospital from June 2019 to December 2019 due to the initial diagnosis of stage IA2-IIA1 cervical cancer were selected. The original DICOM data of the patients were obtained by CT scan and imported into the corresponding 3 D reconstruction software to complete the reconstruction of pelvic vessels and lymph nodes. Then, the diameter line value at the maximum lymph node plane was measured. The shortest diameter line was represented by dmin and the longest diameter line by Dmax, and the diameter line ratio was calculated and represented by letter R, which was compared with the postoperative disease examination results. Results: The shortest diameter value of lymph node was more than 6.32 mm, and the sensitivity and specificity were 0.868 and 0.779, which had higher diagnostic value compared with Dmax and R;The total lymph node metastasis rate of early cervical cancer was 48.00%(12/25), and the total lymph node metastasis rate was 6.80%(50/735). The group with the highest lymph node metastasis rate and degree was obturator lymph nodes. Conclusion: The three-dimensional model of pelvic lymph node was reconstructed by digital 3 D reconstruction technology, and related anatomical parameters were accurately measured. It was preliminary concluded that the shortest diameter of lymph node 6.32 mm and the longest diameter line 10.15 mm were used as the diagnostic criteria for lymph node metastasis with high diagnostic efficiency.

关 键 词：盆腔淋巴结 数字化 三维重建 径线测量 

分 类 号：R319[医药卫生—基础医学] TP391[自动化与计算机技术—计算机应用技术]