Hisense计算机辅助手术系统三维重建在小儿肝脏肿瘤精准治疗中的应用价值  

Application value of Hisense computer-assisted surgery system three-dimensional reconstru-tion in precision treatment of pediatric liver tumors

作　　者：李睿 郝希伟[1] 张桓瑜 陈鑫[1] 朱呈瞻 姜忠[1] 赵静[1] 段于河[1] 尚聪 弭杰 魏宾 夏楠 王菲菲 王凤娇 杨霞 董蒨[1] Li Rui;Hao Xiwei;Zhang Huanyu;Chen Xin;Zhu Chengzhan;Jiang Zhong;Zhao Jing;Duan Yuhe;Shang Cong;Mi Jie;Wei Bin;Xia Nan;Wang Feifei;Wang Fengjiao;Yang Xia;Dong Qian(Department of Pediatric Surgery,Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong Province,China;Hepatobiliary Surgery,Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong Province,China;Shandong Key Laboratory of Digital Medicine&Computer Assisted Surgery,Qingdao 266003,Shandong Province,China)

机构地区：[1]青岛大学附属医院小儿外科,青岛266003 [2]青岛大学附属医院肝胆外科,青岛266003 [3]山东省数字医学与计算机辅助手术重点实验室,青岛266003

出　　处：《中华消化外科杂志》2022年第6期816-821,共6页Chinese Journal of Digestive Surgery

基　　金：山东省“泰山学者”建设工程专项;青岛市科技惠民示范引导专项(17-3-3-8-nsh,20-4-1-5-nsh)。

摘　　要：目的探讨Hisense计算机辅助手术系统(CAS)三维重建在小儿肝脏肿瘤精准治疗中的应用价值。方法采用回顾性描述性研究方法。收集2013年1月至2021年9月青岛大学附属医院收治的82例肝脏肿瘤患儿的临床病理资料;男39例,女43例;年龄为13(19)个月。患儿均行上腹部动态增强CT检查,采用Hisense CAS对CT检查动脉期、平衡期及静脉期图像进行三维重建。首先依据上腹部动态增强CT检查结果判断手术可行性及规划手术方案,然后基于Hisense CAS三维重建结果进行修订。观察指标:(1)二维CT检查图像与Hisense CAS三维重建图像对患儿手术规划的比较。(2)术中及术后情况。(3)随访情况。采用门诊方式进行随访,了解患儿术后并发症、剩余肝脏代偿情况。随访时间截至2021年11月。正态分布的计量资料以x±s表示,偏态分布的计量资料以M(IQR)或M(范围)表示。计数资料以绝对数或百分比表示。结果(1)二维CT检查图像与Hisense CAS三维重建图像对患儿手术规划的比较:①82例患儿根据二维CT检查图像判断手术可行性,其中42例可行Ⅰ期切除术,40例无法行Ⅰ期切除术;根据Hisense CAS三维重建图像,其中48例可行Ⅰ期切除术,34例无法行Ⅰ期切除术。6例患儿根据二维CT检查图像判断无法行Ⅰ期切除术,依据Hisense CAS三维重建图像判断具有手术可行性。34例无法行Ⅰ期切除术先行化疗患儿中,31例化疗后根据二维CT检查图像判断具有手术可行性,3例因肿瘤缩小不明显、肿瘤包围重要血管无法手术。34例患儿根据Hisense CAS三维重建图像判断均可行手术治疗。82例患儿的手术可行性修订率为11.0%(9/82)。②82例患儿根据二维CT检查结果,15例行肝左叶切除术,21例行肝右叶切除术,7例行肝中叶切除术,13例行扩大左半肝切除术,23例行扩大右半肝切除术,3例行肝段切除术;依据Hisense CAS三维重建结果,20例行肝左叶切除术,29例�Objective To investigate the application value of Hisense computer-assisted surgery system(CAS)three-dimensional reconstruction in the precision treatment of pediatric liver tumors.Methods The retrospective and descriptive study was conducted.The clinicopathological data of 82 children with liver tumors who were admitted to Affiliated Hospital of Qingdao University from January 2013 to September 2021 were collected.There were 39 males and 43 females,aged 13(19)months.Children underwent upper abdominal dynamic enhanced computed tomography(CT)examination,and three-dimensional reconstruction was performed on CT images of arterial,equili-brium and venous phases with Hisense CAS.Surgical feasibility and scheme were evaluated and conducted based on the results of upper abdominal dynamic enhanced CT examination,and then revised according to three-dimensional reconstruction results of Hisense CAS.Observation indicators:(1)comparison of surgical scheme between two-dimensional enhanced CT images and three-dimensional reconstruction results of Hisense CAS;(2)intraoperative and postoperative situations;(3)follow-up.Follow-up was conducted by outpatient examination to detect postoperative compli-cations and residual liver compensation up to November 2021.Measurement data with normal distribution were represented as Mean±SD.Measurement data with skewed distribution were represented as M(IQR)or M(range).Count data were described as absolute numbers or percentages.Results(1)Comparison of surgical scheme between two-dimensional CT images and three-dimensional reconstruction results of Hisense CAS.①Based on the two-dimensional CT images,42 cases of 82 children could undergo one-stage resection and 40 children could not.However,based on the three-dimensional reconstruction results of Hisense CAS,48 cases of 82 children could undergo one-stage resection and 34 children could not.There were 6 children with one-stage resection feasibility based on the three-dimensional reconstruction results of Hisense CAS rather than the two-dimen

关 键 词：肝肿瘤 外科手术 三维 精准医学 计算机辅助 

分 类 号：R735.7[医药卫生—肿瘤]