DeepInsight 3D-CTBA 434例胸部增强CT数据运行分析及临床应用  

Clinical analysis of 434 enhanced CT scan data and application for improving DeepInsight 3D-CTBA results

作　　者：严煜[1] 周学军[2] 覃文军[3] 王晓谭[1] 杨茗峻 YAN Yu;ZHOU Xuejun;TAN Wenjun;WANG Xiaotan;YANG Mingjun(Department of Thoracic Surgery,Affiliated Hospital of Nantong University,Nantong 226001;Department of Radiology,Affiliated Hospital of Nantong University,Nantong 226001;Key Laboratory of Intelligent Computing in Medical Image of Ministry of Education,Northeastern University)

机构地区：[1]南通大学附属医院胸外科,南通226001 [2]南通大学附属医院影像科,南通226001 [3]东北大学医学影像智能计算教育部重点实验室

出　　处：《南通大学学报（医学版）》2022年第3期201-205,F0002,共6页Journal of Nantong University(Medical sciences)

摘　　要：目的:为获得满意的DeepInsight三维CT支气管血管成像(3D-computed tomography bronchography and angiography, 3D-CTBA)导航效果,观察胸部增强CT不同条件设置对DeepInsight 3D导航软件运行结果的影响。方法:全组434例进行DeepInsight 3D-CTBA手术导航。采用“团注测试法”预注射对比剂获得肺动脉,主动脉“时间-密度”曲线。为掌握增强CT设置条件,首先对41例患者,按“肺动脉峰值”时间8.8、10.3、11.8 s分为3组,收集各组患者的肺动脉峰值-主动脉峰值(V-A)间隔时间,对比剂注射量和CT扫描延时时间,并进行统计学分析,以发现影响3D导航软件运行结果的相关因素。结果:不同肺动脉峰值时间分组对照结果表明,8.8 s组中对比剂用量减少、扫描延时时间缩短与3D导航软件运行结果不满意有关(均P<0.05)。全组434例DeepInsight 3D-CTBA运行血管提取、染色结果满意391例,较满意30例,不满意13例。满意、较满意病例均成功应用于胸腔镜亚肺叶切除手术导航。结论:正确掌握增强CT对比剂用量和扫描延时时间是DeepInsight 3D导航软件运行获取满意3D图像的关键技术因素。DeepInsight 3D-CTBA能为精准亚肺叶切除提供导航保障。Objective: To obtain an efficient navigation with DeepInsight 3D-computed tomography bronchography and angiography, this primary research was conducted to evaluate the relationship between different enhanced CT scan data and DeepInsight 3D-CTBA results. Methods: 434 cases were enrolled in this research, the pulmonary artery(PA), aorta “time-density” curve was obtained by a pre-injection “bolus tracking” method. In order to obtain the optimal data setting for the enhanced CT scan, first 41 cases were divided by the criteria of PA pick time into 8.8, 10.3 and 11.8 s groups. The V-A interval time, the contrast dosage and the scan delay time data on each group were calculated and statistical evaluated. Results: Statistical results showed that at the PA pick time 8.8 s group, lack of enough contrast dosage, short of CT scan delay time control were related to 3D-CTBA unsatisfactory results(both P<0.05). Of the 434 DeepInsight 3D-CTBA cases, 391 were satisfied, 30were relatively satisfied and 13 were dissatisfied respectively. We applied successfully the satisfied, relatively satisfied 3D-CTBA navigation to the thoracoscopic sub-lobectomies. Conclusion: Correct calculation contrast dosage and precises scan delay time setting on the enhanced CT scan are the key factors for the successful DeepInsight 3D-CTBA. Our primary research results showed that DeepInsight 3-CTBA provide a satisfactory navigation for the thoracoscopic sub-lobectomies.

关 键 词：DeepInsight胸腔镜微创手术 肺段切除术 亚肺叶切除 三维CT支气管血管成像导航 

分 类 号：R655.3[医药卫生—外科学]