三维重建技术在辅助胰头癌手术治疗中的应用  

Application of three-dimensional reconstruction in the surgery for pancreatic head cancer

作　　者：黄文涛 吴俊艺 邱福南[1] HUANG Wentao;WU Junyi;QIU Funan(Department of Hepatopancreatobiliary Surgery,Fujian Provincial Hospital,Shengli Clinical Medical College of Fujian Medical University,Fujian Province,Fuzhou 350001,China)

机构地区：[1]福建省立医院肝胆胰外科、福建医科大学省立临床医学院,福建福州350001

出　　处：《中国当代医药》2023年第8期97-99,103,共4页China Modern Medicine

基　　金：福建医科大学教育教学改革研究项目(J22025)。

摘　　要：目的探讨三维重建技术在辅助胰头癌手术治疗中的应用价值。方法回顾性分析2019年5月至2021年9月福建省立医院收治并以三维重建技术辅助手术治疗的14例胰头癌患者的临床资料。采集术前CT/MRI增强扫描的影像资料,通过IQQA-3D系统完成三维可视化重建,进行三维可视化可切除性分型、肝动脉变异分型,并与术中情况进行比较。结果14例患者中,可切除性评估为Ⅰ型7例,Ⅱ型5例,Ⅲ型2例。主要术式为胰十二指肠切除术12例,加行门静脉部分切除重建2例。肝动脉变异4例,术中所见与重建影像相符。结论三维重建技术有助于对胰头肿瘤和周围重要结构空间关系的评估及对重要血管变异的预判,在辅助胰头癌手术治疗方面具有良好的应用前景。Objective To evaluate the application value of three-dimensional(3-D)reconstruction in the surgery for pancreatic head cancer.Methods From May 2019 to September 2021,clinical data of 14 patients with pancreatic head cancer were retrospectively analyzed,who were admitted to Fujian Provincial Hospital and underwent surgery assisted by 3-D visual technique.3-D visual technique was used to reconstruct the preoperative CT/MRI images with IQQA-3D system.The classification for resectability and variation of the hepatic arteries were evaluated and the results were analyzed during surgery.Results In the 14 cases,the classification for resectability was assessed as 7 cases of typeⅠ,5 cases of typeⅡ,2 case of typeⅢ.Pancreaticoduodenectomy was performed as the main procedure in 12 patients;while additional resection and reconstruction of portal vein were performed in the other 2 patients.Variation of the hepatic arteries was discovered in 4 patients.The anatomical relationship of the 3-D reconstruction was approximately consistent with surgical exploration.Conclusion 3-D reconstruction could benefit the evaluation of anatomical relationship between pancreatic head cancer and important structures around,and the prediction of variation of hepatic artery.Thus 3-D visual technique could be applied more widely in clinic.

关 键 词：三维重建 胰头癌 胰十二指肠切除术 肝动脉变异 

分 类 号：R736[医药卫生—肿瘤]