人工智能三维重建辅助规划胸腔镜肺段切除术的应用价值  

Application Value of Artificial Intelligence-assisted Three-dimensional Reconstruction in Planning Thoracoscopic Segmentectomy

作　　者：郑智中 任美玉 李斌[1] 杨建宝[1] 魏小平[1] 宋铁牛[1] 孟于琪[1] 陈玉珍 刘晴 Zhizhong ZHENG;Meiyu REN;Bin LI;Jianbao YANG;Xiaoping WEI;Tieniu SONG;Yuqi MENG;Yuzhen CHEN;Qing LIU(Department of Thoracic Surgery,Lanzhou University Second Hospital,Lanzhou University Second Clinical Medical College,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院胸外科,兰州大学第二临床医学院,兰州730030

出　　处：《中国肺癌杂志》2023年第7期515-522,共8页Chinese Journal of Lung Cancer

基　　金：兰州大学产学研技术开发项目[No.(20)0458]资助。

摘　　要：背景与目的三维重建可辅助规划肺段切除手术,基于人工智能算法的三维重建软件正逐步应用于临床中。本研究旨在评估人工智能三维重建辅助规划胸腔镜肺段切除术的准确性及安全性。方法共纳入兰州大学第二医院胸外科收治的90例经评估拟行胸腔镜肺段切除术的患者,术前使用人工智能三维重建软件制作肺三维图像并进行术前规划,术中保存手术录像,记录围手术期数据。选取38例患者的视频录像,探究人工智能三维重建对于手术规划的效能。将人工智能三维重建图像及Mimics 21软件重建结果与术中实际所见进行对比,比较两种重建方法对支气管、血管的检测及分型能力。结果90例患者均在人工智能三维重建规划下完成手术,其中单一肺段切除57例(63.3%),联合亚段切除33例(36.7%)。人工智能三维重建对病变定位的准确率为100.0%,计算机断层扫描(computed tomography,CT)报告准确率为94.4%(85/90)。人工智能三维重建和Mimics 21软件的检测准确率分别为92.1%(35/38)和89.5%(34/38),解剖分型准确率分别为89.5%(34/38)和84.2%(32/38),总准确率分别为76.3%(29/38)和71.1%(27/38)。在对38例手术视频与重建图像的对比观察中发现,使用人工智能三维重建进行术前规划的靶段规划、手术入路、动脉离断、静脉离断、支气管离断的一致率分别为92.1%(35/38)、92.1%(35/38)、89.5%(34/38)、86.8%(33/38)、94.7%(36/38),总规划操作一致率为68.4%(26/38)。结论使用人工智能三维重建辅助规划胸腔镜肺段切除术是准确且安全的。Background and objective The three-dimensional(3D)can assist in planning lung segmentectomy.3D reconstruction software based on artificial intelligence algorithm is gradually applied in clinic.The aim of this study was to evaluate the accuracy and safety of 3D reconstruction assisted planning of thoracoscopic segmentectomy.Methods A total of 90 patients admitted to Department of Thoracic Surgery of Lanzhou University Second Hospital were evaluated for thoracoscopic segmentectomy.Before operation,artificial intelligence 3D reconstruction software was used to make 3D lung images and conduct preoperative planning.Surgical videos were saved during the operation and perioperative data were recorded.Video recordings of 38 patients were selected to explore the effectiveness of artificial intelligence 3D reconstruction for surgical planning.The results of artificial intelligence 3D reconstruction and Mimics 21 software reconstruction were compared with the actual results in the operation,and the detection and classification ability of bronchus and blood vessels of the two reconstruction methods were compared.Results All the 90 patients underwent artificial intelligence 3D reconstruction planning,including 57 patients(63.3%)with single lung segmentectomy and 33 patients(36.7%)with combined sub-segmentectomy.The accuracy of artificial intelligence 3D reconstruction for lesion localization was 100.0%,and the accuracy of computed tomography(CT)was 94.4%(85/90).The detection accuracy of artificial intelligence 3D reconstruction and Mimics 21 software was 92.1%(35/38)and 89.5%(34/38),and the anatomic typing accuracy was 89.5%(34/38)and 84.2%(32/38),and the total accuracy was 76.3%(29/38)and 71.1%(27/38).In the comparative observation of 38 surgical videos and reconstructed images,the consistent rates of target segment planning,surgical approach,artery dissection,vein dissection and bronchial dissection for preoperative planning using artificial intelligence 3D reconstruction were 92.1%(35/38),92.1%(35/38),89.5%(34/38),86.8%(33

关 键 词：人工智能 三维重建 磨玻璃结节 肺段切除术 

分 类 号：R734.2[医药卫生—肿瘤]