基于3D Slicer软件的局限性肾癌供血动脉解剖分布研究  

Artery anatomy of localized renal cell carcinoma:an initial study based on 3D Slicer software

作　　者：高珂 万紫妍 张娅[1] 张慧[1] 杨小杰[1] 种铁[1] 付德来[1] GAO Ke;WAN Ziyan;ZHANG Ya;ZHANG Hui;YANG Xiaojie;CHONG Tie;FU Delai(Department of Urology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;Department of Urology,Shaoxing People's Hospital,Shaoxing 312000,China)

机构地区：[1]西安交通大学第二附属医院泌尿外科,陕西西安710004 [2]绍兴市人民医院泌尿外科,浙江绍兴312000

出　　处：《现代泌尿外科杂志》2024年第4期298-301,共4页Journal of Modern Urology

摘　　要：目的利用3D Slicer软件分析局限性肾癌供血动脉进入肿瘤的位置、数目与分布规律,为肾部分切除术中精准缝合提供解剖依据。方法收集2021年1月—2022年6月西安交通大学第二附属医院泌尿外科因肾癌行肾部分切除术的患者资料,将患者术前肾动脉计算机断层扫描(CT)血管成像资料以DICOM格式导入3D Slicer软件,从水平面、矢状面和冠状面对肿瘤-血管的相对位置进行重建,分析各平面中肿瘤供血动脉的数目及分布特点。结果共收集112例(男59例、女53例)肾癌患者相关资料,肿瘤均为单发,RENAL评分为4~10分,肿瘤分期T1a 58例、T1b 48例、T2a 6例。其中38例(33.93%)有1条肿瘤供血动脉、53例(47.32%)有2条肿瘤供血动脉、21例(18.75%)有3条肿瘤供血动脉。这207条肿瘤供血动脉中有22条(10.63%)经肿瘤-肾脏接触面(肿瘤床)浅部进入肿瘤,有185条(89.37%)经肿瘤床深部进入肿瘤。结论在局限性肾癌中,近90%的供血动脉由肿瘤床深部进入肿瘤,为肾部分切除术中精准肿瘤切除及创面缝合提供了解剖依据。Objective To analyze the position of the feeding artery entering the renal cell carcinoma(RCC)with 3D Slicer software,so as to explore the distribution pattern of the tumor artery and to provide an anatomical basis for the accurate surgical resection.Methods The clinical data of RCC patients who underwent partial nephrectomy in the Department of Urology,The Second Affiliated Hospital of Xi'an Jiaotong University during Jan.2021 and Jun.2022 were collected.The preoperative renal artery CT angiography data were imported into 3D Slicer software in DICOM format to construct the relative positions of tumor-feeding artery from horizontal,sagittal and coronary planes.The number and distribution of tumor feeding arteries in each plane were analyzed.Results A total of 112 patients(59 male and 53 female)with single tumor were involved.RENAL score was 4-10.The tumor stages were T1a in 58 cases,T1b in 48 cases,and T2a in 6 cases.Among them,38 cases(33.93%)had 1 tumor artery,53 cases(47.32%)had 2 tumor arteries,and 21 cases(18.75%)had 3 tumor arteries.Of these 207 tumor arteries,22(10.63%)entered the tumor through the superficial part of the tumor bed,and 185(89.37%)through the deep part.Conclusion In localized RCC,nearly 90%of the feeding arteries enter the tumor from deep part of the tumor bed,which provides an anatomical basis for accurate tumor resection and wound suture in partial nephrectomy.

关 键 词：肾肿瘤 肿瘤血管 肾部分切除术 热缺血时间 3D Slicer软件 

分 类 号：R737.11[医药卫生—肿瘤]