磁共振成像三维重建在子宫内膜癌淋巴结切除术中的应用  

Application of magnetic resonance imaging three-direction reconstruction in pelvic lymph node resection of endometrial carcinoma

作　　者：陈少敏[1] 王文娟[2] 宿淑臻 柳林[1] 孙凤仪 薛迎峰[3] CHEN Shaomin;WANG Wenjuan;SU Shuzhen;LIU Lin;SUN Fengyi;XUE Yingfeng(Department of Gynecology,Weifang People’s Hospital,Weifang 261041,China;Department of Radiology,Weifang People’s Hospital,Weifang 261041,China;Department of Gynecology,Zoucheng People’s Hospital,Jining 273500,China)

机构地区：[1]山东省潍坊市人民医院妇科,山东潍坊261041 [2]山东省潍坊市人民医院放射科,山东潍坊261041 [3]山东省邹城市人民医院妇科,山东济宁273500

出　　处：《医学影像学杂志》2024年第12期112-115,共4页Journal of Medical Imaging

基　　金：山东省潍坊市科技发展计划(软科学)项目(编号:2022RKX016);济宁医学院教师科研扶持基金项目(编号:JYFC2018FKJ121)。

摘　　要：目的探讨MRI三维重建术前规划对子宫内膜癌盆腔淋巴结切除术的指导作用。方法选取91例经术前盆腔MRI检查显示淋巴结大小正常或轻度肿大的子宫内膜癌患者,随机分为术前规划组(46例)和系统切除组(45例)。采用多模态影像学手术规划系统进行规划,指导淋巴结定位切除。记录手术时间、出血量、术后住院时间、术后并发症发生率。术后随访时复查影像学检查。结果术前规划组盆腔淋巴结切除手术时间显著短于系统切除组,差异有统计学意义(P<0.05),手术出血量差异无统计学意义(P>0.05),术后住院时间显著缩短(P<0.05),术后并发症发生率明显下降,差异有统计学意义(P<0.05)。术后影像学检查显示术前规划组的目标淋巴结全部切除,而系统切除组中2例漏切淋巴结。结论通过术前MRI三维重建定位和规划,术中可以成功发现并切除目标淋巴结,有效防止漏切,同时缩短手术时间和术后住院时间,提高手术准确率和安全性。Objective The purpose of this study was to investigate the guiding role of the three-direction visualization preoperative planning based on magnetic resonance imaging in the pelvic lymph node resection for endometrial cancer.Methods A total of 91 patients of endometrial cancer were included in the study and underwent the pelvic and abdominal MR examination with normal size or mild enlargements of lymph nodes before laparoscopic operation.Multimodal imaging surgery planning system was used for the preoperative planning to guide the localization and resection of lymph nodes.The operation time,blood loss,postoperative hospital stay and postoperative complication rate were recorded.MR or CT examination was conducted during follow-up.Results Compared to the systemic resection group,the preoperative planning group had the shorter operation time(P<0.05),slightly decreased amount of surgical blood loss(P>0.05),shorter postoperative hospital stay(P<0.05),and lower postoperative complication rate(P<0.05).According to preoperative and postoperative imaging comparison,the target lymph nodes were all removed in the preoperative planning group,and the missed target lymph nodes were found in 2 cases in the systemic resection group.Conclusion Three-dimensional reconstruction software system can be used to guide the accurate selective resection of pelvic lymph nodes.It is helpful to improve the three-dimensional visualization and the decision-making ability of pelvic lymph node resection of endometrial cancer,and to achieve individualized and accurate treatment.Through the preoperative three-dimensional reconstruction localization and planning,the target lymph nodes are successfully found and removed during the operation,which has shortened the operation time and postoperative hospitalization time and improved the accuracy and safety of the laparoscopy operation.

关 键 词：子宫内膜癌 术前规划 数字化三维重建 磁共振成像 盆腔淋巴结切除术 

分 类 号：R711.74[医药卫生—妇产科学] R445.2[医药卫生—临床医学]