影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (5): 801-806.DOI: 10.7517/issn.1674-0475.191201

• 综述与论文 • 上一篇    下一篇

基于Amira软件的三维立体重建技术在精准肝切除术中的应用研究

季渝军   

  1. 陆军军医大学第一附属医院, 重庆 400000
  • 收稿日期:2019-12-03 出版日期:2020-09-15 发布日期:2020-09-15
  • 基金资助:
    重庆市基础与前沿研究计划项目(Y2016012038)资助

Application of 3D Reconstruction Technique Based on Amira Software in Precise Hepatectomy

JI Yujun   

  1. First Affiliated Hospital of Army Military Medical University, Chong Qing 400000, P. R. China
  • Received:2019-12-03 Online:2020-09-15 Published:2020-09-15

摘要: 为了研究使用Amira软件进行术前三维重建对评估单发病灶原发性肝癌手术方案拟定的临床价值,我们回顾性纳入连续111例进行肝切除术的患者,其中59例仅行术前CT (对照组),52例行同期肝脏及周围血管三维重建(观察组)。观察组分别通过二维及三维重建两种方法评估手术切除范围,并测量肝脏总体积及预切除肝体积。分别对比了两组病人各临床指标间的差异。结果显示两组患者的临床特征无明显差异;观察组R0切除率为88.5%,与对照组(71.2%)存在统计学差异;观察组采用两种不同方法计算出的肝预计切除体积无统计学差异;观察组和对照组术后实际肝切除体积无统计学差异。观察组并发症发生率、术中出血量、肝门血管阻断时间均小于对照组,差异有统计学意义。因此,基于Amira软件的三维重建技术有助于发现瘤体与脉管系统的临界关系及手术关键部位的解剖变异,指导个体化治疗,完善术前安全性评估。

关键词: Amira, 三维重建技术, 精准肝切除, 原发性肝癌, 门静脉

Abstract: In this paper, we explored the clinical value of three-dimensional reconstruction based on Amira software in making the liver cancer surgery plan. In our retrospective study, 111 consecutive patients admitted for hepatectomy were included, among which 59 received preoperative CT (control group), and 52 received simultaneous three-dimensional reconstruction of liver and peripheral vessels (observation group). The scope of surgical resection, total volume of the liver and the volume of the pre-resection liver of the observation group were evaluated by two-dimensional and three-dimensional reconstruction. The differences among the clinical indicators of the two groups of patients were compared. The results showed that there was no significant difference in clinical characteristics between the two groups. The R0 resection rate was 88.5% in observation group, which was significantly higher than the control group (71.2%). In the observation group, there was no significant difference in the volume of liver resection 801 calculated by two different methods. There was no significant difference in actual postoperative liver resection volume between the observation group and the control group. The incidence of complications, intraoperative blood loss and time to block hilar vessels in the observation group were all lower than those in the control group. In a word, the three-dimensional reconstruction technology based on Amira software can help to find the critical relationship between the tumor and the vascular system, as well as the anatomical variation of the key parts of the operation, which can guide the individualized treatment, and improve the preoperative safety assessment.

Key words: Amira, three dimensional reconstruction technique, precise hepatectomy, hepatocellular carcinoma, portal vein