南方医科大学学报 ›› 2019, Vol. 39 ›› Issue (10): 1127-.doi: 10.12122/j.issn.1673-4254.2019.10.01

• •    下一篇

计算机辅助联合吲哚菁绿分子荧光影像技术在肝脏肿瘤诊断和手术导航中的应用指南(2019版)

方驰华   

  • 出版日期:2019-10-20 发布日期:2019-10-20

Guidelines for application of computer-assisted indocyanine green molecular fluorescence imaging in diagnosis and surgical navigation of liver tumors (2019)   

  • Online:2019-10-20 Published:2019-10-20

摘要: 计算机辅助联合吲哚菁绿分子荧光影像技术可以从三维的形态解剖和细胞功能水平进行术前规划和术中侦测,从而导航 肝癌解剖性、功能性、根治性的肝切除术,临床应用证明其有重要的诊疗价值,此项技术现已在全国得到了广泛推广和应用。为 规范计算机辅助联合吲哚菁绿分子荧光影像技术在肝脏肿瘤精准诊疗中的应用,本指南在以下几个方面进行了研究:(1)三维 可视化技术应用流程;(2)ICG分子荧光成像的机制及应用流程;(3)三维可视化和虚拟现实技术的临床应用;(4)ICG分子荧光 影像技术的临床应用。ICG分子荧光成像技术能从分子、细胞水平层面实现肿瘤边界界定、肝段和肝叶切除切线的确定;微小 病灶或转移灶的侦测;术中根据肝脏肿瘤的荧光信号特点,结合术中快速冰冻病理学检查,可初步判定肝脏占位性病变的分化 程度;肝切除后对肝断面进行残留肿瘤病灶和胆漏的检测。计算机辅助联合ICG分子荧光影像技术在肝脏肿瘤诊断和手术导 航中的应用,为肝脏肿瘤的外科治疗提供了一种新的数字智能化外科诊疗技术,该项技术亦将不断改进和完善,为肝脏肿瘤的 精准诊疗展现出良好的应用前景。

Abstract: Computer-assisted combined indocyanine green (ICG) molecular fluorescence imaging technology can be used for preoperative planning and intraoperative detection from three-dimensional (3D) morphological anatomy and level of cellular function to guide the anatomical, functional and radical hepatectomy of liver tumor. This technology has received wide acceptance and has shown important diagnostic and therapeutic value. This guideline is intended to standardize the application of computer-assisted combined ICG molecular fluorescence imaging for accurate diagnosis and treatment of liver tumors in the following aspects: (1) the workflow of 3D visualization technology; (2) the mechanism and application flow of ICG molecular fluorescence imaging; (3) clinical application of 3D visualization technology and virtual reality technology; and (4) clinical application of ICG molecular fluorescence imaging. ICG molecular fluorescence imaging can help to define tumor boundary, determine hepatic segment and hepatic lobectomy tangent at the molecular and cellular level, and detect small lesions or metastases. According to the fluorescence signal characteristics of liver tumors and combined with rapid frozen pathological examination during operation, the differentiation degree of liver space-occupying lesions (such as primary liver cancer) can be preliminarily determined, and residual tumors and biliary leakage on the hepatic section can be detected after hepatectomy. Computer-assisted ICG molecular fluorescence imaging in the diagnosis and surgical navigation of liver tumors provides a new approach to digital diagnosis and treatment of liver tumors. With its development in clinical practice and the technological innovation, this technology will be further improved to allow more accurate diagnosis and treatment of liver tumors.