南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (04): 562-.

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个人电脑上肺癌64排CT数据的三维重建及虚拟手术

张书新,刘阳   

  • 出版日期:2016-04-20 发布日期:2016-04-20

Computer-based three-dimensional reconstruction of lung cancer using 64-slice CT scanning data and virtual surgery

  • Online:2016-04-20 Published:2016-04-20

摘要: 目的研究肺脏及其脉管系统的三维重建在肺癌虚拟手术中的应用价值。方法选取2015 年5 月~2015 年8 月在我院胸 外科进行手术治疗的24例非小细胞肺癌患者作为研究对象,将患者随机分为实验组和对照组,每组各12 例。对于实验组的12 例患者,在个人电脑上利用胸部CT扫描数据和Mimics 软件,使用面绘制的方法进行三维建模。通过对模型进行移动、分离、组 合、显隐等操作进行术前模拟演练。对照组的12 例患者按照常规方案进行手术治疗。分析两组患者的手术时间、术中出血量、 术后住院时间的差异。结果成功构建了包括胸部骨骼、肺、肿瘤、气管支气管树、肺血管的结构的实验组肺癌数字化模型。模 型几何相似性高、立体感强,真实地反应了肺癌的形态特点及其毗邻结构的空间关系。模型可编辑性强,模拟手术切除过程生 动、逼真,效果良好。所有患者均行手术切除,无围手术期死亡,无术后出血、感染等术后并发症。实验组手术时间优于对照组, 差异有统计学意义(P<0.05),其余无统计学意义。结论肺癌个体化建模有助于术前安全评估并制定精确的手术计划。

Abstract: Objective To study the clinical value of three-dimensional (3D) reconstruction of the lung and its vasculature in virtual surgery for lung cancer. Methods From May 2015 to August 2015, 24 patients with non-small cell lung cancer underwent surgical treatment in our department. The patients were randomly divided into experimental and control groups (12 in each group). For the patients in the experimental group, 3D models were reconstructed by surface rendering based on thoracic CT scanning data using Mimics software on a personal computer, and manipulations of the structures were simulated on the models before the operation. For the patients in the control group, surgeries were performed according to the conventional scheme. The operation time, blood loss and postoperative hospital stay were compared between the two groups. Results The 3D models of lung cancer consisting of the thoracic bone, lungs, tumor, tracheobronchial tree, and pulmonary vessels were reconstructed successfully. The models had highly geometrical similarity and offered excellent 3D view of the morphological characteristics of the tumor and the spatial relationship between the adjacent structures. The models allowed editing and provided vivid view during the simulated operation of tumor excision to facilitate individualized surgical planning and reduce the surgery risks. All the patients underwent tumor resection smoothly without perioperative death or incidences of postoperative hemorrhage or infection. The operation time was significantly shorter in the experimental group than in the control group (P<0.05) but the blood loss and postoperative hospital stay were comparable between the two groups. Conclusion The individualized lung cancer modeling can facilitate the evaluation of preoperative risks and allows for more accurate surgical planning.