The Establishment And Clinical Application Of Diagnosis And Treatment Platform Based On Three-dimensional Visualization Of Hilar Cholangiocarcinoma

Research BackgroundHilar cholangiocarcinoma accounts for 58%?75%of extrahepatic cholangiocarcinoma,and the incidence of the disease is upgrading.Surgical resection is the main treatment of hilar cholangiocarcinoma,it has significant meaning to implement precise preoperative assessment and optimize surgical planning.In recent years,with the rapid development of digital medicine technology and promotion and practice of the conception of precise diagnosis and management based on three-dimensional visualization,application of three-dimensional visualization technology?3D printing in healthcare domain is more and more frequent.Three-dimensional visualization model is more intuitive and precise than two dimensional imaging,therefore,it is contributed to precise diagnosis?preoperative assessment?precise surgery for hilar cholangiocarcinoma,and accepted by hepatobiliary surgeons gradually.Objectives1.To optimize the method for abdominal enhanced CT scan,acquisition of high-quality sub-millimeter spiral CT data in cases of hilar cholangiocarcinoma.2.Investigating the method for the rapid construct high quality three-dimensional visualization model of hilar cholangiocarcinoma based on three-dimensional reconstruction combining surface and volume rendering.3.Establishing the three-dimensional visualization platform in the diagnosis and treatment of hilar cholangiocarcinoma and formulating its management process as well as evaluating its clinical significance.4.Discuss the clinical application value and significance of three dimensional visualization technology applied to preoperative assessment for hilar cholangiocarcinoma surgical therapy.MethodsThis study collected high quality sub-millimeter spiral CT data in cases of hilar cholangiocarcinoma by retrospective cases analysis,using medical image three-dimensional visualization system to investigate the method for the rapid construct high quality three-dimensional visualization model based on three-dimensional reconstruction combining surface and volume rendering,establish three-dimensional visualization platform management process for hilar tumors and discuss its clinical significance;systematic evaluate the clinical application value and significance of construction of three-dimensional visualization diagnosis and treatment platform for hilar cholangiocarcinoma.Statistical analysisVarious inspection methods of detecting morphological changes comparing to the surgical pathologic results using chi-square test(the gold standard),adopting the mean+/-standard deviation showing measurement variable compling with normal distribution,Select SpSS19.0(SPSSInc,Chicago,IL,USA)statistical APP for all the raw data for analysis.Result1.Acquired high quality sub-millimeter CT data;Constructed three-dimensional models with features such as great stereotype effect?represent the characteristics of liver spatial morphology and hilar anatomical structures distinctly;Established the three-dimensional visualization platform for hilar cholangiocarcinoma.2.Three-dimensonal visualization guided the classification of hilar cholangiocarcinoma?assessment of resectability?preoperative planning,especially in cases with intrahepatic bile duct variations.Formulating proper treatment plans to guide actual surgical practice.3.The consequences of individual vascular classification for hilar cholangiocarcinoma based on three-dimensional visualization were consistent with intraoperative surgical exploration.Conclusions1.High quality sub-millimeter CT data of patients with hilar cholangiocarcinoma provide high resolution imaging characteristics of abdominal organs and vessels,which are satisfy the need of three-dimensional data segmentation and three-dimensional reconstruction.2.3D models of patients with hilar cholangiocarcinoma have ability to make systematic and comprehensive diagnosis according to tumors location and morphology?Spatial relationship between tumors and intrahepatic vessels,which have great significance for surgeons to assess the resectability of tumor.3.The process design of three-dimensional visualization platform in the diagnosis and treatment of hilar cholangiocarcinoma is reasonable and clinical demonstration.4.Three dimensional visualization technology used for patients with hilar cholangiocarcinoma has ability to optimize surgical planning,especially in cases with hilar bile duct or vascular variations,through analysis of three dimensional visualization models surgeons are able to avoid unnecessary injury.As a novel approach fulfill precise diagnosis and treatment,it has certain clinical application value and prospect.