Clinical Application Of Three-dimensional Reconstruction With Thoracic Surgery

Background:Three-dimensional reconstruction from medical images is a multi-disciplinary subject. It is an important application of computer graphics and image processing in biomedicine engineering. Three-dimensional reconstruction from medical images is widely used in diagnostic, surgery planning and simulating, plastic and artificial limb surgery, radiotherapy planning, and teaching in anatomy. It relates to the subjects of digital image processing, computer graphics and some related knowledge in medical area. The study included two parts:Part one:Objective:Video-assisted thoracic surgery (VATS) provides a minimally invasive means to resect pulmonary nodules. However, small solitary pulmonary nodules(SPN) remain problematic during VATS owing to unpredictable visualization and palpation. Intraoperative small SPN localization provides a more obvious target to facilitate intraoperative resection. This study is a single-institution validation of intraoperative CT-guided hook wire localization for small SPN in VATS. The purpose of this article was to study the effectiveness of video-assisted thoracoscopic solitary pulmonary nodules resection after three-dimensional and to show the safety and accuracy of the new marking technique using three-dimensional for preoperative localization of a small pulmonary nodule. Methods:28 patients were scanned with spiral computed tomography. The CT DICOM data of the patients with peripheral pulmonary nodule<20 mm in size were transmitted to the Osirix software is used for three-dimensional reconstruction. Then the lesion was underwent intraoperative CT-guided double-thorn hook wire localization prior to video-assisted thoracoscopic wedge resection. Results:28 patients underwent this procedure and all the nodules were identified due to the precise location of the probe. They were resected with sufficient margins. There were no surgical complications. Pathologic examination revealed 24 primary lung cancers,3 nonspecific chronic inflammation,1 atypical adenomatous hyperplasia(AAH). Conclusion: Video-assisted thoracoscopic solitary pulmonary nodule resection after three-dimensional reconstruction localization is a safe and effective procedure for accurate diagnosis and resection of indeterminate solitary pulmonary nodules, and has a very low rate of minor complications.Part two:Objective:To evaluate the diagnostic value of three dimensional reconstruction of multislice spiral CT in chest trauma fractures. Methods:24 patients of chest trauma fractures were examined by X-ray, multislice spiral CT, volume rendering of three dimensional reconstruction, the position, number, types and detected rate of fractures were observed and analyzed. Results:18 rib fractures in 24 patients were displayed by plain films, with 3 suspected fractures. 2 sternal fracture and 24 fractures were detected by 3D reconstruction technique of multislice spiral CT. Conclusion:The detected rate of rib fracture by 3D reconstruction technique of multislice spiral CT is higher than that by X-ray plain film, especially for impalpable rib fracture. The detected rate of sternal fracture by 3D reconstruction technique of multislice spiral CT much better than multislice spiral CT.