Study On Application Of Three-dimensional Visualizationtechnology In The Preoperative Evaluation Of Abdominal Surgery

ObjectiveEvaluation of clinical application and value on three-dimensional visualizationtechnology in abdominal surgical reconstruction in biliary tract disease, liver disease (including bile duct stones, hilar, huge liver cancer, liver hemangioma) and retroperitoneal tumors.Methods1.Data collection on reconstruction of three-dimensional visualization72cases of abdominal diseases patients (including30cases of bile duct stones,10cases of hilar cholangiocarcinoma,12cases of huge liver cancer,12cases of complicating hepatic hemangioma,8cases of retroperitoneal tumor) treated by Xiamen University affiliated successful hospital from December2011to December2013,scanned througth320-computed tomograph (Toshiba) Scan phase, arterial, portal venous phase and delayed phase.Data collection:all data recorded by disc two-dimensional image data stored througth DICOM (digital imaging and communications in medicine, DICOM), case data were introduced into the United States IQQA-Liver V1.0system, Xiamen strong independent research and development of the Company liver3D visualization system.2.Reconstruction of three-dimensional visualizationautomatical recognizes thtougth three-dimensional reconstruction software in the abdominal lesions. three-dimensional and dynamic observation to the adjacent relation.3.Preoperative evaluation3.1combination liver function,liver reserve function, in patients of biliary tract and liver disease, to accurately measure individual liver volume using three-dimensional voxel method; 3.2evaluating perioperative risk throuhth dynamic observation between the retroperitoneal tumor and surrounding blood-vessel4.surgical planningand simulationFormulating surgical planning,surgical removal of the line drawn, cut liver plane,according to the results of a three-dimensional reconstruction, following the principle of anatomic resection; formulating a number of surgical options for the same patient according to the results of a three-dimensional reconstruction of guiding surgery operation5.Statistical analysisAnalyzing using SPSS17.0statistical software.Expression in for measurement data, expression using the percentage for count data.Pearson rank correlation analysis used between the analog cut liver volume and actual cut liver volume.P<0.05was considered statisticallysignificant.Results1.Hepatocholangiolithiasis, patients with hilar cholangiocarcinoma1.1CT image data of30cases of bile duct stones is automatically recognized by the system, and human-computer interaction are to complete the final three-dimensional reconstruction; Three-dimensional reconstruction of10cases of hilar cholangiocarcinoma patients were successfully conducted. Three-dimensional structure of the liver, relations between liver lesions and adjacent piping system can be clear, transparent display throuhth reconstruction of three-dimensional visualization.1.2Relation of liver volume in analog resection and actual cutLiver volume of the liver bile duct stones patients was (1390±148) ml measred by three-dimensional reconstruction. Liver volume (275±156) ml pre-resection, actual volume (261±148) ml, rate of deviation was5.4%.Liver volume of hilar cholangiocarcinoma was (1496±162) ml measred by three-dimensional reconstruction. Average volume of tumour was (67±18) ml, the average volume of pre-liver resection was (335±241) ml, average volume of the remaining liver was (1140±197) ml. The average rate of deviation6.4%. 2.Large liver cancer, hepatic hemangioma2.1effection of reconstruct on three-dimensional visualizationCT image reconstruction data of12patients with Large liver cancer were successfully completed, clearly showing the hepatic artery, portal vein, hepatic vein, the tumor structure, observating the tumor from any angle stereoscopic visual understanding the space adjacent to the tumor and surrounding tissue relationship; CT image reconstruction data of12hepatic hemangiomawere successfully completed, liver, tumor, are clearly visible.2.2Relation of liver volume in analog resection and actual cut2.2.1Pre-removal of nine cases before the pre-surgery patients liver volume (1856.10±255.85) ml, the actual removal of liver volume (1817.02±251.17) ml, There was no the statistical differences between the two quantitative value(t=0.32, P <0.052.2.2Reconstruction of three-dimensional visualization of12cases of complicated hemangiomas were successfully completed. Preoperative pre-resection liver volume were (611.67±182.36) ml; the actual quality were (80.00±22.06) ml, there was statistically significant (t=11.34, P<0.05) between analog value and the actual value.2.3Comparing between analog liver resection surgery section and section the actual liver resection surgery section.Following principles of anatomical liver resection,setting pre-liver resection plane (margin from the tumor margin about1cm), the resulting between the actual surgical anastomosis and simulation results were almost identical, severe postoperative complications wee reduced.3.Patients with retroperitoneal tumors3.1Effecting of three-dimensional visualization reconstructThree-dimensional reconstruction of8patients were successfully perfommed. the tumor size, abdominal aorta, inferior vena cava, the structure of the surrounding organs clearly showed.3.2Volume relationship of tumor betweeb analog resection with the actual resection. The mean tumor volume (3973.04±4654.33) ml were measured througth three-dimensional reconstruction, mean tumor volume analog (4050.12±4998.10) ml were measured througth three-dimensional reconstruction; Rate of deviation was8.97percent.3.3surgical resultsSurgical resection were succsessfully performed in all8cases.spleen and pancreas tail resection was performed in1case,intestinal resection and reconstruction were combined in4cases, inferior vena cava resection and repair sidewall portions forming was combined in one case.4.Conclusion4.1Three-dimensional visualization technology is based on conventional imaging technology,having a better characteristics comparing to conventional imaging, abdominal lesions and adjacent relationship can be more intuitivly and accuratly observed; Meanwhile,line lesion excision can be simulated performed, guiding the actual operation, reducing the risk of surgery, has certainly clinical value.4.2.Clinical applications of IQQA-Liver V1.0, three-dimensional reconstruction software of Xiamen Johnson are deserved recommended.