Three-dimensional Reconstruction Technology Research And Clinical Application In The Sagittal Section Of The Liver

Objective:By using 64-slice spiral CT scan data to study the three-dimensional reconstruction of hepatic artery, especially in the sagittal section of the portal vein, hepatic artery and hepatic vein imaging,vascular anatomy of the three groups to investigate the natural law of above three groups vasculars’ anatomy, analyzing the advantages and clinical applications of 64-slice spiral CT scan three-dimensional reconstruction.Methods: 30 patients in our hospital were normal inspection(Wannan Medical College Affiliated Hospital Yijishan) check on three abdominal plain and enhanced 64-slice spiral CT.Equipment: 64-slice spiral CT, high-pressure injector is produced in the United States MEDRAD binoculars syringe. After completion of image, use Brilhanee64 layer spiral CT Mxview continue after-treatment; scanning parameters tube voltage 120 kv, tube current 300 m A/s, gathering thickness 5mm, pitch 15,spiral factor 0.938 per one rotation time 0.5s. From the cubital vein with 3.5m L / s and press 2ml / kg injection rate of high concentration of non-ionic Iopamidol 370 mg I / ml or ultravist 370 mg I / ml; after the injection of contrast agent, flushing the pipe with saline 100 ml, through Sure- start the software automatically trigger bolus scanning technology, the average scan time after arterial injection began after contrast injection 18 ~ 23 s, portal venous phase average time is 50 ~ 60 s, the average time of the hepatic vein is 100 ~ 120 s. Raw data are recombinant layer 1mm thick, all recombinant interval is 0.5mm, and then transmitte them to the workstation, the liver CT scan data acquisition.Firstly,use MIMICS software to preprocessing acquired tomographic image, including the use of threshold method and artificial binding method for image segmentation. Secondly, the segmented image reconstruction, the reconstructed three-dimensional image in the IGS and STL export format and stored on a computer monitor for stereoscopic display, deal the completed model with precision work, geometric transformation operation, complete tomographic reconstruction. Finally got the left lobe of liver(upper part if the left lateral lobe,under part of the left lateral lobe), side lobe, the right lobe of the sagittal reconstructed image and measure each oblique sagittal plane major and minor axis length, analyzed the relationship between the length of each sagittal its major and minor axes of the location of the volume size of the liver and its clinical application.Results:1.Studies using 64-slice spiral CT-PHILIPS liver scans and three-dimensional reconstruction of the vascular.64-slice spiral CT liver plain and enhanced, received a total of 656 tomography images were plain, arteries, veins, and portal venous phase. Through a three-dimensional reconstruction of the liver model can reflect the true size of liver morphology and volume, and can regulate liver transparency through computer software technology were more clearly shows the branch levels of arteries, veins and portal vein in the liver and out of shape. After rebuilding the liver artery, vein and portal vein type and scan reconstruction through parallel processing workstation Mxview VR(volume rendering) pipeline system to the liver consistent reconstruction.Image visualization of liver, Liver model reconstructed, in the image at different times, the size of the liver and its shape all matches, color quality and sharpness are good, browse strong continuity, no swing. Thus,in the course of the study,it provides a great help when encounter or interest in an important position for manual tagging. And can be freely reconstructed model to zoom in, zoom out, rotation, 360 degree no dead observed, lifelike form. After joining blood vessels in the model, you can get a contain hepatic artery, hepatic vein, and hepatic portal vein of three vascular structures.2.Analysis of the relationship between the size of the liver volume sagittal length of each lobe of its major and minor axes location.Hepatic left lateral lobe, side lobe, the right lobe, caudate volumes were as follows:(241.12 ± 66.03) mm3,(227.20 ± 65.04) mm3,(801.66 ± 176.21) mm3,(32.58 ± 12.02) mm; hepatic left lateral upper lobe, the left lateral lobe, side lobe, the right lobe of the long axis of the long axis oblique sagittal plane were:(. 97.24 ± 10.96) mm,(94.48 ± 12.03) mm,(128.26 ± 14.33) mm,(165.36 ± 13.67) mm; minor axis, respectively:(31.64 ± 13.52) mm(56.75 ± 10.58) mm(71.08 ± 8.88) mm(98.29 ± 12.34) mm;The liver volume of left lateral lobe, side lobe and the right lobe, respectively, there is a positive correlation between hepatic left lateral lobe, side lobe and the right lobe oblique sagittal the long axis and short axis, the correlation coefficient R are: 0.649,0.810, 0.819(P <0.05), the Department decided to RR are: 0.432,0.649,0.669, the regression equation is: Y =-69.30 + 2.1g X1 + 1.79X2(P = 0.001), Y =-310.501 + 2.69 XI + l.89 l X2(P = 0.000), Y =-1016 + 6.59X1 + 7.29X2(P = 0.000); also showed a positive correlation between hepatic left lateral oblique sagittal major and minor axes of the left lateral lobe of the liver volume the correlation coefficient R is 0.698(P <0.05), the coefficient of determination RR = 0.550, the regression equation is: Y =-212.09 + 4.79X1-O.471X2 :, but its minor axis coefficient is negative, it is not realistic significance.(X1 on behalf of the long axis, X2 on behalf of the minor axis)3 Studies on liver three-dimensional reconstruction and vascularity in sagittal sections and their clinical application. 64-slice spiral CT tomography images using computer software(Liv1.0), reconstruct satisfactory three-dimensional image.Applied to the diagnosis and treatment of liver cancer in clinical aspects,it has obvious advantages. By understanding the liver blood vessels on the sagittal section distribution, the relationship between the liver tumors with liver blood vessels, location of the tumor and its size clear at a glance. It can provide more realistic images especially in the blood vessels distribution、the relationship between tumor and adjacent vital vessels. By understanding the liver blood vessels distribution on the sagittal section, you can make a reasonable preoperative surgical plan, preoperative simulation visualization, can calculate the remnant liver volume and surgical risks that may arise, in advance of the surgery by repeatedly planning, measuring residual liver volume, evaluate the residual liver volume ratio, the possibility of residual liver volume and liver tumors predict postoperative liver failure calculations. So choose the best surgical section, you can minimize liver damage, liver tissue to maximize retention capabilities, and further promote the development of precise hepatectomy.Conclusions:. 1. 64-slice spiral CT scan liver tomographic image data, the use of computer software for three-dimensional reconstruction of the liver three blood vessels; it clearly shows that the liver, the hepatic artery, hepatic vein, and portal vein anatomy and normal variation, and three-dimensional sense of strong, realistic shape. Image reconstruction by the liver after liver can reflect the true form and the actual volume of the liver and various anatomical landmarks, especially in the distribution of blood vessels inside the liver, their distribution and adjacent relationship. Comparison with the traditional inspection, 3D 64-MSCT is a simple, non-invasive method, and anatomical images obtained are also more vivid, blood vessels inside the liver can provide information on the promotion of human anatomy and clinical teaching has an important development significance.2.Hepatic left lateral lobe, side lobe, the right lobe oblique sagittal plane exists between the length of the lobe volume in correlation,its relevance was positively correlated. Changes in the size of the volume of each lobe of the liver shows can be reflected in the length of each leaf oblique sagittal liver meridian.3.Three dimensional reconstruction of hepatic angiography interior, especially in the sagittal plane angiography for clinical liver is a very useful method of operation, it clearly shows that the intrahepatic duct and its variants, bright. By rebuilding the liver sagittal sections of blood vessels, making the diagnosis and treatment of liver tumors, blood vessels and tumor information clearly, including the tumor feeding arteries, draining veins, etc., virtual surgery of liver greatly assisted and can simulate multiple surgical approach, intraoperative risk prevention may be encountered, and postoperative residual liver volume compensatory estimates can be infinitely close to the precise hepatectomy standard, and lay a solid foundation for future clinical development of liver surgery.