A Study Of Judging The Plane Of The Neck And Thoracic Junction Based On 3D Reconstruction System

Objective: This article aims to reconstruct the right subclavian artery,right common carotid artery,and the Plane of the cervical thoracic junction plane through a three-dimensional reconstruction system,and analyze the relationship between the start of the right subclavian artery and the Plane of the cervical thoracic junction plane,based on this relationship,the position of the cervical thoracic junction plane was determined according to the position of the starting part of the right subclavian artery,so that the cervical and thoracic lymph nodes can be more accurately divided during the operation.Methods: This study included 73 patients with complete data who were treated in the Department of Thoracic Surgery of the Fu Jian Medical University Union Hospital from December 2018 to March 2019.All patients had a thin CT scan of the chest and enhanced image data by 3D reconstruction of IQQA System(EDDA technology)to reconstruct upper edge of the cervical thoracic junction plane,brachiocephalic trunk,right common carotid artery,and right subclavian artery.The distance from the intersection of the right subclavian artery and the upper edge of the cervical thoracic junction plane to the beginning of the right subclavian artery was measured,and the relationship between the distance and the patient’s sex,age,weight and height was analyzed.Results: A total of 73 patients were enrolled,of which 12 cases showed the start of the right subclavian artery above and 61 cases showed the start of the right subclavian artery below the upper edge of the cervical thoracic junction plane.The relationship between age,BMI and height was analyzed.There was no significant difference between the relative position and age(59.6 ± 14.4 years vs 52.6 ± 11.3 years,P = 0.04)of the starting part of the right subclavian artery and the cervical thoracic junction plane,compared with height(162.8 ± 7.4cm vs 162.8 ± 6.4cm,P = 0.9),weight(62.0 ± 8.9kg vs 60.8 ± 8.7kg,P = 0.7),BMI(23.4±3.4 vs 22.9±2.6,p=0.56).The average distance from the intersection of the right subclavian artery origin and the upper edge of the cervical thoracic junction plane to the right subclavian artery was 26.7 ± 7.6mm.The relationship between the distance and gender,BMI,height was analyzed,and the difference between the distance and,BMI(P = 0.02)was statistically significant,and to some extent,it increases with the increase of BMI.Conclusions: According to the reconstruction results,most of the patients had the right subclavian artery located below the thoracic entrance,a small part of the patients had the right subclavian artery located above the thoracic entrance,there was no mediastinal paralaryngeal lymph nodes(106 recr group),and the lymph node stage of these patients would be affected.By measuring the distance from the intersection of the right subclavian artery and the upper edge of the thoracic entrance plane to the beginning of the right subclavian artery,we can preliminarily define the cervical thoracic junction and guide the definition of the parathoracic lymph node of the cervical thoracic and laryngeal recurrent nerve in the minimally invasive radical operation of esophageal cancer.By measurement,the average distance from the intersection of the right subclavian artery and the upper edge of the first costal plane to the right subclavian artery was 26.7 ± 7.6mm,which was related to body BMI,but not to height and age.