The Research Of CT Three Dimensional Reconstruction

Objective (s):1、By comparing the three dimensional reconstruction of the liver volume and the volume of the liver in the experimental animals, the accuracy of CT was compared.2、To discuss the clinical value of 3D reconstruction,mimetic hepatectomy model and preoperative virtual hepatectomy planning to prccisc hcpatcctomy before the surgical treatment of liver cancer by comparing 3D reconstruction and mimetic hepatectomy model with intelligent CT for anatomic hepatecmomy. with a CT routinely.Methods:1、Animal modelTo acquire 30 pigs’photgraphs of arterial phase,portal phase and venaecavae phase have been scanned by 256i CT scan and enhanced and establised the three-dimensional reconstruction of the pig liver model and simulated hepatic lobectomy, for measuring the volume and quality. Comparative analysis the simulation resection of the hepatic lobes and the actual liver excision and excision of the liver volume and the quality is consistent to evaluate the feasibility and precision of 256iCT liver 3D reconstruction and simulation precise liver resection.2、Clinical study88 patients who have been hospitalized at second hospital affiliated kunming medical university between January 2014 to January 2016 were causally divided into two groups, study group (44n) and control group(44n). Patients whose in study group have been accepted the Philips Brilliance Workspace Portal software of Philips 256 slice intelligent CT to build three dimensional reconstruction model of liver and to locate and segment tumor. To synthesize those information and analysis to establish a mimetic model of anatomical hepatectomyand toformulate individualized operation scheme. Patients whose have been controlled were accepted same operations except CT scan and enhanced. We synthesize information including total Live Volume,Tumour Volume,Virtualtual Resected Liver Volume,LRV/SLV etc. from both two group and make comparisons. Postoperative liver function recovery, complications and malignant tumor cure rate(edge negative rate)and the tumor recurrence of study group were compared with those of control group to determine the clinical value of three dimensional reconrustction technologyin the design and planning of the precise hepatectomy and the specific implementation. Results:Animal modelThere is no significant difference (P>0.05) by Three dimensional reconstruction of liver resection and pig simulated actual hepatic resection volume and quality the differences of volume and quality. Three dimensional reconstruction technique can accurately reflect the liver volume and three-dimensional reconstruction of the liver and the distribution and variation of the hepatic vascular distribution and variation.Clinical study1、There are no significant differences amongreconstruct the volume of liver of study group, control group and that in practicality. However Three dimensional reconstruction can be used to observe the liver, tumor and the residual liver after resection of liver and tumor.2、Simulation showed higher correlation (r=0.966,P<0.05) between predicted three dimensional volume andactual liver resection volume. Simulation showed correlation between estimated two dimensional volume and actual liver resection (r=0.879,P<0.05) volume.3、The results of surgical resection were basically consistent with the preoperative simulation results. Preoperative planning of the resection margin was significantly correlated with the actual surgical margins (r=0.924, P<0.05). The mean difference was not statistically significant (t=0.43, P=0.664).4、The observation group in the intraoperativeoperation time, blood loss, liver function recovery section index is better than that of control group, and there were no significant differences in hospitalization time.5、Theliver failure and the incidence of postoperative bile leakage in the control group were higher than in observation group, but there is no obvious difference between theincidence of pulmonary infection, abdominal cavity infection.Cnclusion(s):1、Preoperative liver CT three-dimensional reconstruction technology to design virtual liver resection, improve the resection rate of liver cancer and the prevention of liver failure, and ultimately design the optimization of the surgical plan.2、CT three-dimensional reconstruction technology is easier and more comprehensivethan the intraoperative ultrasound about showing the whole liver shape, the position, the range and the adjacent area of the lesion, and the distribution direction and variation of the intrahepatic vessels.3、Preoperative virtual liver resection in the prediction of the occurrence of the occurrence of the guidance of anatomical liver resection operation, reduce the intraoperative bleeding less trauma.