Virtual hepatic resection using three-dimensional reconstruction of helical computed tomography angioportograms
Virtual hepatic resection using three-dimensional reconstruction of helical computed tomography angioportograms
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DOI：
10.1097/00000658-200102000-00011
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发表时间：
2001-02-01
影响因子：
9
通讯作者：
Garden, OJ
中科院分区：
文献类型：
--
作者：
Wigmore, SJ;Redhead, DN;Garden, OJ
目的建立虚拟肝切除术的准确性，使用三维（3D）模型构建的计算机断层扫描血管门静脉造影（CTAP）图像在确定肝切除体积（LV）切除肝surgery.Summary背景数据的能力，以衡量左心室手术前可能是有用的，在确定范围和性质的肝切除。准确评估左心室和肝功能估计也可以预测术后肝功能衰竭的患者接受切除术，协助体积增强栓塞程序，帮助计划分阶段肝切除术的双叶疾病，并帮助选择生活相关的肝脏donors.Methods进行了回顾性研究，涉及27例患者计划肝切除术，使用映射技术，从螺旋CTAP图像构建3D模型。根据这些3D模型，计算肿瘤体积、总LV和功能性LV，并与体重进行比较。对3D肝脏模型沿建立的解剖平面进行虚拟肝切除沿着，并计算切除的LV。切除体积预测的放射科医生（不知道的实际重量）进行了比较，实际手术切除后测得的标本重量。结果体重和功能LV，但不是总LV之间存在显着的相关性。结论三维CTAP重建图像的虚拟肝切除术可准确预测肝切除后的肝脏质量。作者打算将联合收割机这项技术与肝功能评估相结合，试图预测肝切除术后有肝衰竭风险的患者。
Objective To establish the accuracy of virtual hepatic resection using three-dimensional (3D) models constructed from computed tomography angioportography (CTAP) images in determining the liver volume (LV) resected during resectional liver surgery.Summary Background Data The ability to measure LV before surgery could be useful in determining the extent and nature of hepatic resection. Accurate assessment of LV and an estimate of liver function may also allow prediction of postoperative liver failure in patients undergoing resection, assist in volume-enhancing embolization procedures, help with the planning of staged hepatic resection for bilobar disease, and aid in selection of living-related liver donors.Methods A retrospective study was conducted involving 27 patients scheduled for liver resection, Using mapping technology, 3D models were constructed from helical CTAP images. From these 3D models, tumor volume, total LV, and functional LV were calculated and were compared with body weight. The 3D liver models were subjected to a virtual hepatectomy along established anatomical planes, and the resected LV was calculated. The resected volume predicted by radiologists (unaware of the actual weight) was compared with the specimen weight measured after actual surgical resection.Results A significant correlation was found between body weight and functional LV but not total LV. The computer prediction of resected LV after virtual hepatectomy of 3D models compared well with resected liver weight.Conclusion Virtual hepatectomy of 3D CTAP reconstructed images provides an accurate prediction of liver mass removed during subsequent hepatic resection. The authors intend to combine this technology with an assessment of liver function to attempt to predict patients at risk for liver failure after hepatic resection.