本文關(guān)鍵詞：基于VTK實現(xiàn)三維重建在膽囊管變異中的診斷價值　出處：《山東大學(xué)學(xué)報(醫(yī)學(xué)版)》2017年07期 　論文類型：期刊論文

  更多相關(guān)文章： 膽囊管 解剖變異 磁共振胰膽管成像 VTK 醫(yī)學(xué)三維可視化

【摘要】：目的探討利用VTK實現(xiàn)三維可視化系統(tǒng)對膽囊管變異的診斷價值及臨床意義。方法回顧性分析經(jīng)臨床確診的160例膽石癥患者,分別采用傳統(tǒng)最大密度投影(MIP)及三維可視化系統(tǒng)輔助,對磁共振胰膽管水成像(MRCP)進行膽囊管變異的診斷,并與手術(shù)結(jié)果進行比較。結(jié)果以手術(shù)結(jié)果為金標(biāo)準(zhǔn),在三維可視化系統(tǒng)輔助下檢出膽囊管變異81例,與手術(shù)結(jié)果一致且差異無統(tǒng)計學(xué)意義(κ=0.950,P=1.000);而單純采用MIP結(jié)合薄層圖像檢出則為51例,與手術(shù)結(jié)果存在差異且具有統(tǒng)計學(xué)意義(κ=0.477,P0.001)。對難以明確診斷的39例膽囊管旋前或旋后匯入肝總管的變異,在三維可視化系統(tǒng)的輔助下分別檢出12例及27例,與手術(shù)結(jié)果一致且差異無統(tǒng)計學(xué)意義(κ=0.880,P=1.000);而單純采用MIP結(jié)合薄層圖像則分別檢出24例及15例,與手術(shù)結(jié)果的差異具有統(tǒng)計學(xué)意義(κ=0.246,P=0.004)。結(jié)論利用VTK實現(xiàn)的三維可視化系統(tǒng)可以提高對膽囊管變異診斷的準(zhǔn)確性,不僅彌補了MIP對于空間比鄰關(guān)系顯示欠確切的不足,更有助于臨床術(shù)前了解膽囊管解剖變異的情況,避免膽囊切除術(shù)中所引起的膽道損傷。
[Abstract]:Objective to explore the diagnostic value and clinical significance of three-dimensional visualization system (VTK) for cystic duct variation. Methods 160 cases of cholelithiasis diagnosed by clinical diagnosis were analyzed retrospectively. Mr cholangiopancreatography (MRCP) was used to diagnose the variation of the cystic duct with the help of traditional maximum density projection (MIP) and 3D visualization system. Results 81 cases of cholecystic duct variation were detected under the aid of 3D visualization system, which were consistent with the results of operation and had no statistical significance (魏 0.950). Pu 1.000; However, 51 cases were detected by MIP combined with thin-layer image alone, which was significantly different from the results of operation (魏 0.477). In 39 cases of cholecystic duct pronation or convolution into the common hepatic duct, 12 cases and 27 cases were detected respectively with the aid of 3D visualization system. There was no significant difference between the results of the operation and that of the operation (魏 0. 880, P < 1. 000). However, 24 cases and 15 cases were detected by MIP and thin-layer images respectively, and the difference was statistically significant compared with the results of operation (魏 0.246). Conclusion the 3D visualization system based on VTK can improve the accuracy of diagnosis of cystic duct variation, which not only makes up for the deficiency of MIP in displaying spatial neighbor relationship. It is helpful to understand the anatomic variation of gallbladder duct before operation and to avoid bile duct injury caused by cholecystectomy.
【作者單位】： 天津市南開醫(yī)院放射科;
【分類號】：R445.2;R575.6
【正文快照】： 膽石癥是目前普外臨床的多發(fā)病,開腹或腹腔鏡膽囊切除術(shù)仍是治療膽石癥的基本術(shù)式[1],術(shù)中對膽囊管的處理是膽囊切除術(shù)的關(guān)鍵,而膽囊管變異則增加了手術(shù)難度[2]。隨著磁共振胰膽管成像(magnetic resonance cholangiopancreatography,MRCP)檢查的逐漸普及,通過最大密度投影(max

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