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1.
目的 通过三维CT血管成像(CTA)评估分析直肠癌患者肠系膜下动脉(IMA)分型及解剖特点,为直肠癌手术血管处理提供参考。 方法 回顾分析2018年1月至2019年12月华中科技大学同济医学院附属协和医院接受IMA CTA检查的直肠癌患者临床及影像学资料。通过三维CT血管成像重建IMA图像。对IMA进行分类并测量统计肠系膜下血管各解剖参数。 结果 266例研究对象中男性187例,女性79例。111例(41.7%)左结肠动脉(LCA)从主干独立发出,112例(42.1%)LCA和乙状结肠动脉(SA)共干发出,33例(12.4%)LCA、SA及直肠上动脉(SRA)共干,10例(3.8%)缺乏LCA。全组IMA主干长度(LIMA)为(39.1±10.1)mm、IMA根部至髂血管分叉距离(DIMA)为(44.1±7.4)mm、IMA根部与肠系膜下静脉(IMV)水平距离为(24.6±8.9)mm、IMA分支点与IMV水平距离为(13.0±5.3)mm。LCA走行包括:122例(47.6%)高位型,88例(34.4%)中位型,46例(18.0%)低位型。65例(25.4%)LCA紧贴IMV内侧,136例(53.1%)LCA紧贴IMV外侧,55例(21.5%)LCA外侧远离IMV。 结论 术前利用三维CT血管成像可准确评估IMA分型及肠系膜下血管的形态走行关系,为直肠癌手术中血管处理提供指导。 相似文献
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目的 在肺癌微波消融治疗中探究基于CT的三维数字化导航技术的应用价值。方法 回顾性分析我院收治的92例肺癌患者,随机进行三维数字化导航微波消融或传统CT引导下微波消融,分为三维导航组和传统组,依据肿瘤位置、大小(最大径差值≤2 mm)及微波消融条件不同两两配对,共46对,比较2组手术时间、微波针穿刺次数、CT剂量指数、术中并发症发生率、术后病灶控制情况。结果 三维导航组与传统组的手术时间分别为(30.07 ± 6.36)min、(47.20 ± 9.65)min、穿刺次数分别为(1.72 ± 0.69)次、(7.13 ± 3.00)次、CT剂量指数分别为(11.16 ± 2.20)mGy、(26.67 ± 8.72)mGy、术中并发症发生率分别为10.87%、34.78%,以上3个指标三维导航组均低于传统组,三维导航组治疗有效率(93.48%)高于传统组(71.74%),差异均有统计学意义(P < 0.05)。结论 CT引导下利用三维数字化导航技术行肺癌微波消融治疗,使介入穿刺手术的操作更加精准安全。 相似文献
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目的分析三维重建指导胸腔镜肺段切除术诊治磨玻璃结节(GGN)的效果。 方法回顾性分析2020年10月至2021年6月于北京大学国际医院接受三维重建指导胸腔镜肺段切除术9例GGN患者临床资料。 结果9例患者均顺利完成三维重建指导胸腔镜肺段切除术,其中,右肺上叶2例,右肺下叶1例,左肺上叶5例,左肺下叶1例,无中转开胸,R0切除率为100%。手术时间(377.89±115.96)min,术中出血为(150.00±96.82)ml。术后最高视觉模拟评分法(VAS)评分为(3.67±0.71)分,术后引流时间(6.33±2.39)d,术后引流总量(1 278.89±511.23)ml,术后住院时间(8.78±2.68)d。术后引流时间>7 d者1例(11.11%),拔管延迟原因为肺漏气。9例患者均出现术后并发症,其中,1级4例,2级5例,无3~5级严重并发症或围术期死亡。清扫淋巴结3~6组[(4.89±1.05)组],清扫淋巴结11~20个[(14.00±2.73)个]。 结论三维重建指导胸腔镜肺段切除术诊治GGN安全有效。 相似文献
4.
T.-Y. Huang Y.-J. Hsia M.-Y. Sung Y.-T. Wu P.-C. Hsu 《International journal of oral and maxillofacial surgery》2021,50(8):1100-1106
Zygomatic implant treatment is widely applied for severe maxillary atrophy to help rehabilitate the maxillary dentition. This retrospective study was performed to evaluate the actual radiographic bone–implant contact (rBIC) lengths of zygomatic implants. The records of 28 patients who underwent zygomatic implant surgery and subsequent follow-up examinations between August 2013 and September 2018 in the Department of Oral and Maxillofacial Surgery, Taipei Tzu Chi Hospital were reviewed. The surgeries were performed by a single surgeon using the same treatment protocol. All patients had a computed tomography scan at 1 year after the surgery. Using three-dimensional imaging software, an investigator measured the rBIC lengths of 66 implants and documented their clinical status. The implant survival rate was 100%. The mean rBIC length was significantly longer in male patients than in female patients (20.80 ± 5.88 mm versus 17.79 ± 6.34 mm; P = 0.028). The mean rBIC length of double zygomatic implants was significantly longer when compared to that of single implants (21.11 ± 6.23 mm versus 17.75 ± 5.85 mm; P = 0.027). This article is novel in reporting the exact rBIC lengths of zygomatic implants in a clinical setting. The results showed that zygomatic implants are a viable treatment modality for full-mouth rehabilitation. 相似文献
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Sven Goetstouwers Dagmar Kempink Bertram The Denise Eygendaal Bart van Oirschot Christiaan JA van Bergen 《World journal of orthopedics》2022,13(1):1-10
Three-dimensional (3D) printing is a rapidly evolving and promising field to improve outcomes of orthopaedic surgery. The use of patient-specific 3D-printed models is specifically interesting in paediatric orthopaedic surgery, as limb deformity corrections often require an individual 3D treatment. In this editorial, various operative applications of 3D printing in paediatric orthopaedic surgery are discussed. The technical aspects and the imaging acquisition with computed tomography and magnetic resonance imaging are outlined. Next, there is a focus on the intraoperative applications of 3D printing during paediatric orthopaedic surgical procedures. An overview of various upper and lower limb deformities in paediatrics is given, in which 3D printing is already implemented, including post-traumatic forearm corrections and proximal femoral osteotomies. The use of patient-specific instrumentation (PSI) or guiding templates during the surgical procedure shows to be promising in reducing operation time, intraoperative haemorrhage and radiation exposure. Moreover, 3D-printed models for the use of PSI or patient-specific navigation templates are promising in improving the accuracy of complex limb deformity surgery in children. Lastly, the future of 3D printing in paediatric orthopaedics extends beyond the intraoperative applications; various other medical applications include 3D casting and prosthetic limb replacement. In conclusion, 3D printing opportunities are numerous, and the fast developments are exciting, but more evidence is required to prove its superiority over conventional paediatric orthopaedic surgery. 相似文献
7.
《International journal of oral and maxillofacial surgery》2022,51(1):113-121
The aim of this study was to perform a three-dimensional evaluation of the skeletal relapse of the proximal and distal mandibular segments following isolated bilateral sagittal split osteotomy advancement surgery. One hundred consecutive patients (mean age 25.8 ± 11.7 years), comprising 65 female patients (mean age 26.4 ± 12.1 years) and 35 male patients (mean age 24.6 ± 11.0 years) requiring mandibular advancement without genioplasty, were enrolled prospectively in the study. Cone beam computed tomography scans were acquired for each patient at three time-points: preoperatively, immediately (1–6 weeks) after surgery, and 1 year after surgery. A validated tool was utilized to assess the surgical movement and relapse. Based on percentage, the majority of the distal and proximal translational and rotational movements relapsed within the range of ≤2 mm and ≤2°. The distal segment revealed a significant relapse in a posterior, inferior, and clockwise pitch direction. Both left and right proximal segments showed a significant translational relapse in the medial, posterior, and superior direction. Amongst the rotational parameters, proximal segments relapsed significantly in clockwise pitch, clockwise roll, and counterclockwise yaw direction. Overall, both distal and proximal bone segments showed a clinically acceptable translational and rotational stability. The proximal segments torqued towards their original position with a reduction of flaring. 相似文献
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《Journal of cranio-maxillo-facial surgery》2022,50(4):353-363
This study aimed to establish a three-dimensional (3D) cephalometric analysis of craniofacial morphology and discuss its theoretical usefulness in orthognathic patients.Cone-beam computed tomography (CBCT) images of Japanese subjects with skeletal Class I malocclusion before treatment were selected from among 1000 patients so that samples matched a historic 2D cephalometric cohort with normal occlusion using propensity score matching. In each CBCT image, 67 3D measurements were calculated based on manually identified landmarks. The mean and standard deviation of the measurements were calculated and used as the normative range for each sex. To confirm the usefulness of the 3D measurements, pre- and post-treatment CT data of nine jaw deformity patients who underwent orthognathic surgery with two-dimensional planning (2DP) in the past were used. Pre- and post-treatment CT values were evaluated with a paired t-test as well as a Z-score, which was calculated using the aforementioned normative range, and then categorized into five groups (“deteriorated”, “no improvement”, “over-treatment”, “no change”, “improvement”) with ?1 < Z-score < 1 considered normal.Fifty-six patients were matched to normal skeletal 1 subjects. The normative range of 67 items indicating 3D craniofacial morphology of the Japanese was calculated. Postoperatively, the horizontal position of the pogonion to the mid-sagittal plane significantly decreased (p = 0.043) and “improved”; however, the ramus axis on the right side significantly increased (p = 0.005) and “deteriorated”. Maxillary yaw and the horizontal position of the gonion also tended to “deteriorated”.The normative range for the 3D cephalometric analysis in Japanese has been established. Given findings of deteriorated maxillomandibular yawing after surgery when using conventional 2DP, 3D cephalometric measurements should be used when planning jaw positions after surgery for orthognathic patients. 相似文献