基于计算机断层血管造影的盆部原发肿瘤三维模型重建及临床应用

目的探索基于计算机断层血管造影(CTA)二维图像的盆部原发肿瘤及其周围结构的三维模型重建方法,为术前明确诊断、制订个体化的手术方案、指导手术路径及评估预后提供更加全面、直观的影像学信息。方法对证实为盆部原发肿瘤患者行动静脉期64排螺旋CT扫描,形成格式为标准Dicom 3.0的CT连续断层图像,利用计算机三维图像重建软件Mimics建立盆部原发肿瘤及其周围结构的三维数字化模型。结果该方法的使用,可成功建立活体盆部原发肿瘤及其周围结构的三维模型,包括骨盆、盆部动脉、瘤体、子宫、膀胱、肠管、皮肤及皮下软组织,从而从解剖上完全还原其相对结构。结论多排螺旋CT扫描技术、血管造影及Dicom 3.0标准格式的应用使模型的建立更为精确、方便。该模型可以真实反映肿瘤与邻近结构的解剖关系,对于盆部原发肿瘤的诊疗具有重要指导意义;另外,该数字化模型可为盆部解剖结构的教学及手术培训提供详尽的资料,为建立可视化医疗教学平台提供帮助。

The reconstruction of digital three-dimensional model based on computed tomography angiographic data and its application in the primary extra- organic tumors in pelvis

Objective To establish a method to reconstruct a digital three-dimensional （3D） model of the extra-organic primary tumors in pelvis and the surrounding structures based on computed tomography angiographic （CTA） data, which aims at providing comprehensive and visual imaging information for pre-operation diagnosis, individual operation plan, operation route choice and prognosis assessment. Methods The patients, who were diagnosed to have pelvic primary tumors, were scanned by 64-slice spiral CT during the arterial phase and venous phase. The digital three-dimensional models were reconstructed by using Mimics software 10.01 based on the images obtained by Dicom 3.0 standard CT. Results The 3D models of tumors and the surrounding structures, including pelvis, pelvic artery, tumor, uterus, bladder, bowl, skin and subcutaneous tissue were reconstructed. They were definitely identical with the real human anatomy Structures. Conclusion The applications of multi-slice spiral CT angiography, Dicom 3.0 standard CT as well as Mim- ics software 10.01 provide an effective and accurate way to establish digital models, which are of great importance in diagnosing and curing the extra-organic primary pelvic tumors. Moreover, these models may play important parts in surgical skills training and pelvic anatomy learning.