64排CT检查及软件辅助系统在肝门部胆管癌术前评估和手术规划中的应用

目的 探讨应用64排CT检查及软件辅助系统在肝门部胆管癌术前评估和手术规划中的应用价值.方法 回顾性总结2009年6月至12月中山大学附属第一医院应用64排CT检查及软件辅助系统分析6例肝门部胆管癌患者的临床资料,6例患者术前行上腹部64排CT检查,然后使用软件辅助系统进行肝脏、肿瘤、血管、胆道的三维重建,显示血管和胆道与肿瘤的三维关系,进行虚拟的肝切除手术方式设计.结果 成功完成对肝脏、肿瘤、血管以及扩张胆道的三维重建,其画面可以任意角度旋转、放大观察.术中证实术前评估和规划及设计的虚拟手术方式与手术的实施一致.手术切除的肝脏体积与软件辅助系统评估的体积差别在5%左右.患者术后恢复良好,无肝功能衰竭发生.结论 64排CT检查及软件辅助系统能对肝门部胆管癌作出准确的术前评估和手术规划.

Application of 64-slice computed tomography and software-assisted image analysis in preoperative evaluation and surgical planning of hilar cholangiocarcinoma

Objective To evaluate the application of 64-slice computed tomography (CT) and software-assisted image analysis in preoperative evaluation and surgical planning of hilar cholangiocarcinoma. Methods The clinical data of six patients with hilar cholangiocarcinoma who were admitted to The First Affiliated Hospital of Sun Yat-sen University from June to December, 2009 were retrospectively analyzed. All six patients underwent 64-slice CT scanning before the operation, and then three-dimensional (3D) reconstruction of the liver, tumor, blood vessels and bile ducts was achieved with the assistance of Myrian (R) XP-Hepatic software. The relationships of the tumor, blood vessels and bile ducts were illustrated in the 3D model. Virtual liver resection was carried out for surgical planning. Results The 3D models of the liver, tumor, blood vessels and bile ducts were successfully constructed . The 3D models were able to be rotated and magnified as necessary. Preoperative evaluation and surgical planning were in accordance with actual surgery. The relative accuracy of the software-assisted image analysis system for calculating the hepatic volume to be resected was 5%. Patients recovered well without occurrence of hepatic failure. Conclusion Sixty-four-slice CT scanning and software-assisted image analysis are important for preoperative evaluation and surgical planning of hilar cholangiocarcinoma.