Fang Chi-hua, Chang Xu, Lu Chao-min, Yang Jian, Xiang Nan, Bao Su-su, Peng Feng-ping, Pan Jia-hui
Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2008 Mar;28(3):370-2.
To study the clinical value of 3-dimensional (3D) reconstruction of the liver and its ductal structures using 64-slice spiral CT data in hepatobiliary surgery.
The image data of 64-slice spiral CT scanning was obtained from patients with biliary calculi. Image segmentation was performed both using computer programs and manually, and 3D reconstruction of the liver was carried out using Mimics software. The reconstructed model of the liver and the ductal system was exported in STL format, and then into the FreeForm Modeling System for modification and smoothing, followed by image registration of the liver with the ductal system and the calculi.
The reconstructed liver model accurately represented the actual size of the liver and its anatomic landmarks, and by adjusting the transparency of the liver, the hepatic and intrahepatic arteries, veins, the portal vein, some abdominal vessels and the biliary system with the calculi were clearly visualized. The calculi in the intrahepatic and extrahepatic bile ducts were distinct in terms of the location and number, and dilation and stenosis of the intrahepatic and extrahepatic bile ducts were also clearly observed. The model presented with realistic profile of the liver that allowed vivid 3D observation. The model also allowed zooming and rotation for observation in full views.
The reconstructed model of the liver and its ductal system can be useful for preoperative planning and intraoperative complete removal of the calculi from the bile duct, and for the bile duct dilation and stenosis detected in the model, appropriate measures should be taken to reduce the residual calculi and prevent reoccurrence.
探讨利用64层螺旋CT数据对肝脏及其管道结构进行三维（3D）重建在肝胆外科手术中的临床价值。
获取64层螺旋CT扫描的胆管结石患者的图像数据。使用计算机程序和手动方式进行图像分割，并使用Mimics软件对肝脏进行3D重建。将重建的肝脏和管道系统模型导出为STL格式，然后导入FreeForm Modeling System进行修改和平滑处理，随后将肝脏与管道系统及结石进行图像配准。
重建的肝脏模型准确呈现了肝脏的实际大小及其解剖标志，通过调整肝脏的透明度，肝内、肝外动脉、静脉、门静脉、一些腹部血管以及带有结石的胆道系统清晰可见。肝内和肝外胆管内的结石在位置和数量上清晰可辨，肝内和肝外胆管的扩张和狭窄也能清楚观察到。该模型呈现出逼真的肝脏外形，可进行生动的三维观察。该模型还允许缩放和旋转以进行全景观察。
重建的肝脏及其管道系统模型有助于术前规划以及术中完整清除胆管结石，对于模型中检测到的胆管扩张和狭窄，应采取适当措施以减少结石残留并防止复发。
