Department of Urology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanagawa-ku, Yokohama, Kanagawa 236-0004, Japan.
BMC Urol. 2014 Jun 13;14:47. doi: 10.1186/1471-2490-14-47.
The purpose of this study is presenting a method to predict the presence of an open urinary tract and the position of the opening in laparoscopic partial nephrectomy from three dimensional (3D) computed tomography (CT) images by using novel image segmentation and visualization techniques.
From CT images of patients who underwent laparoscopic partial nephrectomy, 3D regions of the kidney, urinary tract, and tumor were segmented. For each patient, multiple virtual resection planes of the kidney with different surgical margins (1 mm to 5 mm, every 1 mm) were generated and the presence of an open urinary tract and the position of the opening were predicted from the images.
We compared the predictions with actual operations in 5 cases by using recorded video of the operations and operative notes. In terms of the presence of an open urinary tract, agreement of the predictions and the intraoperative results was obtained in all patients. The expected positions of the openings were close to those in the actual operations.
We have developed a method to virtually visualize the resection plane of laparoscopic partial nephrectomy. Image segmentation methods used in this study were precise and effective. The comparison indicated that our method accurately predicted the presence of an open urinary tract and the position of the opening and provided useful preoperative information.
本研究旨在介绍一种通过使用新的图像分割和可视化技术，从三维（3D）计算机断层扫描（CT）图像预测腹腔镜部分肾切除术时存在的开放尿路和开口位置的方法。
从接受腹腔镜部分肾切除术的患者的 CT 图像中，分割出肾脏、尿路和肿瘤的 3D 区域。对于每个患者，生成多个具有不同手术边缘（1mm 至 5mm，每 1mm 一个）的虚拟肾脏切除平面，并从图像中预测开放尿路的存在和开口的位置。
我们通过使用手术记录视频和手术记录比较了 5 例患者的预测结果与实际手术结果。在开放尿路的存在方面，所有患者的预测结果与术中结果一致。预计的开口位置与实际手术中非常接近。
我们已经开发了一种虚拟可视化腹腔镜部分肾切除术切除平面的方法。本研究中使用的图像分割方法准确有效。比较结果表明，我们的方法能够准确预测开放尿路和开口的位置，并提供有用的术前信息。
