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恶性肌肉骨骼肿瘤术前准确手术切缘的回顾性研究。

The accurate surgical margin before surgery for malignant musculoskeletal tumors: a retrospective study.

作者信息

Hao Yun, Yang Caihong, He Jinpeng

机构信息

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, Hubei, China.

Department of Orthopaedic, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, Hubei, China.

出版信息

Am J Transl Res. 2018 Aug 15;10(8):2324-2334. eCollection 2018.

Abstract

There is no accurate volume measurement method for evaluating the response to chemotherapy in malignant musculoskelal tumors, and there is no specific preoperative evaluation method to evaluate surgical margins. Twenty-five cases of malignant musculoskeletal tumors treated from Mar 2012 to Mar 2014 were analyzed. Through the use of a connective slice-scan and augmented virtual reality technique, accurate measurement of the tumor volume and determination of surgical margins according to the standard proposed by Kawaguchi were easily reached. Specimens were sent for a pathological examination to determine the tumor type. The preoperative surgical margin was compared with the postoperative surgical margin. Curative resection or wide resection facilitated by the preoperative imaging data occurred in 92% of patients; only one case resulted in intralesional resection for malignant tumor progression, and one case resulted in marginal resection for femoral nerve invasion. There was no significant difference between the predicted margin before the operation and final margin after the operation (P>0.05). Our results demonstrate that application of continuous imaging data with enough sectional anatomy detail can provide a scientific basis for measuring the size of a tumor and identifying the tumor's surgical margins in multiple dimensions using an augmented virtual reality technique.

摘要

目前尚无准确的体积测量方法来评估恶性肌肉骨骼肿瘤对化疗的反应,也没有特定的术前评估方法来评估手术切缘。分析了2012年3月至2014年3月期间治疗的25例恶性肌肉骨骼肿瘤病例。通过使用连续切片扫描和增强虚拟现实技术,能够轻松地根据川口提出的标准准确测量肿瘤体积并确定手术切缘。将标本送去进行病理检查以确定肿瘤类型。比较术前手术切缘和术后手术切缘。术前影像学数据辅助下的根治性切除或广泛切除发生在92%的患者中;仅1例因恶性肿瘤进展而行病灶内切除,1例因股神经侵犯而行边缘性切除。术前预测切缘与术后最终切缘之间无显著差异(P>0.05)。我们的结果表明,应用具有足够断面解剖细节的连续影像数据可为使用增强虚拟现实技术在多个维度测量肿瘤大小和识别肿瘤手术切缘提供科学依据。

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