Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Research Center for Sectional and Imaging Anatomy, Digital Human Institute, School of Basic Medical Science, Shandong University, Jinan, Shandong, China.
Cancer Med. 2023 Apr;12(7):7992-8004. doi: 10.1002/cam4.5583. Epub 2023 Jan 6.
This study aims to use the three-dimensional (3D) mixed-reality model of liver, entailing complex intrahepatic systems and to deeply study the anatomical structures and to promote the training, diagnosis and treatment of liver diseases.
Vascular perfusion human specimens were used for thin-layer frozen milling to obtain liver cross-sections. The 104-megapixel-high-definition cross sectional data set was established and registered to achieve structure identification and manual segmentation. The digital model was reconstructed and data was used to print a 3D hepatic model. The model was combined with HoloLens mixed reality technology to reflect the complex relationships of intrahepatic systems. We simulated 3D patient specific anatomy for identification and preoperative planning, conducted a questionnaire survey, and evaluated the results.
The 3D digital model and 1:1 transparent and colored model of liver established truly reflected intrahepatic vessels and their complex relationships. The reconstructed model imported into HoloLens could be accurately matched with the 3D model. Only 7.7% participants could identify accessory hepatic veins. The depth and spatial-relationship of intrahepatic structures were better understandable for 92%. The 100%, 84.6%, 69% and 84% believed the 3D models were useful in planning, safer surgical paths, reducing intraoperative complications and training of young surgeons respectively.
A detailed 3D model can be reconstructed using the higher quality cross-sectional anatomical data set. When combined with 3D printing and HoloLens technology, a novel hybrid-reality navigation-training system for liver surgery is created. Mixed Reality training is a worthy alternative to provide 3D information to clinicians and its possible application in surgery. This conclusion was obtained based on a questionnaire and evaluation. Surgeons with extensive experience in surgical operations perceived in the questionnaire that this technology might be useful in liver surgery, would help in precise preoperative planning, accurate intraoperative identification, and reduction of hepatic injury.
本研究旨在使用包含复杂肝内系统的三维（3D）混合现实肝脏模型，深入研究解剖结构，并促进肝脏疾病的培训、诊断和治疗。
使用血管灌注人体标本进行薄层冷冻铣削以获取肝脏横断面。建立了 1.04 亿像素的高清横断面数据集，并进行了注册，以实现结构识别和手动分割。对数字模型进行重建，并使用数据打印出 3D 肝脏模型。将模型与 HoloLens 混合现实技术相结合，以反映肝内系统的复杂关系。我们模拟了 3D 患者特定解剖结构以进行识别和术前规划，并进行了问卷调查，评估了结果。
建立的 3D 数字模型和 1:1 透明彩色肝脏模型真实反映了肝内血管及其复杂关系。重建模型导入 HoloLens 后可以精确匹配 3D 模型。只有 7.7%的参与者可以识别副肝静脉。92%的人更好地理解了肝内结构的深度和空间关系。100%、84.6%、69%和 84%的人认为 3D 模型分别有助于规划、更安全的手术路径、减少术中并发症和培训年轻外科医生。
使用更高质量的横断面解剖数据集可以重建详细的 3D 模型。当与 3D 打印和 HoloLens 技术结合使用时，创建了一种用于肝脏手术的新型混合现实导航培训系统。混合现实培训是向临床医生提供 3D 信息的一种有价值的替代方法，并且可能应用于手术中。这一结论是基于问卷调查和评估得出的。手术经验丰富的外科医生在问卷调查中认为，这项技术可能对肝脏手术有用，有助于精确的术前规划、术中准确识别和减少肝损伤。
