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目的研究三维重建技术在儿童腹部肿瘤中的临床应用价值。方法利用自主研发的医学图像处理与模拟软件,对儿童腹部肿瘤CT图像进行分割、三维重建,根据重建结果对肿瘤与周围脏器及血管的关系进行分析,并对手术难易程度及可切除性进行评估。手术中进行拍照、录像,与重建结果进行对比。术后再用病理结果对肿瘤组织来源进行验证。结果例1:三维重建的模型显示肿瘤占居腹部和盆腔大部,形状不规则,其内有一不规则高密度骨质样物,腹主动脉、髂血管位于肿瘤后侧,与肿瘤有一定的距离。术前预测为畸胎瘤。经手术验证,重建结果符合患者个体化实际情况。肿瘤内为大量褐色液体,内含少量毛发及骨骼样组织。术后病理证实为囊性成熟性畸胎瘤。例2:重建的模型显示腹主动脉、腹腔干及其分支、肝动脉、门静脉主干及分支、脾静脉等结构均清楚显示,胃网膜血管迂曲增粗,肿瘤来源于胰腺,胰体尾受压萎缩,仅保留少量胰头组织。术中结果证实肿瘤来源于胰腺,胰体尾受压。术后病理证实为胰腺实性-假乳头状瘤。结论三维重建技术可对儿童腹部肿瘤进行准确定位,并于术前进行肿瘤性质及来源预测,有利于手术方案的合理设计,降低手术风险。
Objective To study the clinical value of three-dimensional reconstruction in children with abdominal tumors. Methods Using the self-developed medical image processing and simulation software, CT images of children’s abdominal tumor were segmented and reconstructed. The relationship between the tumor and surrounding organs and blood vessels was analyzed according to the reconstructed results. The degree of surgical difficulty and resectability to evaluate. During surgery to take pictures, video, and reconstructed results were compared. Postoperative pathological results were used to verify the source of tumor tissue. Results Example 1: The 3D reconstruction model shows that the tumors occupy the abdomen and the pelvis mostly with irregular shape. There is an irregular high-density bone mass inside the abdominal aorta. The iliac blood vessels are located on the posterior side of the tumor and have certain tumor distance. Preoperative prediction of teratoma. After operation verification, the reconstruction result accords with the actual situation of patient individuation. Tumor a large number of brown liquid, containing a small amount of hair and bone-like tissue. Postoperative pathology confirmed cystic maturity teratoma. Example 2: The reconstructed model shows the abdominal aorta, celiac trunk and its branches, hepatic artery, portal vein trunk and branches, splenic vein and other structures are clearly show that gastric vessels tortuous thickening, the tumor from the pancreas, body and tail of pancreas Pressure atrophy, leaving only a small amount of pancreatic head tissue. Intraoperative results confirmed that the tumor originated in the pancreas, pancreatic body tail pressure. Postoperative pathology confirmed pancreatic solid - pseudopapillary tumor. Conclusion Three-dimensional reconstruction can accurately locate the abdominal tumor in children and predict the nature and source of the tumor before surgery, which is beneficial to the rational design of the surgical plan and to reduce the surgical risk.