摘要
目的探讨利用VTK实现三维可视化系统对胆囊管变异的诊断价值及临床意义。方法回顾性分析经临床确诊的160例胆石症患者,分别采用传统最大密度投影(MIP)及三维可视化系统辅助,对磁共振胰胆管水成像(MRCP)进行胆囊管变异的诊断,并与手术结果进行比较。结果以手术结果为金标准,在三维可视化系统辅助下检出胆囊管变异81例,与手术结果一致且差异无统计学意义(κ=0.950,P=1.000);而单纯采用MIP结合薄层图像检出则为51例,与手术结果存在差异且具有统计学意义(κ=0.477,P<0.001)。对难以明确诊断的39例胆囊管旋前或旋后汇入肝总管的变异,在三维可视化系统的辅助下分别检出12例及27例,与手术结果一致且差异无统计学意义(κ=0.880,P=1.000);而单纯采用MIP结合薄层图像则分别检出24例及15例,与手术结果的差异具有统计学意义(κ=0.246,P=0.004)。结论利用VTK实现的三维可视化系统可以提高对胆囊管变异诊断的准确性,不仅弥补了MIP对于空间比邻关系显示欠确切的不足,更有助于临床术前了解胆囊管解剖变异的情况,避免胆囊切除术中所引起的胆道损伤。
Objective To investigate the diagnostic value and clinical significance of three-dimensional visualization system implemented by Visualization Toolkit （VTK） for cystic duct variation. Methods Data of 160 cases with biliar- y tract diseases were retrospectively analyzed. Diagnosis of cystic ductal variation by magnetic resonance cholangiopan- creatography （MRCP） was proceeded respectively by using the traditional maximum density projection （MIP） and three-dimensional visualization system assist, and compared with the results of the operation which was used as the golden standard. Results Totally 81 cases of cystic ductal variance were detected by the three-dimensional visualization system which were consistent with the operation results without significant difference （ K = 0. 950, P = 1. 000）. Only 51 cases were detected by MIP combined with thin-layer image, and the difference with the operation results were statisti- cally significant （ K = 0. 477, P 〈 0. 001 ）. Among 39 cases of the cystic duct variation forward and backward to the he- patic duct which is difficult to be definitely diagnosed, 12 cases and 27 cases were detected by the three-dimensional vi- sualization system, which were consistent with the operation results without significant difference （ K = 0. 880, P = 1. 000）. However, using MIP combined with thin layer 24 cases and 15 cases were detected, and the difference with the operation results was statistically significant （ K = 0. 246, P = 0. 004）. Conclusion Three-dimensional visualization system implemented by VTK has the ability to improve the detection rate in the diagnosis of cystic duct variation, which not only makes up for the deficiency of accurate display of MIP to the space adjacent relations, but also help to under- stand the cystic duct anatomic variation before operation and avoid bile duct injury in cholecystectomy.
作者
窦瑞欣
薛敏娜
李国华
DOU Ruixin XUE Minna LI Guohua(Department of Radiology, Tianjin Nankai Hospital, Tianjin 300100, China)
出处
《山东大学学报（医学版）》
CAS
北大核心
2017年第7期84-88,共5页
Journal of Shandong University:Health Sciences
关键词
胆囊管
解剖变异
磁共振胰胆管成像
VTK
医学三维可视化
Cystic duct
Anatomic variations
Magnetic resonance cholangiopancreatography
Visualization toolkit
Medical three-dimensional visualization
