摘要目的 分析自主研发的腹部医学图像处理系统(AMIPS)在极量肝切除术中的临床应用价值.方法 收集2007年9月至2009年7月收治的32例肝肿瘤患者的64排螺旋CT数据,男性15例,女性17例,平均年龄52岁.其中巨大肝肿瘤(直径≥10 cm)9例,包括肝血管瘤2例、原发性肝癌7例.运用AMIPS对9例巨大肝肿瘤患者进行极量肝切除分析.根据计算出的数据选择合适的手术方式.结果 在AMIPS中,三维模型能直观显示肿瘤与肝内血管树的毗邻关系及肿瘤的血供类型,数字化肝脏分段实现了对肝肿瘤的个体化准确定位诊断.巨大肝脏占位模型中各个肝段相对体积的计算,实现了肝段切除及极量肝切除的分析.9例巨大肝肿瘤患者中,右半肝切除术2例,肝脏6、7段切除术5例,肝脏5、6、7段、部分8段肝切除术2例.术后病理均未见切缘有瘤细胞,未发生肝功能衰竭等并发症,平均住院时间为21 d.结论 AMIPS有助于巨大肝肿瘤的个体化病灶定位及术前手术方式的选择,可降低手术风险及术后肝功能衰竭的发生.

abstractsObjective To study the applied value of abdominal medical image proceeding system (AMIPS) in extended hepatectomy. Methods Sixty-four-slice spiral computer tomography (CT) scan data of 32 cases treated from September 2007 to July 2009 (15 male, 17 female; mean age 52 years old) with liver tumor was collected, among which there were 9 cases with huge liver tumor. The data was imported into AMIPS for sequence segmenting and three-dimensional (3D) reconstruction. The reconstructed models were imported into virtual system of AMIPS for digital hepatic segment partition and extended hepatectomy analysis for huge liver tumor of 9 cases. According to the calculated data, suitable modus operandi were selected. Results In the AMIPS,the 3D models could show the relationships between the lesions to the surrounding tissue more intuitively and the type of blood supply. Digital hepatic segment partition made localize lesions more exactly. It was possible to hepatic segmentectomy and analysis of extended hepatectomyz by calculating the relative volume of hepatic segment of huge liver tumor. Huge liver tumor of 9 cases performed different modus operandi, including two cases with right hemihepatectomies, five cases with hepatic segmenteetomy of S6 and S7,two cases with hepatic segmentectomy of S5-7 and part of the S8. There were margin-free tumor cells and no complications such as liver failure in all eases. The average hospitalization time was 21 d. Conclusion AMIPS is helpful in the diagnosis of hepatic disease and in the optimizing surgical plans which can decrease surgical risk and help prevent postoperative hepatic failure.