Objective To discussion the diagnostic significance of CT three dimension reconstruction in local recurrence after surgery for gastric cancer. Methods Thirty-nine patients with gastric cancer recurrence after radical surgery were performed multislice CT scan between December 2004 and December 2008 in The Third Affiliated Hospital of Harbin Medical University, and the images were reconstructed by three dimension reconstruction in workstation. The axial CT images and three dimension images of gastric cancer recurrence patients were diagnosed and compared. Results The detection rates of axial images and three dimensional CT images were 82.1% (23/28) and 100% (28/28) for pathological morphology, 62.5% (10/16) and 93.8%(15/16) for extension of tumors, 66.7% (10/15) and 93.3% (14/15) for lymph node metastasis, 87.5% (7/8) and 87.5% (7/8) for distant metastasis, respectively. Conclusions CT three dimension reconstruction can carry out more direct and solid results, such as measuring the vertical thickness of the thickened gastric wall, observing the infiltration situation with proximal organ, and metastasis of the lymph node. The method of three dimension reconstruction used for the diagnosis of local recurrence after surgery for gastric cancer is better than the axial image, and it can supply data which would be useful for the tumor advancing treatment.
【Abstract】Objective To investigate the anatomic structure and experimental methods of peribiliary vascular plexus(PVP) in rat’s hepatic portal bile duct.Methods To observe the morphological structure of PVP in rat’s hepatic portal bile duct after the hepatic artery was perfused with Chinese ink and transparency management, performed and to make three dimensional reconstruction of PVP’s spacial structure in MoticBuaa3Dvol software.Results The microvascular distribution and plane structure of PVP in rat’s hepatic portal bile duct could be shown clearly through Chinese ink perfusion and transparency management. The three dimensional structure of PVP could be reconstructed effectively by MoticBuaa3Dvol software, its effect was verisimilitude. Conclusion Chinese ink perfusion and vitrification is a simple and easy method in PVP’s morphologic study of rat’s hepatic portal bile duct. MoticBuaa3Dvol software is useful in microvascular study of hepatic portal bile duct.
ObjectiveTo observe the in vivo three-dimensional (3-D) transient motion characteristics of the subaxial cervical spine in healthy adults. MethodsSeventeen healthy volunteers without cervical spine related diseases were recruited for this study, including 8 males and 9 females with a mean age of 26 years (range, 23-41 years). The vertebral segment motion of each subject was reconstructed with CT, and Rhinoceros 4.0 solid modeling software were used for 3-D reconstruction model of the subaxial cervical spine. In vivo cervical vertebral motion in flexionextension, left and right bending, left and right rotation was observed with dual fluoroscopic imaging system (DFIS). Coordinate systems were established at the vertebral center of C3-7 to obtain the intervertebral range of motion (ROM) and displacement at C3, 4, C4, 5, C5, 6, and C6, 7. The X-axis pointed to the left along the coronal plane, the Y-axis pointed to the back along the sagittal plane, and the Z-axis perpendicular to the X-Y plane pointed to the head. The ROM along X, Y, and Z axises were represented by rotation in flexion-extension (α), in left-right bending (β), and in left-right twisting (γ) respectively, and the displacement in left-right direction (x), in anterior-posterior direction (y), and in proximaldistal direction (z), respectively. ResultsIn flexion and extension, the displacement in anterior-posterior direction of C6, 7 was significantly less that of other segments (P<0.05), but the displacements in left-right direction and in proximaldistal direction showed no significant difference between segments (P>0.05); the ROM values in flexion-extension of C4, 5 and C5, 6 were significantly larger than those of C3, 4 and C6, 7 (P<0.05), and the ROM value in left-right twisting of C4, 5 was significantly larger than those of C5, 6 and C6, 7 (P<0.05), but the ROM value in left-right bending showed no significant difference between segments (P>0.05). In left and right bending, there was no significant difference in the displacement between other segments (P>0.05) except that the displacement in anterior-posterior direction of C3, 4 was significantly larger than that of C4, 5 (P<0.05), and that the displacement in proximal-distal direction of C6, 7 was significantly less than that of C3, 4 and C4, 5 (P<0.05); no significant difference was shown in the ROM value between segments (P>0.05), except that the ROM value in left-right twisting of C3, 4 was significantly larger than that of C5, 6 and C6, 7 (P<0.05). In left and right rotation, the ROM value in left-right twisting of C3, 4 was significantly larger than that of C4, 5 and C6, 7 (P<0.05), and the displacement and ROM value showed no significant differece between other segments (P>0.05). ConclusionThe intervertebral motions of the cervical spine show different characters at different levels. And the 6-degree-of-freedom data of the cervical vertebrae are obtained, these data may provide new information for the in vivo kinematics of the cervical spine.
ObjectiveTo investigate the feasibility and early effectiveness to treat osteonecrosis of the femoral head (ONFH) with pedicled iliac bone graft assisted by individual digital design and three dimensional (3D) printed navigation templates. MethodsBetween February and June 2014, 15 patients (24 hips) with ONFH underwent pedicled iliac bone graft assisted by individual digital design and 3D printed navigation templates. There were 11 males (17 hips) and 4 females (7 hips) with a mean age of 38 years (range, 18-56 years) and a mean disease duration of 7.5 months (range, 1-24 months); the left hip was involved in 2 cases, the right hip in 4 cases, and both hips in 9 cases. There were 7 cases (12 hips) of steroid-induced ONFH, 5 cases (8 hips) of alcohol-induced ONFH, 1 case (1 hip) of traumatic ONFH, and 2 cases (3 hips) of idiopathic ONFH. The preoperative Harris score was 56.60±6.97. According to Association Research Circulation Osseous (ARCO) staging system, 5 hips were classified as stage IIB, 8 hips as stage IIC, 6 hips as stage IIIB, and 5 hips as stage IIIC. The navigation templates were designed and printed to assist accurate location and debridement of necrosis area according to preoperative CT scanning at the beginning of pedicled iliac bone grafting procedure. ResultsThe mean operation time was 135 minutes (range, 120-160 minutes), mean amount of bleeding was 255 mL (range, 200-300 mL). All the wounds healed primarily, no complication of deep vein thrombosis or infection was observed. All patients were followed up 12-16 months (mean, 14 months). The location of necrosis area was in accordance with preoperative design, which was removed completely without penetration of joint surface, pedicled iliac bone graft was performed at the right site according to postoperative imaging examination. Radiographically, graft fusion was achieved at 2.7 months (range, 2-3 months) in all patients. All the hips had no collapse during follow-up. Hip pain was relieved, and range of motion was improved. The Harris score was significantly improved to 89.53±5.83 at last follow-up (t=14.319, P=0.000). The results were excellent in 12 hips, good in 10 hips, and fair in 2 hips according to Harris score standard. ConclusionPedicled iliac bone graft assisted by individual digital design and 3D printed navigation templates for treatment of adult ONFH has the advantages of accurate location and complete debridement of necrosis area, so satisfactory results can be obtained.
ObjectiveTo fabricate the bionic scaffolds of rat spinal cord by combining three dimensional (3D) printer and 3D software, so as to lay the foundation of theory and technology for the manufacture of scaffolds by using biomaterials. MethodsThree female Sprague Dawley rats were scanned by 7.0T MRI to obtain the shape and position data of the cross section and gray matter of T8 to T10 spinal cord. Combined with data of position and shape of nerve conduction beam, the relevant data were obtained via Getdata software. Then the 3D graphics were made and converted to stereolithography (STL) format by using SolidWorks software. Photosensitive resin was used as the materials of spinal cord scaffolds. The bionic scaffolds were fabricated by 3D printer. ResultsMRI showed that the section shape of T8 to T10 segments of the spinal cord were approximately oval with a relatively long sagittal diameter of (2.20±0.52) mm and short transverse diameter of (2.05±0.24) mm, and the data of nerve conduction bundle were featured in the STL format. The spinal cord bionic scaffolds of the target segments made by 3D printer were similar to the spinal cord of rat in the morphology and size, and the position of pores simulated normal nerve conduction of rat spinal cord. ConclusionSpinal cord scaffolds produced by 3D printer which have similar shape and size of normal rat spinal cord are more bionic, and the procedure is simple. This technology combined with biomaterials is also promising in spinal cord repairing after spinal cord injury.
ObjectiveTo investigate the value of computer assisted radiology and surgery solutions system (IQQA-Liver) in surgical planning for precise hepatectomy. MethodsThe clinical data of 95 cases performed precise hepatec-tomy from January 1, 2012 to June 30, 2013 in our hospital were retrospectively analyzed, and the computer assisted radiology and surgery solutions system was used for three dimensional quantitative analysis, volume measurement and designing for liver resection in all the cases before operation. ResultsThe intuitive and clear three dimensional images of all the 95 cases were obtained by using the computer assisted radiology and surgery solutions system, which could show the precise anatomical relationship of the liver, tumor, and main hepatic vascular.The three dimensional images could be observed at any angle and rotated freely, and could show the involved and needed to be resected vascular away from the tumor margin for 2 mm, 5 mm, 10 mm, and 20 mm and the liver volume dominated by this vascular.Of all the 95 cases, the total liver volume was (1 776.4±998.5) cm3, the proposed removed liver volume was (1 026.2±811.5) cm3, the functional residual liver volume was (795.3±522.6) cm3.The ratio of functional residual liver volume to the standard total liver volume was (58.2±25.1)%, which the ratio of patients without cirrhosis was > 30% and with cirrhosis was > 40%.All the 95 cases were implemented precise operation.The operation plan was designed based on a combination of factors such as the amount of functional residual liver volume and function.The surgery programs were changed for 13 cases, in which 9 cases were narrowed the scope of resection and 4 cases were expanded the scope of resection.No patients died perioperation. ConclusionBy using the computer assisted radiology and surgery solutions system (IQQA-Liver), we could precisely locate liver tumor, calculate the functional residual liver volume, identify the relationship between tumor and adjacent vascular, and ultimately help to design the optimal surgical plan.
ObjectiveTo review the research progress of adipose-derived stem cells (ADSCs) compound with three dimensional (3D) printing scaffold in tissue engineering of fat, bone, cartilage, blood vessel, hepatocyte, and so on. MethodsThe recently published literature about ADSCs compound with 3D printing scaffold in tissue engineering at home and abroad was reviewed, analyzed, and summarized. ResultsA large number of basic researches showed that ADSCs could differentiate into a variety of tissues on 3D printing scaffold and involve in tissue repair and regeneration. But there is still a long way between the basic theory and the clinical practice at the early stages of development. ConclusionIt can effectively improve and restore the structure and function of the damaged tissue and organ to use ADSCs and 3D printing scaffold.
Objective To explore and solve the key technologies of the three dimensional (3D) visual ization reconstruction of functional fascicular groups inside long segmented peri pheral nerve. Methods A 20 cm ulnar nerve from upper arm of fresh adult dead body was embedded by OCT with four pieces of woman’s hair which was used as locating material, then the samples were serially horizontally sl iced into 400 sl ices with 15 μm thickness and 0.5 mm interval. All sl iceswere stained with acetylcholinesterase (AchE) histochemical staining. After that, the 2D panorama images of the same sl ice were obtained with Olympus stereomicroscope and MSHOT MD90 micro figure image device before and after AchE staining. Using the layer processing technique of Photoshop image processing software, the recomposition images including complete 4 location pots were obtained, based on which the algorithm of optimized least square support vector machine (Optimized LS-SVM) and space transformation method was used to fulfill automatic registration. Finally, with artificial assistant outline obtaining, the 3D visual ization reconstruction model of functional fascicular groups of 20 cm ulnar nerve was made using Amira 4.1, and the effects of reverse reduction and the suitabil ity of 3D reconstruction software were evaluated. Results The two-time imaging technique based on the layer process of Photoshop image processing software had the advantages: the image outline had high goodness of fit; the locating pots of merging image was accurate; and the whole procedure was simple and fast. The algorithm of Optimized LS-SVM had high degree of accuracy, and the error rate was only 8.250%. The 3D reconstruction could display the changes of the chiastopic fusion of different nerve functional fascicular groups directly. It could extract alone, merge and combine arbitrarily, and revolve at any angles. Furthermore, the reverse reduction on arbitrarily level dissection of the 3D model was very accurately. Conclusion Based on the two-time imaging technique and computer image layer processing technology, the compute algorithm of auto-registration can be developed and appl ied to 3D visual ization reconstruction of long segmented peripheral nerve. The technological processes is fast, and the reconstruction effect is good.
ObjectiveTo evaluate the feasibility and accuracy of a novel three dimensional (3D) preoperative simulation software in a clinical setting for patients undergoing precise hepatectomy. MethodsThe clinical data of 85 patients with hepatocellular carcinoma underwent precise hepatectomy were retrospectively studied. All the patients received CT screening and subsequent evaluation on the liver resection volume and margin and the percentage of resected tumor by 3D preoperative simulation software, which compared with the actual resection liver values. The operation plan was optimized by virtual hepatectomy. ResultsThe liver, tumor as well as blood vessel could be clearly showed and reconstructed by 3D preoperative simulation software. All the patients underwent precise hepatectomy. After operation ascites occurred in 3 patients on 2 d, moderate pleural effusion occurred in 2 patients on 2 d, and bile leakage appeared in 4 patients on 5 d, which were improved by conservative treatment. The length of stay in all patients ranged from 6 to 88 d (mean 23 d), and no recurrence and death occurred within 30 d of operation. The predicted resection liver volume was significantly correlated with the actual resection volume (r=0.960, Plt;0.001), and the difference between the mean volume of predicted and actual resection liver was not significant (896.7 ml vs. 819.1 ml， t=1.851, P=0.068). In addition, the predicted resection margin was also correlated with the actual resection margin (r=0.972, Plt;0.001), with the difference in the mean resection margin was not significant too (12.2 mm vs. 11.9 mm， t=1.143, P=0.256). No patients suffered from severe postoperative complications. ConclusionsThe 3D preoperative simulation software is able to evaluate and simulate liver resection accurately, which may contribute to a safe precise hepatectomy plan.
ObjectiveTo investigate the three-dimensional (3D) culture and morphology of human eccrine sweat gland cells. MethodsThe human eccrine sweat gland cells were isolated from normal abdominal full thickness skin by digestion of type II collagenase, and cultured in defined-keratinocyte serum free medium supplemented with 5 ng/mL recombinant human epidermal growth factor, 25 mg/mL bovine pituitary extract, 100 U/mL penicillin, and 100 μg/mL streptomycin at 37℃ in a humidified atmosphere of 5%CO2/95% air incubator. When the cell fusion reached above 80%, the cells were harvested and the concentration was adjusted to 1×105 cells/mL. The mixture of 0.3 mL cell suspension and 0.3 mL Matrigel basement-membrane matrix was cultured in 12-well plate. The cell growth was observed under an inverted phase contrast microscope. At 14 days after culture, frozen sections were prepared and were stained with HE to observe the cells morphology, and immunohistochemical analysis was used to detect the antigen expressions of cytokeratin 7 (CK7) and CK19. ResultsInverted phase contrast microscope observation showed that many free eccrine sweat gland tissues were seen after digestion of type II collagenase; eccrine sweat gland cells grew adhering to the wall at 3-5 days and continued division for 2-3 weeks to form single ring around the block sweat glands; cellular senescence were observed after 3-4 weeks. During the process of 3D culture, the single eccrine sweat gland cell divided into 2-4 cells after 2-3 days, and these cells subsequently formed small cell clusters, tubular-like structures and finally spheric-like shapes. After cultured for about 2 weeks, there was crack in part of the gelled mixture or liquefaction occurred. HE staining of frozen sections of the 3D cultures showed some of the tubular-like structures composed of 1-2 layers of epithelial cells, which were similar to the secretion part and the duct part of the eccrine sweat gland. Immunohistochemical analysis showed that CK7 and CK19 antigens expressed positively in the cells. ConclusionHuman eccrine sweat gland cells cultured in Matrigel can form the 3D structures which simulate the morphology of eccrine sweat glands in vivo.