【Abstract】ObjectiveTo evaluate the value of MR imaging with a contrast-enhanced multi-phasic isotropic volumetric interpolated breath-hold examination (VIBE) in diagnosis of primary liver carcinoma. MethodsThirty-two consecutive patients with surgical-pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two-dimensional (2D) T1WI and T2WI images were acquired before administration of Gd-DTPA for contrast enhancement. Then, contrast-enhanced multi-phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non-enhanced T1WI, enhanced T1WI and enhanced 3D-VIBE images (P＜0.05). The hepatic arterial anatomy of 30 patients （93.8%） and the portal venous structure of 31 patients （96.9%） were clearly depicted on enhanced 3D-VIBE images. Using MIP and MPR reconstruction techniques, the feeding arteries of 14 foci and draining vein of 12 foci were clearly displayed.ConclusionHigh-quality 3D-VIBE images are not only better than 2D images in lesion detection and characterization for primary liver carcinoma, but also able to provide much more information about hepatic vascular anatomy.
ObjectiveTo evaluate the application value of three-dimensional (3D) reconstruction in preoperative surgical diagnosis of new classification criteria for lung adenocarcinoma, which is helpful to develop a deep learning model of artificial intelligence in the auxiliary diagnosis and treatment of lung cancer.MethodsThe clinical data of 173 patients with ground-glass lung nodules with a diameter of ≤2 cm, who were admitted from October 2018 to June 2020 in our hospital were retrospectively analyzed. Among them, 55 were males and 118 were females with a median age of 61 (28-82) years. Pulmonary nodules in different parts of the same patient were treated as independent events, and a total of 181 subjects were included. According to the new classification criteria of pathological types, they were divided into pre-invasive lesions (atypical adenomatous hyperplasia and and adenocarcinoma in situ), minimally invasive adenocarcinoma and invasive adenocarcinoma. The relationship between 3D reconstruction parameters and different pathological subtypes of lung adenocarcinoma, and their diagnostic values were analyzed by multiplanar reconstruction and volume reconstruction techniques.ResultsIn different pathological types of lung adenocarcinoma, the diameter of lung nodules (P<0.001), average CT value (P<0.001), consolidation/tumor ratio (CTR, P<0.001), type of nodules (P<0.001), nodular morphology (P<0.001), pleural indenlation sign (P<0.001), air bronchogram sign (P=0.010), vascular access inside the nodule (P=0.005), TNM staging (P<0.001) were significantly different, while nodule growth sites were not (P=0.054). At the same time, it was also found that with the increased invasiveness of different pathological subtypes of lung adenocarcinoma, the proportion of dominant signs of each group gradually increased. Meanwhile, nodule diameter and the average CT value or CTR were independent risk factors for malignant degree of lung adenocarcinoma.ConclusionImaging signs of lung adenocarcinoma in 3D reconstruction, including nodule diameter, the average CT value, CTR, shape, type, vascular access conditions, air bronchogram sign, pleural indenlation sign, play an important role in the diagnosis of lung adenocarcinoma subtype and can provide guidance for personalized therapy to patients in clinics.
Reconstructing three-dimensional (3D) models from two-dimensional (2D) images is necessary for preoperative planning and the customization of joint prostheses. However, the traditional statistical modeling reconstruction shows a low accuracy due to limited 3D characteristics and information loss. In this study, we proposed a new method to reconstruct the 3D models of femoral images by combining a statistical shape model with Laplacian surface deformation, which greatly improved the accuracy of the reconstruction. In this method, a Laplace operator was introduced to represent the 3D model derived from the statistical shape model. By coordinate transformations in the Laplacian system, novel skeletal features were established and the model was accurately aligned with its 2D image. Finally, 50 femoral models were utilized to verify the effectiveness of this method. The results indicated that the precision of the method was improved by 16.8%–25.9% compared with the traditional statistical shape model reconstruction. Therefore, the method we proposed allows a more accurate 3D bone reconstruction, which facilitates the development of personalized prosthesis design, precise positioning, and quick biomechanical analysis.
Objective To assess the value of precise hepatectomy in treatment of primary hepatocellular carcinoma. Methods Three-dimensional (3D) models from MR image were reconstructed by 3D-Doctor software in 32 patients with primary hepatocellular carcinoma scheduled for liver resection between July 2007 and Sept 2009. From these 3D models, the vena cava, portal vein, hepatic vein, and short hepatic vein images were reconstructed, total liver volume, tumor volume, functional liver volume and ratio of functional liver volume to standard liver volume (SFLVR) were calculated. The patients were followed-up for 1-27 months, with an average of 12 months. Results The anatomic detail of liver veins and its relationship with the tumor could be displayed clearly in liver 3D models. By the 3D models, total liver volume was calculated as （1 353±419）ml, tumor volume as （287±248） ml, functional liver volume as （830±289） ml, and SFLVR as （71±22）%. Of 32 patients with hepatocellular carcinoma, right hemihepatectomy was performed in 8 cases, left hemihepatectomy in 2, and segmental or limited resection in 22. All operations were completed successfully. Postoperative complications included pulmonary infection in 1 case, bile leak in 1, moderate ascites (500-3 000 ml) in 8, and massive ascites (gt;3 000 ml) in 2 including one patient developed hepatic failure. Six and 12-month survival rates were 100% and 87%. Three, 6, and 12-month disease-free survival rates were 78%, 72%, and 72%. Conclusions Precise hepatectomy technique provides an accurate picture of liver veins anatomy and its relationship with the tumor， and allows the procedure to be simulated preoperatively for adequate and safe hepatectomy.
Objective To introduce the recent advances of the application of computer technology in tissue engineering. Methods The recent original articlesrelated to computer technology, medical image technology, computer-aided design, the advanced manufacture technology were summarized and systematically analyzed.Results Computer-aided tissue engineering is a new fieldon tissue engineering. It is the future direction of tissue engineering study. This article reviews recent development of medical CT/MRI scanning, three-dimensional reconstruction, anatomical modeling, computeraided design, computer-aided manufacturing, rapid prototyping， RP manufacturing of tissue engineering scaffolds and computeraided implantation.Conclusion Computer-aided tissue engineering can be used in scaffolds design and fabrication, computer-aided artificial tissue implantation. It is a new field on tissue engineering.
Objective To discuss the authenticity of reconstructing the anterior cruciate l igament (ACL) threedimensional digital model of normal adult knee joint by use of MRI. Methods The double knee joint specimens were selected from 20 fresh normal adult corpses and double knee joint of 20 normal adult volunteers, and were scanned with MRI; continuous image data of level thick 1.0 mm were acquired, and then these data were imported into Mimics 10.01 software for three-dimensional reconstruction; and full three-dimensional digital models were built, including the corpse specimens (corpsemodel group) and normal adult (normal model group). The relevance anatomy index of ACL were measured with easuring tool of Mimics 10.01 software, and double knee joint specimens of 20 fresh normal adult corpses were dissected, and the relevance data were measured (corpse specimens group). Results There was no significant difference in all indexes between corpse model group and corpse specimen group (P gt; 0.05), and between corpse model group and normal model group (P gt; 0.05). Conclusion The image data gathered by MRI could reconstruct the ACL three-dimensional digital model of normal adult knee joint, which has authenticity.
Lung cancer is the leading cause of death worldwide. With the prevalence of CT screening and early diagnosis and treatment of lung cancer in China, more and more patients with early-stage lung cancer characterized with ground-glass opacity are discovered and urgently require treatment, which poses a significant challenge to surgeons. As an emerging technology, three dimensional reconstruction technology plays a crucial auxiliary role in clinical work. This review aims to briefly introduce this technology, focusing on its latest advances in surgical applications in early lung cancer screening, malignant risk assessment, and perioperative period application and medical education.
ObjectiveTo explore the value and role of post-processing techniques such as 3D reconstruction in the online education mode in neurosurgery undergraduate clinical probation teaching.MethodsA retrospective analysis method was used to collect 120 clinical 5-year medical students who were trained in neurosurgery at West China Hospital of Sichuan University from January 2019 to May 2020, including 40 students receiving traditional imaging materials offline (control group 1), 40 students being taught on image post-processing technology offline (control group 2), and 40 students being taught on-line image post-processing technology during the novel coronavirus epidemic (observational group). The students’ scores of departmental rotation examination and feedback survey results on teaching satisfaction were collected, and multiple comparison was conducted between the observational group and the two control groups respectively.ResultIn the control group 1, the control group 2, and the observational group, the theoretical test scores were 36.80±3.22, 38.17±2.61, and 38.97±2.79, respectively; the case analysis scores were 37.05±2.01, 38.40±2.62, and 39.25±2.88, respectively; the total scores were 73.85±5.06, 76.57±4.29, and 78.10±4.53, respectively; the scores of interest in teaching were 84.47±3.71, 86.05±2.87, and 86.82±2.60, respectively; the scores of mastery of knowledge were 82.85±4.39, 84.90±2.72, and 85.78±2.36, respectively; and the scores of overall satisfaction with teaching were 84.17±3.45, 85.97±2.64, and 86.37±2.59, respectively. The differences among the three groups were all statistically significant (P<0.05). The observational group differed significantly from the control group 1 in all the above scores (P<0.05), while did not differed from the control group 2 in any of the above scores (P>0.05).ConclusionsIn neurosurgery internship activities, the online application of image post-processing techniques such as 3D reconstruction will help students establish 3D spatial concepts, better understand the brain anatomy, and improve students’ academic performance and acceptance.
Objective To quantitatively evaluate the effect of 2 types of pressures induced injury by using threedimensional (3D) reconstruction of rats loaded tibial is anterior muscle from two-dimensional (2D) image of serial histological sections. Methods Twenty female or male Sprague Dawley rats, aged 10-12 weeks and weighing 280-300 g, were randomlydivided into experimental group (n=10) and control group (n=10). The random side of tibial is anterior muscle was givenintermittent gradient (8.0-21.3 kPa) and sustained (13.3 kPa) pressure in 0.12 cm2 area in experimental group and controlgroup, respectively; the experiment was terminated and the general condition of rats was observed after 3 cycles, and a single cycle included 2 hours of compression and 30 minutes of release. The general observations of pressed skin and tibial is anterior muscle were done after 24 hours of pressure rel ief, and the tibial is anterior muscle was harvested integrally from the loaded side, then made into interval 4 μm serial sections. After HE staining, 2D images were obtained. Necrosis and injury areas were distinguished by Image Pro Plus (IPP) 6.0 software and image registration was conducted by Photoshop 8.0.1 after 2D panorama images acquired by digital microscope (× 40) and IPP mosaic software. 3D reconstruction was establ ished via data processing using Mimics 10.1 software so as to get the volume, the surface area, and 3D images of the whole piece of tibial is anterior muscle and injury areas respectively. Results All rats of 2 groups survived till experiment terminated and no skin ulcers occurred after 24 hours. Edema and indentation were observed on press side skin and tibial is anterior muscles of 2 groups, fadeless maroon area was observed in control group. A total of 994 sl ices were obtained from 20 samples of tibial is anterior muscles. 3D images suggested that injury of control group was severe, which penetrated the whole piece of tibial is anterior muscle and expandedalong the tibia bony prominence. By contrast, injury of experimental group was less, but had similar width to the contact surface of indentor. There was no significant difference in the volume and the surface area of tibial is anterior muscle between 2 groups (P gt; 0.05), while the injury volume and the injury surface area were significantly smaller in experimental group than in control group (P lt; 0.05). Conclusion 3D reconstruction is an effective method to quantitatively evaluate pathological changes inside the integrity tissue and can provide the visual basis for the mechanical property distributed in the loaded muscle. Intermittent gradient pressure can reduce deep tissue injury.
Objective To review the research progress on the three-dimensional (3D) reconstruction and visual ization of peri pheral nerve. Methods Literature about the research on the 3D reconstruction and visual ization of peripheral nerve both at home and abroad were extensively reviewed and thoroughly analyzed. Results The appl ication of 3D reconstruction and visual ization technology was capable of not only reappearing the 3D outer contour and spatial adjacent relationship of peripheral nerve veritably but also displaying, rotating, zooming, dividing and real-time measuring their 3D internal structure and the del icate pathways in any direction either separately or totally. Prel iminary achievements were achievedin terms of brachial plexus, lumbosacral plexus, the functional cluster of nerve trunk, intramuscular nerve distribution pattern, peripheral nerve regeneration and the 3D reconstruction and visual ization research of complex tissue including peripheral nerve. However, the research on the visual ization of peripheral nerve was still in the initial stage since such problems as recognition, segmentation, registration and fusion of the peripheral nerve information were not resolved yet. Conclusion Researching 3D reconstruction and visual ization of the peripheral nerve is of great value for updating the diagnosis and treatment principle of peripheral nerve injury, improving its diagnosis and treatment method and launching a new way for the studying and teaching, which may be a new growing point for the peripheral nerve surgery.