智能化腹部外科术前决策系统的理论与应用研究

Malignant tumors of the abdomen are major threats to the health of the people in China and the whole world, among which advanced gastrointestinal cancer and complex retroperitoneal tumors account for a significant proportion. In China,screening for malignant tumors is far from universal, a considerable number of patients are already in advanced stage when being diagonsed, or with lymph nodes & distant metastasis. Preoperative two-dimensional images alone can not provide an accurate condition of the surgical field, what surgeons rely on more is their personal experience and judgment from exploratory laparotomy,which may cause two negative consequences: since the exact indications for surgery can not be excavated, many patients miss the chance of operation; perform operations at the risk of sever complications, but find it impossible to remove the tumor, the patient bear the trauma with no benefit. The traditional three-dimensional reconstruction of CT can not meet the surgical need for precise analysis. The project is based on clinical data and the technology of computer-aided analysis.We establish a visualization model of a variety of tissues and organs in the abdomen and the digital model of them. Depending on this,we explore the law of deformation and displacement of the abdominal tissues and organs under the force from the outside, then we will study the perfomance of virtual surgery and the evaluation of the standards of surgical simulation. With all the results of the previous study we will finally develop an intelligent system for pre-operative planning in abdominal surgery, providing effective preoperative planning solutions for advanced cancer patients, reducing surgical risk and improve the surgical treatment for patients with gastrointestinal cancer and malignant retroperitoneal tumors.

腹部恶性肿瘤是严重威胁我国和世界人民健康的重大疾病,而其中进展期胃肠道恶性肿瘤和复杂性腹膜后肿瘤又占据了相当大的比例。由于我国肿瘤的筛查远未普及，相当多病人就诊时已属进展期，或已有淋巴结或其他器官的转移。术前仅凭二维影像无法准确判断术区情况，只能靠经验判断或剖腹探查，可能造成两种负面后果：由于确切的手术指征无法被挖掘，很多患者最终失去手术机会；冒险手术却发现无法切除肿瘤，患者承受创伤却无法获益。传统的CT三维重建无法满足外科医师对术区精准分析的要求。本项目基于临床影像数据与计算机辅助技术，通过建立腹部多种组织与器官的三维可视化模型并进行数字化建模，探索腹部组织和器官的受力变形规律，研究虚拟手术的模拟及手术方案的评价标准，开发智能化腹部术前决策系统，为进展期肿瘤患者制定有效的术前规划方案，降低手术风险，进一步提高进展期胃肠道和腹膜后恶性肿瘤患者的手术疗效。

腹部恶性肿瘤是严重威胁我国和世界人民健康的重大疾病,而其中进展期胃肠道恶性肿瘤和复杂性腹膜后肿瘤又占据了相当大的比例。由于我国肿瘤的筛查远未普及，相当多病人就诊时已属进展期，或已有淋巴结或其他器官的转移。术前仅凭二维影像无法准确判断术区情况，只能靠经验判断或剖腹探查，可能造成两种负面后果：由于确切的手术指征无法被挖掘，很多患者最终失去手术机会；冒险手术却发现无法切除肿瘤，患者承受创伤却无法获益。传统的CT三维重建无法满足外科医师对术区精准分析的要求。本项目基于临床影像数据与计算机辅助技术，通过建立腹部多种组织与器官的三维可视化模型并进行数字化建模，探索腹部组织和器官的受力变形规律，利用自主建立的三维可视化分析平台，初步实现了外科医师及时对来自放射科断层CT图像直接进行三维重建，从不同角度对肿瘤相关大血管（动脉）进行观察，并根据本学科专业知识对受侵血管进行任意层面初步定性和定量分析。可以为进展期肿瘤患者制定有效的术前规划方案，降低手术分险，进一步提高进展期胃肠道和腹膜后恶性肿瘤患者的手术疗效。