ObjectiveTo investigate feasibility and safety of laparoscopic liver resection with vascular variation.MethodsThe clinical data of one patient with preoperative diagnosis of primary liver cancer, who was admitted into the Department of Hepatobiliary Surgery of the Second Affiliated Hospital of Army Military University in October 2017, were analyzed retrospectively. The three-dimensional (3D) reconstruction was completed basing on the preoperative CT data, then the liver volume was calculated and the preoperative planning was made, finally the subsequent surgery was performed.ResultsThe results of the 3D reconstruction suggested that the tumor was situated in the central of the right liver, including the segment Ⅴ, Ⅵ, Ⅶ, and Ⅷ. There was a type Ⅱ portal vein variation, the right anterior branch of the portal vein divided a branch into the left medial lobe. The right hepatic vein was divided into the ventral and dorsal branches. There was a thick right posterior inferior vein in this case. The preoperative planning was that the right posterior lobectomy or right anterior lobectomy could not completely remove the tumor. According to the standard right hemihepatectomy, the remaining liver volume accounted for 27% of the standard liver volume. If preserving the right anterior branch of the portal vein for the right hemihepatectomy, the remaining liver volume accounted for 41% of the standard liver volume. According to the concept of precise hepatectomy, the laparoscopic partial right hepatectomy with preservation of the main branch of the right anterior portal vein was performed smoothly. The liver function recovered well after the surgery. The right pleural effusion appeared after the surgery, then was relieved by the thoracentesis.ConclusionFor primary liver cancer patient with vascular variation, laparoscopic liver resection is feasible and safe basing on guide of 3D reconstruction technology.
ObjectiveTo investigate the correlation between glenohumeral joint congruence and stability in recurrent shoulder dislocations. Methods Eighty-nine patients (89 sides) with recurrent shoulder dislocation admitted between June 2022 and June 2023 and met the selection criteria were included as study subjects. There were 36 males and 53 females with an average age of 44 years (range, 20-79 years). There were 40 cases of left shoulder and 49 cases of right shoulder. The shoulder joints dislocated 2-6 times, with an average of 3 times. The three-dimensional models of the humeral head and scapular glenoid were reconstructed using Mimics 20.0 software based on CT scanning images. The glenoid track (GT), inclusion index, chimerism index, fit index, and Hill-Sachs interval (HSI) were measured, and the degree of on/off track was judged (K value, the difference between HSI and GT). Multiple linear regression was used to analyze the correlation between the degree of on/off track (K value) and inclusion index, chimerism index, and fit index. ResultsMultiple linear regression analysis showed that the K value had no correlation with the inclusion index (P>0.05), and was positively correlated with the chimerism index and the fit index (P<0.05). Regression equation was K=–24.898+35.982×inclusion index+8.280×fit index, R2=0.084. ConclusionHumeral head and scapular glenoid bony area and curvature are associated with shoulder joint stability in recurrent shoulder dislocations. Increased humeral head bony area, decreased scapular glenoid bony area, increased humeral head curvature, and decreased scapular glenoid curvature are risk factors for glenohumeral joint stability.
ObjectiveTo explore the feasibility and clinical value of free-of-puncture positioning in three-dimension-guided anatomical segmentectomy for ground-glass nodule (GGN) compared with percutaneous positioning.MethodsClinical data of 268 enrolled patients undergoing anatomical pulmonary segmentectomy from October 2018 to June 2019 were retrospectively collected, including 75 males and 193 females with an average age of 56.55±12.10 years. The patients were divided into two groups, including a percutaneous positioning group (n=89) and a free-of-puncture positioning group (n=179). Perioperative data of the two groups were compared.ResultsThe average CT scan times of the percutaneous positioning group was 3.01±0.98 times, and the numerical rating scale (NRS) score of puncture pain was 3.98±1.61 points. Pulmonary compression pneumothorax (≥30%) occurred in 7 (7.87%) patients and intercostal vascular hemorrhage occurred in 8 (8.99%) patients after puncture. Lung nodules were successfully found and removed in both groups. There was no statistically significant difference between the two groups in the location of nodules (P=0.466), operation time (151.83±39.23 min vs. 154.35±33.19 min, P=0.585), margin width (2.07±0.35 cm vs. 1.98±0.28 cm, P=0.750), or the number of excised subsegments (2.83±1.13 vs. 2.73±1.16, P=0.530).ConclusionAnatomical segmentectomy with three-dimensional navigation avoids the adverse consequences of puncture, which has the same clinical efficacy and meets the requirements of oncology compared with percutaneous positioning. The free-of-puncture positioning method can be used for GGN located in the central region of pulmonary segment/subsegment or adjacent to intersegment veins instead of percutaneous positioning.
ObjectiveTo observe the volume and distribution of necrotic tissue of femoral head in steroid-induced osteonecrosis of femoral head (SONFH) patients by three-dimensional reconstruction of CT.MethodsA clinical data of 25 patients with SONFH between September 2016 and December 2018 was analyzed. There were 22 males and 3 females, with an average age of 38.8 years (range, 20-63 years). The necrosis of the femoral head was in stage Ⅱ of Association Research Circulation Osseous (ARCO). The disease duration ranged from 3 to 18 months, with an average of 9.2 months. A three-dimensional reconstruction with CT data of SONFH patients were performed by Mimics Research 21.0 software and the femoral head was segmented into eight regions by 3-matic Research 13.0 software. The volume of necrotic tissue of the femoral head and the volume rate of necrotic tissue to femoral head were calculated and the distribution was also analyzed.ResultsThe three-dimensional digital model of the femoral head showed that the necrotic tissue of the femoral head was located above the anterior superior medial, and the area of the necrotic tissue was in a dome-like shape. The results showed that the necrotic tissue in the femoral head was mainly concentrated on the anterior superior internal area, the anterior superior outer area, and the posterior superior internal area. The volume of femoral head was (48 399.52±9 408.90) mm3, and the volume of necrotic tissue was (20 917.08±6 566.94) mm3, and the volume ratio of necrotic tissue to femoral head was 44.75%±15.72%. The proportion of necrotic volume in different regions was different, and the necrotic tissues were mainly distributed in the anterior superior internal area, the anterior superior outer area, and the posterior superior internal area.ConclusionThe volume and distribution of necrotic tissue in femoral head can be evaluated quickly and intuitively by three-dimensional reconstruction of CT in Mimics software.
In thoracoscopic pulmonary nodule resection surgery, precise preoperative planning is crucial. Artificial intelligence (AI)-assisted three-dimensional (3D) reconstruction technologies have shown great potential in this area. AI-assisted 3D reconstruction technologies can provide accurate, personalized models of the pulmonary vasculature and bronchial anatomy, assisting surgeons in detailed surgical planning and thus enhancing the precision and safety of surgeries. This article reviews the application progress of AI-assisted 3D reconstruction technologies in pulmonary nodule surgery, including their applications in preoperative diagnosis, surgical planning, and intraoperative navigation, as well as the advancements in AI-assisted 3D reconstruction technologies. It analyzes the technical features of all kinds of 3D reconstruction methods, their clinical applications, and the challenges they face.
Objective To analyze the characteristics of femoral neck fractures in young and middle-aged adults by means of medical image analysis and fracture mapping technology to provide reference for fracture treatment. Methods A clinical data of 159 young and middle-aged patients with femoral neck fractures who were admitted between December 2018 and July 2019 was analyzed. Among them, 99 patients were male and 60 were female. The age ranged from 18 to 60 years, with an average age of 47.9 years. There were 77 cases of left femoral neck fractures and 82 cases of right sides. Based on preoperative X-ray film and CT, the fracture morphology was observed and classified according to the Garden classification standard and Pauwels’ angle, respectively. Mimics19.0 software was used to reconstruct the three-dimensional models of femoral neck fracture, measure the angle between the fracture plane and the sagittal plane of the human body, and observe whether there was any defect at the fracture end and its position on the fracture surface. Through reconstruction, virtual reduction, and image overlay, the fracture map was established to observe the fracture line and distribution. Results According to Garden classification standard, there were 6 cases of type Ⅰ, 61 cases of type Ⅱ, 54 cases of type Ⅲ, and 38 cases of type Ⅳ. According to the Pauwels’ angle, there were 12 cases of abduction type, 78 cases of intermediate type, and 69 cases of adduction type. The angle between fracture plane and sagittal plane of the human body ranged from –39° to +30°. Most of them were Garden type Ⅱ, Ⅳ and Pauwels intermediate type. The fracture blocks were mainly in the form of a triangle with a long base and mainly distributed below the femoral head and neck junction area. Twenty-six cases (16.35%) were complicated with bone defects, which were mostly found in Garden type Ⅲ, Ⅳ, and Pauwels intermediate type, located at the back of femoral neck and mostly involved 2-4 quadrants. The fracture map showed that the fracture line of the femoral neck was distributed annularly along the femoral head and neck junction. The fracture line was dense above the femoral neck and scattered below, involving the femoral calcar. Conclusion The proportion of displaced fractures (Garden type Ⅲ, Ⅳ) and unstable fractures (Pauwels intermediate type, adduction type) is high in femoral neck fractures in young and middle-aged adults, and comminuted fractures and bone defects further increase the difficulty of treatment. In clinical practice, it is necessary to choose treatment plan according to fracture characteristics. Anatomic reduction and effective fixation are the primary principles for the treatment of femoral neck fracture in young and middle-aged adults.
Objective The combined appl ication of green fluorescent protein (GFP) and confocal laser scanning microscope three-dimensional reconstruction (CLSM-3DR) were used to monitor the construction and in vivo transplantation of tissue engineered bone (TEB), to provide for technology in selection of scaffolds and three-dimensional constructional methods. Methods After bone marrow mesenchymal stem cells (BMSCs) were isolated from a 2-year-old green goat by a combination method of density gradient centrifugation and adherent culture, and the expressions of CD29, CD60L, CD45, and CD44 in BMSCs were detected by flow cytometry. Plasmid of pLEGFP-N1 was ampl ified, digested by enzymes (Hind III, BamH I, Sal I, and Bgl II), and identified. Transfection of pLEGFP-N1 into PT67 cells was performed under the help of l iposome. Positive PT67 cells were picked out with G418, and prol iferated for harvesting virus. Based on the titre of virus, after BMSCs were infected by virus containing pLEGFP-N1, GFP positive BMSCs were collected and prol iferated for seeding cells. TEB was fabricated by GFP positive BMSCs and decalcified bone matrix (DBM) and observed by CLSM-3DR for the evaluation of the distribution and prol iferation of seeding cells. After TEB was transplanted in the defect of goat femur, CLSM was used for observing the survival and distribution of GFP positive cells in the grafts. Results The isolated cells were fibroblast-l ike morphous, with the positive expression of CD29 and CD44, and negative expression of CD60L and CD45. The digested production of pLEGFP-N1 was collected for ionophoresis, whose results showed the correct fragment length (6 900 bp). The virus of pLEGFP-N1 was harvested by transfection of pLEGFP-N1 into PT67 cells and used for further infection to obtain GFP positive BMSCs. The prol iferated GFP positive BMSCs and DBM were used for fabrication of TEB. The distribution, prol iferation, and migration of BMSCs in TEB were observed by CLSM-3DR. GFP positive cells also were observed in images of TEB graft in goat femur 28 days after transplantation. Conclusion The BMSCs labeled by GFP in three-dimensional scaffold in vivo were monitored well by CLSM-3DR. It suggests a wide use potency in monitoring of three-dimensional cultured TEB.
Neurosurgery navigation system, which is expensive and complicated to operate, has a low penetration rate, and is only found in some large medical institutions. In order to meet the needs of other small and medium-sized medical institutions for neurosurgical navigation systems, the scalp localization system of neurosurgery based on augmented reality (AR) theory was developed. AR technology is used to fuse virtual world images with real images. The system integrates computed tomography (CT) or magnetic resonance imaging (MRI) with the patient's head in real life to achieve the scalp positioning. This article focuses on the key points of Digital Imaging and Communications in Medicine (DICOM) standard, three-dimensional (3D) reconstruction, and AR image layer fusion in medical image visualization. This research shows that the system is suitable for a variety of mobile phones, can achieve two-dimensional (2D) image display, 3D rendering and clinical scalp positioning application, which has a certain significance for the auxiliary neurosurgical head surface positioning.
ObjectiveTo conduct a comprehensive analysis of proximal humeral anatomical characteristics in the Chinese population utilizing three-dimensional reconstruction technology, thereby establishing an evidence base for the enhancement of shoulder hemiarthroplasty procedures and the development of domestically manufactured prostheses. Methods The study cohort comprised 30 patients (60 shoulders) presenting with cervicoscapular pain between July 2023 and June 2025, with equal gender distribution (15 males and 15 females); age distribution ranged from 20 to 75 years (mean, 53.7 years). Data acquisition was performed via high-resolution CT imaging (technical parameters: slice thickness 0.625 mm, voltage 120 kV, current 150 mA, matrix 512×512). Subsequently, CT datasets were processed in DICOM format using Mimics17.0 software for three-dimensional reconstruction, followed by quantitative assessment via Imageware12.0 software to evaluate key proximal humeral parameters: humeral head dimensions (coronal diameter, sagittal diameter, surface curvature diameter, thickness), angular measurements [neck-shaft angle, retroversion angle (retroversion angle 1 was the angle between the humeral head axis and the line connecting the medial and lateral condyles, and retroversion angle 2 was the angle between the humeral head axis and the tangent of the trochlea)], and positional metrics (medial offset, posterior offset). Statistical analysis incorporated Pearson correlation coefficients to determine parameter relationships, with comparative evaluations conducted across demographic variables including gender, height, body mass, and age. Results Quantitative analysis yielded the following measurements: humeral head coronal diameter (41.8±3.6) mm, sagittal diameter (39.1±4.1) mm, surface curvature diameter (44.9±4.6) mm, thickness (17.2±1.8) mm, neck-shaft angle (128.4±4.2)°, retroversion angle 1 (16.9±8.9)°, retroversion angle 2 (21.4±11.3)°, medial offset (3.8±1.7) mm, and posterior offset (5.1±1.6) mm. Correlation analysis demonstrated the most pronounced positive relationship between humeral head surface curvature diameter and thickness (r=0.966, P=0.001), with additional significant positive correlations observed between surface curvature diameter and coronal diameter (r=0.842, P=0.001), posterior offset and retroversion angle 1 (r=0.766, P=0.001), and coronal diameter and thickness (r=0.727, P=0.001). Demographic analysis revealed significantly greater dimensions in males compared to females for humeral head surface curvature diameter, coronal diameter, sagittal diameter, and thickness (P<0.05), with these parameters demonstrating progressive increases corresponding to height (P<0.05). With the exception of neck-shaft angle, all parameters exhibited a positive correlation with body mass. No significant age-related differences were detected across parameters (P>0.05). Conclusion The proximal humeral morphology in the Chinese population exhibits substantial variability, necessitating optimization of prosthetic designs based on population-specific anatomical metrics to enhance the efficacy of personalized clinical interventions.
[Abstract]Lung cancer ranks first in morbidity and mortality among malignant tumors in China. Low-dose computed tomography (LDCT), as the primary screening method, faces increasingly prominent challenges of false positives and overdiagnosis associated with its high sensitivity. In recent years, the integration of artificial intelligence (AI) and three-dimensional reconstruction technology has provided a novel approach to addressing these challenges. This review highlights how AI and three-dimensional reconstruction contribute to improving image quality, enabling precise identification of pulmonary nodules and intelligent risk stratification, optimizing dynamic follow-up strategies, and assisting in preoperative planning, thereby driving the transformation of the LDCT screening paradigm. Meanwhile, current technical limitations and future directions are also discussed.