探讨三维可视化技术在巨大肝癌术前精准评估中的应用价值。

回顾性分析2013年1月至2015年1月厦门大学附属成功医院收治的25例巨大肝癌患者的临床资料，应用三维可视化技术将患者术前二维CT图像进行三维重建和手术模拟，通过分别计算肝脏体积、肿瘤体积、预切除肝脏体积、剩余肝脏体积进行术前评估。对实施手术的患者，分别计算实际切除肝脏体积与术前预切除肝脏体积，并进行相关性检验分析。

25例患者三维可视化重建后图像清晰立体地显示肝脏组织、肿瘤组织、肝内血管的解剖结构及毗邻关系，20例评估后行精准肝癌切除术。20例手术患者术前预切除肝脏体积（1 856.10±255.85）ml，实际切除肝脏体积（1 817.02±251.17）ml，两者比较差异无统计学意义（t=0.487，P>0.05），呈正相关（r=0.972，P<0.05）。

三维可视化技术能够对巨大肝癌进行术前可切除性精准评估，具有一定的临床应用价值。

To explore the value of three-dimensional visualization technology in preoperative precise assessment for huge hepatic carcinoma (HCC).

The clinical data of twenty-five patients with giant HCC who were admitted to Chenggong Hospital Affiliated to Xiamen University from January 2013 to January 2015 were retrospectively analyzed. Based on simulated hepatectomy and three-dimensional visualization technology, the two-dimensional images of CT were converted into three-dimensional images. Preoperative assessment was done by measuring the volume of liver, tumor, pre-resection liver and residual liver. For patients undergoing operation, volume of the predicted resected liver and the results of the actual liver resection was calculated for a correlation test analysis.

All the liver tissues, tumor tissues and the hepatic vessels were reconstructed successfully using the three-dimensional reconstruction software. Twenty patients underwent accurate assessment followed by precise operation. The volume of simulated resected liver was (1 856.10±255.85) ml, while the actual liver resection volume was (1 817.02±251.17) ml. There was no significant difference between the predicted and the actual values (t=0.487, P>0.05). The actual liver resection volume was positively correlated with the predicted liver resection volume (r=0.972, P<0.05).

The three-dimensional visualization technology has a certain degree of clinical value in the precision before giant hepatocellular carcinoma surgery.