Department of Pediatric Urology, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou Key Laboratory of Children Genitourinary Disease, Wenzhou 325027, China
QIAN Weite,ZHOU Weizhong,XIA Liguang, et al. Clinical application of computer image navigation in renal duplication[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(6): 493-497.
Abstract：Objective: To explore the clinical application of 3D reconstruction and 3D printing technology in renal and ureteral duplication. Methods: A total of 23 patients of congenital renal and ureteral duplication who were operated and had undergone computer tomography (CT) in the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from July 2015 to January 2022 were screened, and their clinical history and imaging data were collected. The target tissues were integrated and extracted by threshold segmentation method in Amira. Then 3D reconstruction and 3D model printing were completed, of which 15 cases were performed preoperatively and 8 cases postoperatively. Out of 15 preoperative reconstruction, 8 cases of heminephrectomy were selected as the research subjects, and the cases of heminephrectomy without 3D reconstruction at the same time were randomly selected as the control group. The operation time and bleeding volume were compared between the preoperative reconstruction group and the non-reconstruction group. Results:Relevant 3D reconstructed images of 23 cases were obtained using Amira software, and the 3D model was successfully printed. The 3D reconstructions performed preoperatively or postoperatively were consistent with the actual anatomy and did not affect the results. The comparative study showed that both the 3D reconstructed image and the 3D model could fully display the anatomical details of the kidney, ureter and the surrounding blood vessels, and more intuitively display the parts of ureteral duplication compared with the traditional two-dimensional imaging manifestation. The average operation time for heminephrectomy was 120.0(114.0,144.0)min in the reconstruction group, and 200.0(162.0, 221.3)min in the non-reconstruction group, showing significant difference between the two groups (P=0.002). The intraoperative blood loss in the reconstruction group was 6.0(5.0, 9.3)mL, with statistical difference compared with 15.0(12.5,16.8)mL in the non-reconstruction group (P=0.001). Conclusion: The 3D images obtained by Amira combined with the 3D printed model, as a convenient and feasible clinical aid, can help surgeons better evaluate renal duplication through the integration of computer image technology.
