1.3D visualization-based classification of left intrahepatic vessels and its application in precision hepatectomy.
Jun ZHENG ; Zhihua WANG ; Xiaojun HU ; Xiang HE ; Yingfang FAN
Journal of Southern Medical University 2025;45(5):1047-1055
OBJECTIVES:
To establish a three-dimensional (3D) visualization-based classification of the left hepatic portal vein (LHPV) and left hepatic vein (LHV) systems using 3D reconstruction technology to facilitate precise segmental/subsegmental resection of left liver lesions.
METHODS:
Thin-slice contrast-enhanced CT datasets from 244 patients were reconstructed using MI-3DV Works software. The spatial anatomy (origins, branching patterns, and spatial relationships) of the LHPV and LHV branches was analyzed to determine their 3D classifications and segmental liver divisions for guiding surgical planning for anatomical left liver resections.
RESULTS:
The 3D models of the third- and fourth-order branches of the LHPV and LHV were successfully reconstructed for all the 244 patients. Two types of the LHPV system were identified, where the LHPV either had independent origins [242 cases (99.1%)] or had right anterior portal branches arising from the LHPV trunk [2 cases (0.9%)]. 3D classifications identified two types of the Segment II of the LHPV (based on branch number), 3 types of the Segment III (by spatial distribution of the branches), compact vs dispersed types of the left lateral lobe (determined by Segment II/III branches proximity), 3 types of the Segment IV (by branch number and origin), and 3 types the fourth hilar vessels (transverse branches of the left portal vein) for their supplied segments. The LHV system had two drainage types into the inferior vena cava, and the umbilical fissure veins were classified into 3 types by drainage patterns and distance to the venous roots. These classifications combined with liver segmentations allowed individualized surgical planning for segment-specific resections.
CONCLUSIONS
The 3D classification of the LHPV and LHV provides valuable clinical guidance for precise anatomical resections of left liver lesions using liver segments or subsegments as anatomical units to enhance surgical accuracy and improve the outcomes of hepatobiliary surgery.
Humans
;
Hepatectomy/methods*
;
Imaging, Three-Dimensional
;
Hepatic Veins/anatomy & histology*
;
Portal Vein/anatomy & histology*
;
Liver/surgery*
;
Liver Neoplasms/blood supply*
;
Tomography, X-Ray Computed
;
Female
2.Clinical analysis of changes in the position of the condyle and temporomandibular joint after repair of mandibular defects.
Shensui LI ; Xudong TIAN ; Yadong WU ; Weili WANG ; Zhenglong TANG
West China Journal of Stomatology 2025;43(3):422-430
OBJECTIVES:
This retrospective study aimed to investigate factors influencing positional changes of the condyle and temporomandibular joint (TMJ) following mandibular defect reconstruction with bone flaps, and to evaluate the biomechanical impacts of flap reconstruction on condylar positioning, thereby providing evidence for optimizing surgical protocols and TMJ functional rehabilitation.
METHODS:
A retrospective study was conducted on 90 patients undergoing mandibular segmental resection with immediate bone flap reconstruction at Guizhou Medical University Affiliated Stomatological Hospital (June 2019 to May 2024). After strict screening, 50 cases with complete data were analyzed. Clinical parameters (defect size, location, reconstruction method) and craniofacial CT scans at four timepoints [preoperative (T0), 7-10 days (T1), 3 months (T2), and 6 months (T3) postoperatively] were collected. Mimics 20 software facilitated 3D reconstruction for measuring TMJ anterior/posterior/superior joint spaces (Kamelchuk method) and calculating condylar position via the Pullinger index [Ln (posterior/anterior space)]. Vitral and Krisjane methods quantified mandibular linear parameters (ramus length, condylar pole distances to the sagittal plane, angulation) and glenoid fossa morphology. Statistical analyses were performed using SPSS 21.0.
RESULTS:
Mandibular defect size and location were significant factors influencing postoperative condylar position changes (P<0.05). Compared to preoperative measurements, postoperative condylar anterior, posterior, and superior joint spaces were significantly increased (P<0.001). The most pronounced anterior condylar displacement occurred within 7-10 days postoperatively (P<0.05). In patients with condyle resection, postoperative joint space and angle changes were significant; in patients with condyle preservation, only superior and anterior joint space changes were statistically significant (P<0.05). Additionally, from T1 to T2, the changes in condylar medial-lateral distance, superior joint space, and anterior joint space were negatively correlated with the preoperative condylar position. Compared with preoperative,in the T0-T1 period, condylar medial-lateral distance, posterior joint space, and articular tubercle angle changes were significantly negatively correlated with time (P<0.05). Notably, the angle between the condylar long axis and the coronal axis showed a sustained negative trend from T1 to T3 (P<0.05).
CONCLUSIONS
Condylar position changes after mandibular defect repair with bone flap reconstruction are associated with the size and location of the defect. Additionally, adaptive remodeling of the temporomandibular joint (TMJ) joint space occurs postoperatively. The phenomenon of anterior displacement of the condyle in the early postoperative period (7-10 days) shows a trend of reduction with prolonged follow-up time, and further sample size research is needed.
Humans
;
Retrospective Studies
;
Temporomandibular Joint/surgery*
;
Mandibular Condyle/surgery*
;
Male
;
Female
;
Adult
;
Middle Aged
;
Mandibular Reconstruction/methods*
;
Mandible/surgery*
;
Surgical Flaps
;
Tomography, X-Ray Computed
;
Young Adult
;
Biomechanical Phenomena
;
Aged
;
Adolescent
;
Imaging, Three-Dimensional
3.Comparative study on the accuracy of extraoral scanning versus intraoral scanning in digital impressions for implant restoration in edentulous jaws.
Yongtao YANG ; Xin LI ; Xiangyi SHANG ; Shenyao SHAN ; Wenbo LI ; Qingzhao QIN ; Yong WANG ; Yijiao ZHAO
West China Journal of Stomatology 2025;43(6):771-779
OBJECTIVES:
To evaluate the accuracy of a self-developed extraoral scanning system based on four-camera stereophotogrammetric technology in the acquisition of three-dimensional positional information on dental implants and conduct a comparative study involving an intraoral scanning system.
METHODS:
With the use of an in vitro edentulous jaw model with implants, extraoral (experimental group) and intraoral (control group) scanning systems were employed to obtain STL (Standard Tessellation Language) datasets containing three-dimensional morphological and positional information on scan bodies. In addition, a dental model scanner was used to obtain reference data. The three-dimensional morphological, linear, and angular deviations between groups and reference data were analyzed using Geomagic Wrap 2021 software to compare trueness and precision.
RESULTS:
The extraoral scanning system demonstrated superior trueness in three-dimensional morphological, linear, and angular deviations compared with the intraoral scanning system, with statistically significant differences (P<0.001). The extraoral scanning system also showed a higher precision in three-dimensional morphological deviation (P<0.001). As the number of implants increased, the extraoral scanning system exhibited increased three-dimensional morphological and linear deviations (P<0.001) but maintained a stable angular deviation. The intraoral scanning system displayed significant increases in three-dimensional morphological, linear, and angular deviations with the increase in the number of implants (P<0.05).
CONCLUSIONS
The stereophotogrammetry-based extraoral scanning system outperforms intraoral scanning system in terms of the accuracy for multi-unit implant positioning and provides a novel approach for attaining a fully digital workflow for implant rehabilitation in edentulous jaws.
Jaw, Edentulous
;
Humans
;
Dental Impression Technique
;
Dental Implants
;
Imaging, Three-Dimensional/methods*
;
Photogrammetry/methods*
;
Models, Dental
4.Multi-modal cross-scale imaging technologies and their applications in plant network analysis.
Yining XIE ; Yuchen KOU ; Yanhui YUAN ; Jinbo SHEN ; Xiaohong ZHUANG ; Jinxing LIN ; Xi ZHANG
Chinese Journal of Biotechnology 2025;41(7):2559-2578
A complete plant body consists of elements on different scales, including microscopic molecules, mesoscopic multicellular structures, and macroscopic tissues and organs, which are interconnected to form complex biological networks. The growth and development of plants involve the regulation of elements on different scales and their biological networks, which requires the coordinated operation of multiple molecules, cells, tissues, and organs. It is difficult to reveal the essence of multi-level life activities by a single method or technology. In recent years, the development of various novel imaging technologies has provided new approaches for revealing the complex life activities in plants. Using multi-modal imaging technologies to study the cross-scale network connections of plants from the microscopic, mesoscopic, and macroscopic levels is crucial for understanding the complex internal connections behind biological functions. This paper first summarizes multi-modal cross-scale imaging technologies, three-dimensional reconstruction, and image processing methods, outlines the basic framework of cross-scale network connection properties, and then summarizes the applications of multi-modal imaging technologies in elucidating plant multi-scale networks. Finally, this review systematically integrates the combined analysis of cross-scale 3D spatial structural data and single-cell omics, laying a theoretical foundation for the innovation of novel plant imaging technologies. Furthermore, it provides a new research paradigm for in-depth exploration of the interaction mechanisms among cross-scale elements and the principles of biological network connectivity in plant life activities.
Plants/metabolism*
;
Imaging, Three-Dimensional/methods*
;
Image Processing, Computer-Assisted/methods*
;
Multimodal Imaging/methods*
;
Plant Physiological Phenomena
5.Thermal Ablation of Pulmonary Nodules by Electromagnetic Navigation Bronchoscopy Combined With Real-Time CT-Based 3D Fusion Navigation:Report of One Case.
Yuan XU ; Qun LIU ; Chao GUO ; Yi-Bo WANG ; Xiao-Fang WU ; Chen-Xi MA ; Gui-Ge WANG ; Qian-Shu LIU ; Nai-Xin LIANG ; Shan-Qing LI
Acta Academiae Medicinae Sinicae 2025;47(1):137-141
A nodule in the right middle lobe of the lung was treated by a combination of cone-beam CT,three-dimensional registration for fusion imaging,and electromagnetic navigation bronchoscopy-guided thermal ablation.The procedure lasted for 90 min,with no significant bleeding observed under the bronchoscope.The total radiation dose during the operation was 384 mGy.The patient recovered well postoperatively,with only a small amount of blood in the sputum and no pneumothorax or other complications.A follow-up chest CT on the first day post operation showed that the ablation area completely covered the lesion,and the patient was discharged successfully.
Humans
;
Bronchoscopy/methods*
;
Catheter Ablation/methods*
;
Cone-Beam Computed Tomography
;
Electromagnetic Phenomena
;
Imaging, Three-Dimensional
;
Lung Neoplasms/diagnostic imaging*
;
Tomography, X-Ray Computed
6.Imaging anatomy study on utilizing uncinate process "inflection point" as a landmark for anterior cervical spine decompression surgery.
Jianfeng JIANG ; Jun MA ; Maoyu YANG ; Yaozheng HAN ; Lintao SU ; Changyu LEI ; Chenguang GE ; Hui KANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(3):332-340
OBJECTIVE:
To explore the anatomical parameters of the cervical uncinate process "inflection point" through cervical CT angiography (CTA) and MRI measurements, offering a reliable and safe anatomical landmark for anterior cervical decompression surgery.
METHODS:
A retrospective analysis was conducted on the cervical CTA and MRI imaging data of normal adults who met the selection criteria between January 2020 and January 2024. The CTA dataset included 326 cases, with 200 males and 126 females, aged 22-55 years (mean, 46.7 years). The MRI dataset included 300 cases, with 200 males and 100 females, aged 18-55 years (mean, 43.7 years). Based on the CTA data, three-dimensional models of C 3-C 7 were constructed, and the following measurements were obtained from the superior view: uncinate process "inflection point" to vertebral artery distance (UIVD), uncinate process tip to vertebral artery distance (UTVD), uncinate process "inflection point" to "inflection point" distance (UID), uncinate process long-axis to sagittal angle (ULSA), and uncinate process "inflection point" to transverse foramen-sagittal angle (UITSA). From the anterior view, the anterior uncinate process to sagittal angle (AUSA) was measured. From the posterior view, the posterior uncinate process to sagittal angle (PUSA) was measured. Based on the MRI data, uncinate process "inflection point" to dural sac distance (UIDD) and dural sac width (DSW) were measured. The trends in measurement parameters of C 3-C 7 were observed, and the differences in measurement parameters between genders and between the left and right sides of the same segment were compared, as well as the difference in UID and DSW within the same segment was compared.
RESULTS:
The measurement parameters from C 3 to C 7 in the CTA data showed a general increasing trend, with no significant difference between the left and right sides within the same segment ( P>0.05). The UIVD, UTVD, and UID were greater in males than in females, with significant differences observed in the UIVD and UTVD at C 3 and C 6 and UID at C 3, C 6, and C 7 ( P<0.05). The MRI measured DSW showed a general increasing trend from C 3 to C 7, and the DSW at C 6 was greater in females than in males, with a significant difference ( P<0.05). The UIDD showed a gradual decreasing trend, with the smallest value at C 6. There was no significant difference between males and females or between the left and right sides within the same segment ( P>0.05). The UID was greater than the DSW at C 3-C 7, and the differences were significant ( P<0.05).
CONCLUSION
The uncinate process "inflection point" is a constant anatomical structure located at the anteromedial aspect of the uncinate process tip and laterally to the dural sac. It maintains a certain safe distance from the vertebral artery. As a decompression landmark in anterior cervical spine surgery, it not only ensures surgical safety but also guarantees complete decompression.
Humans
;
Adult
;
Male
;
Female
;
Middle Aged
;
Retrospective Studies
;
Cervical Vertebrae/surgery*
;
Magnetic Resonance Imaging
;
Decompression, Surgical/methods*
;
Young Adult
;
Adolescent
;
Computed Tomography Angiography
;
Imaging, Three-Dimensional
;
Vertebral Artery/anatomy & histology*
;
Anatomic Landmarks/diagnostic imaging*
7.Digital three-dimensional assisted unilateral biportal endoscopy in treatment of highly isolated lumbar disc herniation with translaminar approach.
Weiliang SU ; Suni LU ; Dong LIU ; Jianqiang XING ; Peng HU ; Yongfeng DOU ; Xiaopeng GENG ; Dawei WANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(3):346-353
OBJECTIVE:
To investigate the effectiveness of digital three-dimensional (3D) assisted unilateral biportal endoscopy (UBE) in the treatment of highly isolated lumbar disc herniation (LDH) with translaminar approach.
METHODS:
The clinical data of 59 patients who met the selection criteria and underwent UBE treatment due to highly isolated LDH between January 2022 and December 2023 were retrospectively analyzed. Among them, 25 cases were treated with digital 3D assisted translaminar approach (observation group) and 34 cases were treated with interlaminar approach (control group). There was no significant difference in gender, age, disease duration, surgical segment, and preoperative visual analogue scale (VAS) score and Oswestry disability index (ODI) between the two groups ( P>0.05). The operation time, intraoperative blood loss, and lateral articular surface preservation rate were recorded and compared between the two groups. VAS score and ODI were used to evaluate the improvements of pain and function before operation and at 3 and 6 months after operation. The modified MacNab criteria was used to evaluate the effectiveness at last follow-up.
RESULTS:
One patient in the control group had dural tear, and the other patients had no nerve injury, infection, dural tear, or other related complications. There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). Patients in both groups were followed up 6-13 months, with an average of 8.3 months. The lateral articular surface preservation rate in the observation group was significantly higher than that in the control group ( P<0.05). Three patients in the observation group and 2 patients in the control group had calf muscle venous thrombosis, which was cured after anticoagulant treatment with rivaroxaban and delayed exercise time. There was no recurrence or second operation during the follow-up period. The VAS score and ODI of the two groups at 3 and 6 months after operation significantly improved when compared with those before operation ( P<0.05). There was no significant difference between the two groups at each time point after operation ( P>0.05). At last follow-up, the effectiveness was evaluated according to the modified MacNab criteria, and there was no significant difference in the evaluation grade and excellent and good rate between the two groups ( P>0.05).
CONCLUTION
UBE via translaminar approach is safe and effective for the treatment of highly isolated LDH, which is beneficial to protect the facet joint, maintain spinal stability, and reduce soft tissue injury. With the assistance of digital 3D technique, preoperative planning can be performed accurately.
Humans
;
Intervertebral Disc Displacement/diagnostic imaging*
;
Lumbar Vertebrae/diagnostic imaging*
;
Male
;
Retrospective Studies
;
Female
;
Endoscopy/methods*
;
Treatment Outcome
;
Middle Aged
;
Adult
;
Imaging, Three-Dimensional
;
Operative Time
;
Pain Measurement
8.Biomechanical advantages of personalized Y-shaped plates in treatment of distal humeral intra-articular fractures.
Hao YU ; Jiachen PENG ; Jibin YANG ; Lidan YANG ; Zhi XU ; Chen YANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(5):574-583
OBJECTIVE:
To compare the biomechanical properties of personalized Y-shaped plates with horizontal plates, vertical plates, and traditional Y-shaped plates in the treatment of distal humeral intra-articular fractures through finite element analysis, and to evaluate their potential for clinical application.
METHODS:
The study selected a 38-year-old male volunteer and obtained a three-dimensional model of the humerus by scanning his upper limbs using a 64-slice spiral CT. Four types of fracture-internal fixation models were constructed using Mimics 19.0, Geomagic Wrap 2017, Creo 6.0, and other software: horizontal plates, vertical plates, traditional Y-shaped plate, and personalized Y-shaped plate. The models were then meshed using Hypermesh 14.0 software, and material properties and boundary conditions were defined in Abaqus 6.14 software. AnyBody 7.3 software was used to simulate elbow flexion and extension movements, calculate muscle strength, joint forces, and load torques, and compare the peak stress and maximum displacement of the four fixation methods at different motion angles (10°, 30°, 50°, 70°, 90°, 110°, 130°, 150°) during elbow flexion and extension.
RESULTS:
Under dynamic loading during elbow flexion and extension, the personalized Y-shaped plate exhibits significant biomechanical advantages. During elbow flexion, the peak internal fixation stress of the personalized Y-shaped plate was (28.8±0.9) MPa, which was significantly lower than that of the horizontal plates, vertical plates, and traditional Y-shaped plate ( P<0.05). During elbow extension, the peak internal fixation stress of the personalized Y-shaped plate was (18.1±1.6) MPa, which was lower than those of the other three models, with significant differences when compared with horizontal plates and vertical plates ( P<0.05). Regarding the peak humeral stress, the personalized Y-shaped plate model showed mean values of (10.9±0.8) and (13.1±1.4) MPa during elbow flexion and extension, respectively, which were significantly lower than those of the other three models ( P<0.05). Displacement analysis showed that the maximum displacement of the humerus with the personalized Y-shaped plate during elbow flexion was (2.03±0.08) mm, slightly higher than that of the horizontal plates, but significantly lower than that of the vertical plates, showing significant differences ( P<0.05). During elbow extension, the maximum displacement of the humerus with the personalized Y-shaped plate was (1.93±0.13) mm, which was lower than that of the other three models, with significant differences when compared with vertical plates and traditional Y-shaped plates ( P<0.05). Stress contour analysis showed that the stress of the personalized Y-shaped plate was primarily concentrated at the bifurcation of the Y-shaped structure. Displacement contour analysis showed that the personalized Y-shaped plate effectively controlled the displacement of the distal humerus during both flexion and extension, demonstrating excellent stability.
CONCLUSION
The personalized Y-shaped plate demonstrates excellent biomechanical performance in the treatment of distal humeral intra-articular fractures, with lower stress and displacement, providing more stable fixation effects.
Humans
;
Male
;
Adult
;
Healthy Volunteers
;
Finite Element Analysis
;
Tomography, Spiral Computed
;
Models, Anatomic
;
Biomechanical Phenomena
;
Humeral Fractures, Distal/surgery*
;
Fracture Fixation, Internal/instrumentation*
;
Bone Plates
;
Computer Simulation
;
Precision Medicine/methods*
;
Elbow Joint/surgery*
;
Elbow/surgery*
;
Humerus/surgery*
;
Torque
;
Stress, Mechanical
;
Intra-Articular Fractures/surgery*
;
Prosthesis Design/methods*
;
Imaging, Three-Dimensional
;
Range of Motion, Articular
9.Application of three-dimensional reconstruction technology in preoperative planning of anterolateral thigh flap transplantation.
Zhipeng WU ; Jian DING ; Xinglong CHEN ; Mingming CHEN ; Zipu HONG ; Hede YAN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):748-753
OBJECTIVE:
To investigate the application of three-dimensional (3D) reconstruction technology in preoperative planning for anterolateral thigh flap transplantation.
METHODS:
A retrospective analysis was performed on the clinical data of 11 patients with skin and soft tissue defects treated with free anterolateral thigh flap transplantation between January 2022 and January 2024, who met the selection criteria. There were 8 males and 3 females, aged 34-70 years (mean, 50.8 years). Causes of injury included traffic accidents (4 cases), machine trauma (3 cases), heavy object crush injury (3 cases), and tumor (1 case). The time from injury to flap repair ranged from 7 to 35 days (mean, 23 days). Preoperatively, the patients' CT angiography images were imported into Mimics21.0 software. Through the software's segmentation, editing, and reconstruction functions, 3D visualization and measurement of the vascular pedicle, perforators, wound size, and morphology were performed to plan the flap harvest area, contour, vascular pedicle length, and anastomosis site, guiding the implementation of flap transplantation.
RESULTS:
The length of the vascular pedicle needed by the recipient site was (9.1±0.9) cm, and the maximum length of vascular pedicle in the donor area was (10.6±0.6) cm, with a significant difference ( t=4.230, P<0.001). The operation time ranged from 220 to 600 minutes (mean, 361.9 minutes). One patient had poor wound healing at the recipient site, which healed after dressing changes. All 11 flaps survived well without necrosis. All patients were followed up 6-19 months (mean, 11 months). Four flaps showed bulkiness and underwent secondary debulking; the remaining flaps had good contour and soft texture. The donor sites healed well, with no sensory disturbance around the incision or complications such as walking impairment.
CONCLUSION
Preoperative planning using CT angiography data and 3D reconstruction software can effectively determine the flap area, contour, required vascular pedicle length, anastomosis site, and whether vascular grafting is needed, thereby guiding the successful execution of anterolateral thigh flap transplantation.
Humans
;
Middle Aged
;
Male
;
Female
;
Adult
;
Thigh/diagnostic imaging*
;
Aged
;
Plastic Surgery Procedures/methods*
;
Retrospective Studies
;
Imaging, Three-Dimensional/methods*
;
Soft Tissue Injuries/surgery*
;
Surgical Flaps
;
Computed Tomography Angiography
;
Free Tissue Flaps/blood supply*
;
Preoperative Care
10.Advances in application of digital technologies in surgery for ankylosing spondylitis.
Haorui YANG ; Lu LIU ; Nan KANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(7):896-902
OBJECTIVE:
To explore the application progress and clinical value of digital technologies in the surgical treatment of ankylosing spondylitis (AS).
METHODS:
By systematically reviewing domestic and international literature, the study summarized the specific application scenarios, operational procedures, and technical advantages of digital technologies [including preoperative three-dimensional (3D) planning, intraoperative real-time navigation, robot-assisted surgery, and 3D printing] in AS surgery, and analyzed their impact on surgical accuracy, complication rates, and clinical outcomes.
RESULTS:
Digital technologies significantly improve the precision and safety of AS surgery. Preoperative 3D planning enables personalized surgical protocols; intraoperative navigation systems dynamically adjusts surgical trajectories, reducing the risk of iatrogenic injury; robot-assisted surgery can minimize human errors and enhance implant positioning accuracy; 3D-printed anatomical models and guides optimize the correction of complex spinal deformities. Furthermore, the combined applications of these technologies shorten operative time, reduce intraoperative blood loss, decrease postoperative complications (e.g., infection, nerve injury), and accelerate functional recovery.
CONCLUSION
Through multidimensional integration and innovation, digital technologies provide a precise and minimally invasive solution for AS surgical treatment. Future research should focus on their synergy with biomaterials and intelligent algorithms to further refine surgical strategies and improve long-term prognosis.
Humans
;
Spondylitis, Ankylosing/diagnostic imaging*
;
Printing, Three-Dimensional
;
Surgery, Computer-Assisted/methods*
;
Robotic Surgical Procedures/methods*
;
Imaging, Three-Dimensional
;
Postoperative Complications/prevention & control*
;
Digital Technology
;
Models, Anatomic

Result Analysis
Print
Save
E-mail