Increasing DIEA Perforator Detail in Three-Dimensional Photorealistic Volume-Rendering Visualizations.

Autor:	Necker FN; From the Department of Radiology, Stanford Incubator for Medical Mixed and Extended Reality at Stanford.; Department of Surgery, Division of Plastic and Reconstructive Surgery.; Institute of Functional and Clinical Anatomy, Digital Anatomy Laboratory, Faculty of Medicine, Friedrich-Alexander Universität Erlangen-Nürnberg., Cholok DJ; Department of Surgery, Division of Plastic and Reconstructive Surgery., Shaheen MS; Department of Surgery, Division of Plastic and Reconstructive Surgery., Fischer MJ; From the Department of Radiology, Stanford Incubator for Medical Mixed and Extended Reality at Stanford., Gifford K; Department of Radiology, 3D and Quantitative Imaging, Stanford University School of Medicine., El Chemaly T; From the Department of Radiology, Stanford Incubator for Medical Mixed and Extended Reality at Stanford., Leuze CW; From the Department of Radiology, Stanford Incubator for Medical Mixed and Extended Reality at Stanford., Scholz M; Institute of Functional and Clinical Anatomy, Digital Anatomy Laboratory, Faculty of Medicine, Friedrich-Alexander Universität Erlangen-Nürnberg., Daniel BL; From the Department of Radiology, Stanford Incubator for Medical Mixed and Extended Reality at Stanford., Momeni A; Department of Surgery, Division of Plastic and Reconstructive Surgery.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Oct 01; Vol. 154 (4S), pp. 63S-67S. Date of Electronic Publication: 2024 Sep 20.
DOI:	10.1097/PRS.0000000000011359
Abstrakt:	Summary: Preoperative computed tomographic angiography is increasingly performed before perforator flap-based reconstruction. However, radiologic two-dimensional thin slices do not allow for intuitive interpretation and translation to intraoperative findings. Three-dimensional volume rendering has been used to alleviate the need for mental two-dimensional to three-dimensional abstraction. Even though volume rendering allows for a much easier understanding of anatomy, it currently has limited utility, as the skin obstructs the view of critical structures. Using free, open-source software, the authors introduce a new skin-masking technique that allows surgeons to easily create a segmentation mask of the skin that can later be used to toggle the skin on and off. In addition, the mask can be used in other rendering applications. The authors use Cinematic Anatomy for photorealistic volume rendering and interactive exploration of computed tomographic angiography with and without skin. The authors present results from using this technique to investigate perforator anatomy in deep inferior epigastric perforator flaps and demonstrate that the skin-masking workflow is performed in less than 5 minutes. In Cinematic Anatomy, the view onto the abdominal wall and especially onto perforators becomes significantly sharper and more detailed when no longer obstructed by the skin. The authors perform a virtual, partial muscle dissection to show the intramuscular and submuscular course of the perforators. The skin-masking workflow allows surgeons to improve arterial and perforator detail in volume renderings easily and quickly by removing skin and could alternatively be performed solely using open-source and free software. The workflow can be easily expanded to other perforator flaps without the need for modification. (Copyright © 2024 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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