【作者】 刘勇；

【导师】 高力；

【作者基本信息】 浙江大学 ， 临床医学， 2010， 硕士

【摘要】 目的探讨采用内镜成-摄像法辅助研究气管食管沟和胸骨上窝解剖的可行性。方法2008年7月-2009年12月收治的甲状腺癌病人80例。于术中借助内镜系统(Karl storz Endoscope, Germany)成-摄像观察记录气管食管沟和胸骨上窝组织器官的形态构造。术后经视频回放和截图,比较分析图像的解剖还原效果,并由之拟定了色彩还原,清晰度,层次感和保真度等理想图像的基本质量要求。然后,以之为准,测试评估内镜系统各可调参数和拍摄操作对成像质量的影响,最终调优固定。结果1.对图像解剖还原质量有影响的内镜系统可调参数主要是：(1)色彩还原相关性参数。包括亮度,色彩饱合度,对比度和白平衡。前三者可以解剖直视所见为准调优；白平衡须在每次开机后借对白(镜头对住白纱布后按白平衡键)调整。(2)清晰度和层次感。主要与摄像头的定焦有关,一般取成像机自动变焦范围中值为佳。2.拍摄角度,主要是矢状向夹角对图像形态保真有一定影响。3.经过参数优化和规范拍摄,内镜系统成-摄像可达到理想的气管食管沟和胸骨上窝解剖还原要求。结论现用内镜系统可用于气管食管沟-胸骨上窝区组织器官的解剖成-摄像。经参数优化设置和规范拍摄后,图像的解剖还原效果理想。所获图像既可供术中直接观察,又可被记录保存用于进一步的分析比较。作为一种形态学认知手段,此法可能对局部解剖,尤其是窄小空间环境下的细微解剖研究有较好的辅助作用。更多还原

【Abstract】 Objective Evaluate the technical feasibility of a research method for anatomy by intro-operative endoscopic observation combined with postoperative video-record analysis in LevelⅥneck dissection.Methods 80 papillary micro-carcinoma patients were consecutively selected for the evaluation from July 2008 to December 2009. Anatomic structures in tracheo-esophagial groove and superasternal fosa were studied upon endoscopic view(Camera control unit:Tricam SLⅡ; Endoscope:HopkinsⅡ, Karlstorz Endoscope, Germany), and simultaneously photographed by a digital recorder (DVCAM DSR-PDX10P, Sony, Japan) throughout dissection process. Thereafter, individual DVD files were displayed and specific photos captured (Herosoft v.3500) to evaluate the reduction effects on real anatomy. Efforts were made first to delineating the major quality elements of image, and then, to sieving the possible factors which influence much to them. Relevant adjustable parameters of endoscope system were tested to fulfill the image quality requirements. Photo angles were also assessed to avoid figure distortion.Results (1) The major quality elements of image are color reduction, clearness, layer felling and normal figuration. Correspondingly, factors which influence much to the elements are:①Adjustable parameters of endoscope system, such as lightness, contrast, color saturation of monitor and fixed focus, white balance on camera control unit.②Photographing angle (between mirror plane and object plane) should also be a definitive factor for disfiguration of the image. (2) Best image reduction of the real anatomy can ideally archived by adjustable parameters-resetting and proper endoscope-holding.Conclusion Image reduction on real anatomy can be archived by currently used endoscope system during Level VI neck dissection. Best image qualities can be archived if the system is properly set and the endoscope is well held. The recorded video and captured pictures are also reliable and useful "data" for further analysis and comparison. And thus, local anatomy research, especially the identification of fine shape and structure in narrow tracheo-esophagial groove and superasternal fosa emerges: intro-operative endoscopic observation combined with postoperative video-record analysis.更多还原