An evaluation system and method for simulating regional liver graft procurement

Abstract

The present invention discloses an evaluation system and method for simulating regional liver acquisition. The system includes a local coordinate system establishment module that performs three-dimensional watershed analysis on the scanned image of the target liver obtained according to the portal vein branch situation to establish local coordinate systems for different liver segments and corresponding ducts; an artery and biliary tract number confirmation module that determines the number of arteries and biliary tracts covered by the watershed boundary between the S<subgt;3< / subgt>+S<subgt;4< / subgt> liver segment and the S<subgt;2< / subgt> liver segment according to the local coordinate system; a comparison module that compares the number of arteries and biliary tracts with a preset value; a separation path confirmation module that determines the separation path of the S<subgt;3+S<subgt;4 liver segment according to the local coordinate system; a liver segment separation module that establishes a separation device model according to the parameters of the separation device and performs a simulation separation operation according to the separation path to obtain a separated liver segment model of the S<subgt;3+S<subgt;4 liver segment; and a separated liver segment evaluation module that establishes a separated liver segment evaluation model and inputs the separated liver segment model into the separated liver segment evaluation model to output an evaluation result.

Description

Technical Field

[0001] The present invention relates to the technical field of simulated regional liver graft procurement, and particularly to an evaluation system and method for simulated regional liver graft procurement. Background Art

[0002] For the liver graft harvesting surgery in pediatric liver transplantation, usually two harvesting methods are adopted, namely left and right hemihepatectomy or left lateral lobe and right trisegmentectomy. The left and right hemihepatic grafts are suitable for adult recipients, while the left lateral lobe is suitable for pediatric recipients. It has always been one of the difficulties in pediatric liver transplantation that small-weight infants cannot accommodate the relatively large left lateral lobe graft, which will cause many complications, including large liver syndrome, abnormal new liver blood supply caused by increased abdominal pressure, respiratory problems of the child, thrombosis of anastomosed blood vessels, etc., resulting in the loss of the function of the transplanted liver. The solutions include volume reduction (such as resection of part of liver segments S3 or S2), single liver segment transplantation, rotating the liver 180 degrees and placing it under the right diaphragm, and delayed abdominal wall closure.

[0003] In addition, after the left lateral lobe is harvested, the inflow blood vessels (portal vein and artery) and the reflux bile duct branches of the residual liver segment S4 are cut off, resulting in ischemic cholestasis atrophy of the residual liver segment S4 and damage to the postoperative liver function. Whether it is cadaveric liver splitting or living donor liver resection, at the cost of sacrificing the function of the residual liver segment S4, the obtained left lateral lobe often needs to be further volume-reduced before it can be used in low-age children. Therefore, in this way of harvesting the liver graft, both the graft and the residual liver will lose normal liver tissue, and the liver utilization efficiency is low, which does not conform to the current shortage of liver grafts.

[0004] As the left lateral lobe is used as the liver graft, whether volume reduction is carried out or not, in-sheath dissection has always been the standard technique. Whether it is the standard left lateral lobe or the volume-reduced single liver segment (such as S2, S3), the main trunk of the left portal vein and the main trunk of the hepatic artery are selected at the first hepatic hilum as the vascular anastomosis points for the liver graft, and the cost is that the liver tissue of the left hemihepatic needs to be sacrificed. Therefore, how to improve the utilization efficiency of the left hemihepatic, make full use of the discarded segment S4, and at the same time avoid the liver loss caused by the volume reduction of segment S2 or S3 is one of the difficulties in the selection of liver grafts for pediatric liver transplantation.

[0005] With the wide application of the laennec membrane in anatomical hepatectomy, the Glisson branches above the second level of the liver can be relatively easily separated as a whole outside the liver, making it possible to obtain the regional liver graft (Section Graft) dominated by the second-level branches (such as the regions of S4+S3, S5+S8, S6+S7). This is a method of realizing liver graft procurement by using extra-sheath dissection. For example, the extra-sheath separation and blockage of the common trunk of the inflow blood vessels of liver segments S3+S4 can achieve the complete harvesting and separate perfusion of the liver graft of liver segments S3+S4.

[0006] Due to the complex adjacent relationship between blood vessels and bile ducts in the secondary branches of the liver and large individual differences, it is necessary to confirm the number and variation of blood vessels and bile ducts at the transection site before surgery, and judge whether the liver graft in this area meets the conditions for a small-volume liver graft. However, there is currently no good method to solve the problem of preoperative screening of liver grafts in the secondary branch area. Summary of the Invention

[0007] Aiming at the deficiencies of the existing technology, the purpose of the present invention is to provide an evaluation system and method for simulating the acquisition of regional liver grafts to solve the problem of preoperative screening of liver grafts in the secondary branch area.

[0008] According to the first aspect of the present invention, an evaluation system for simulating the acquisition of regional liver grafts is provided, including a local coordinate system establishment module, an artery and bile duct number confirmation module, a comparison module, a separation path confirmation module, a liver segment separation module, and a separated liver segment evaluation module;

[0009] The local coordinate system establishment module performs three-dimensional watershed analysis on the scanned images of the target liver obtained according to the portal vein branch situation to establish local coordinate systems for different liver segments and corresponding ducts;

[0010] The artery and bile duct number confirmation module determines the number of arteries and bile ducts covered by the watershed boundary between the S3+S4 liver segments and the S2 liver segment according to the local coordinate system;

[0011] The comparison module compares the number of arteries and bile ducts with a preset value. If the number of arteries and bile ducts is within the preset value range, the target liver can be used as a liver graft;

[0012] The separation path confirmation module determines the separation path of the S3+S4 liver segments according to the local coordinate system;

[0013] The liver segment separation module establishes a separation device model according to the parameters of the separation device. The separation device model performs a simulated separation operation according to the separation path to obtain a separated liver segment model of the S3+S4 liver segments after simulation;

[0014] The separated liver segment evaluation module establishes a separated liver segment evaluation model, and inputs the separated liver segment model into the separated liver segment evaluation model to output an evaluation result.

[0015] The evaluation system for simulating the acquisition of regional liver grafts of the present invention preoperatively and accurately simulates the acquisition of the S3+S4 liver segments, evaluates and makes decisions for the preoperative use of small-volume liver grafts, and solves the problem of preoperative screening of liver grafts in the secondary branch area.

[0016] In some embodiments, the local coordinate system establishment module is set as:

[0017] Perform three-dimensional reconstruction on the scanned images of the target liver obtained to obtain three-dimensional stereoscopic images corresponding to different liver segments;

[0018] Perform three-dimensional watershed analysis on the three-dimensional stereoscopic image according to the portal vein branch conditions to establish local coordinate systems for different liver segments and their corresponding ducts.

[0019] In some embodiments, the liver segment separation module is set as follows:

[0020] Determine the spatial distance between the Glisson hepatic pedicle of the S3+S4 liver segment and the Laennec membrane on the liver surface according to the coordinates of the S3+S4 liver segment, compare it with the separation device model, and confirm the separation path;

[0021] Locate the position coordinates of the hepatic pedicle of the S3+S4 liver segment as the blocking position of the separation device model for blocking simulation, calculate the watershed flow void range corresponding to the blocking position according to the watershed algorithm as the ischemic line, and mark the coordinates of the ischemic line;

[0022] Determine the avascular area in the liver segment according to the coordinates of the ischemic line;

[0023] Determine the separation plane of the S3+S4 liver segment according to the avascular area and ducts.

[0024] In some embodiments, the liver segment separation module is also set as follows:

[0025] Locate the position coordinates of the confluence of the roots of the left hepatic vein and the middle hepatic vein. Use the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, and use the separation device model to simulate the separation between the avascular area directly in front of the main trunk of the left hepatic vein and the liver parenchyma, and simulate cutting off the branches that drain into the left hepatic vein. Locate and mark the coordinates of the main trunk and main branches of the left hepatic vein, and at the same time confirm the coordinates of the opening of the umbilical fissure vein. The coordinates of the main trunk, main branches of the left hepatic vein and the opening of the umbilical fissure vein constitute the parameter information of the left hepatic splitting plane; and

[0026] According to the location coordinates of the roots of the left hepatic vein and the middle hepatic vein, use the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, and use the separation device model to simulate the separation between the avascular area directly in front of the main trunk of the middle hepatic vein and the liver parenchyma, and simulate cutting off the reflux branches of the S5 and S8 liver segments that drain into the middle hepatic vein. Locate and mark the coordinates of the main trunk and main branches of the middle hepatic vein. The coordinates of the main trunk and main branches of the middle hepatic vein constitute the parameter information of the right hepatic splitting plane.

[0027] In some embodiments, the liver segment separation module is also set as follows:

[0028] Locate the position coordinates of the hepatic pedicle of the S3+S4 liver segment, determine the coordinates on the surface of the left hepatic pedicle, use the Laennec membrane space at this point as the separation path, and use the separation device model to enter the plane between the S4 liver segment, the caudate lobe and the inferior vena cava, and determine the coordinates where the left and right planes meet here; this confluence surface is based on the left hepatic pedicle, V4a Flowing into the middle hepatic vein, V 4b The coordinate position information of the three points flowing into the middle hepatic vein is determined, and at the same time, it constitutes the parameter information of the dorsal liver splitting plane.

[0029] According to the second aspect of the present invention, there is provided an evaluation method for simulating regional donor liver acquisition, and the evaluation method for simulating regional donor liver acquisition is used to control the above-mentioned evaluation system for simulating regional donor liver acquisition, including:

[0030] Perform three-dimensional watershed analysis on the scanned image of the target liver obtained according to the portal vein branch situation to establish local coordinate systems for different liver segments and corresponding ducts;

[0031] Determine the number of arteries and bile ducts covered by the watershed boundary between the S3+S4 liver segment and the S2 liver segment according to the local coordinate system;

[0032] Compare the number of arteries and bile ducts with a preset value. If the number of arteries and bile ducts is within the preset value range, the target liver can be used as a donor liver;

[0033] Determine the separation path of the S3+S4 liver segment according to the local coordinate system;

[0034] Establish a separation device model according to the parameters of the separation device. The separation device model performs a simulation separation operation according to the separation path to obtain a separated liver segment model of the S3+S4 liver segment after simulation separation;

[0035] Establish a separated liver segment evaluation model, and input the separated liver segment model into the separated liver segment evaluation model to output an evaluation result.

[0036] In some embodiments, performing three-dimensional watershed analysis on the scanned image of the target liver obtained according to the portal vein branch situation to establish local coordinate systems for different liver segments and corresponding ducts includes:

[0037] Perform three-dimensional reconstruction on the scanned image of the target liver obtained to obtain three-dimensional stereoscopic images corresponding to different liver segments;

[0038] Perform three-dimensional watershed analysis on the three-dimensional stereoscopic image according to the portal vein branch situation to establish local coordinate systems for different liver segments and corresponding ducts.

[0039] In some embodiments, the separation device model performs a simulation separation operation according to the separation path to obtain a separated liver segment model of the S3+S4 liver segment after simulation separation, including:

[0040] Determine the spatial distance between the Glisson hepatic pedicle of the S3+S4 liver segment and the Laennec membrane on the liver surface according to the coordinates of the S3+S4 liver segment, compare it with the separation device model, and confirm the separation path;

[0041] Locate the position coordinates of the hepatic pedicle of the S3+S4 liver segments as the blocking position of the separation device model for blocking simulation. Calculate the flow void range of the basin corresponding to the blocking position according to the basin algorithm as the ischemic line, and mark the coordinates of the ischemic line.

[0042] Determine the avascular area in the liver segment according to the coordinates of the ischemic line.

[0043] Determine the separation plane of the S3+S4 liver segments according to the avascular area and the ducts.

[0044] In some embodiments, determining the separation plane of the S3+S4 liver segments according to the avascular area and the ducts includes:

[0045] Locate the position coordinates of the confluence of the roots of the left hepatic vein and the middle hepatic vein. Use the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, and simulate the separation between the avascular area in front of the main trunk of the left hepatic vein and the liver parenchyma using the separation device model, and simulate cutting off the branches that drain into the left hepatic vein, and locate and mark the coordinates of the main trunk and the main branches of the left hepatic vein. At the same time, confirm the coordinates of the opening of the umbilical fissure vein. The coordinates of the main trunk, the main branches of the left hepatic vein and the opening of the umbilical fissure vein constitute the parameter information of the left hepatic splitting plane; and

[0046] According to the location coordinates of the roots of the left hepatic vein and the middle hepatic vein, use the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, and simulate the separation between the avascular area in front of the main trunk of the middle hepatic vein and the liver parenchyma using the separation device model, and simulate cutting off the reflux branches of the S5 and S8 liver segments that drain into the middle hepatic vein, and locate and mark the coordinates of the main trunk and the main branches of the middle hepatic vein. The coordinates of the main trunk and the main branches of the middle hepatic vein constitute the parameter information of the right hepatic splitting plane.

[0047] In some embodiments, determining the separation plane of the S3+S4 liver segments according to the avascular area and the ducts further includes: Locate the position coordinates of the hepatic pedicle of the S3+S4 liver segments, determine the coordinates on the surface of the left hepatic pedicle, use the Laennec membrane space at this point as the separation path, and use the separation device model to enter the plane between the S4 liver segment, the caudate lobe and the inferior vena cava, and determine the coordinates where the left and right planes converge here; this convergence plane is determined by the coordinate position information of the left hepatic pedicle, V 4a draining into the middle hepatic vein, V 4b draining into the middle hepatic vein at three points, and also constitutes the parameter information of the dorsal hepatic splitting plane.

[0048] Compared with the prior art, the evaluation system and method for obtaining a graft in the simulated area of the present invention, by accurately simulating the acquisition of the S3+S4 liver segments before surgery, evaluate and make decisions for the preoperative use of small-volume grafts, and solve the problem of preoperative screening of grafts in the secondary branch area. BRIEF DESCRIPTION OF THE DRAWINGS

[0049] Figure 1 Schematic diagram of the composition of the evaluation system for obtaining a simulated regional donor liver according to an embodiment of the present invention;

[0050] Figure 2 Schematic diagram of the watershed range and watershed boundary of the S2 liver segment, S3 liver segment, and S4 liver segment according to an embodiment of the present invention;

[0051] Figure 3 Schematic diagram of the number of arteries and bile ducts covered by the dashed line a according to an embodiment of the present invention;

[0052] Figure 4 Flowchart of the evaluation method for obtaining a simulated regional donor liver according to an embodiment of the present invention.

[0053] Explanation of the reference numerals in the drawings: Local coordinate system establishment module 100, artery and bile duct number confirmation module 200, comparison module 300, separation path confirmation module 400, liver segment separation module 500, separated liver segment evaluation module 600. Detailed implementation manners

[0054] The present invention will be further described in detail below with reference to the accompanying drawings.

[0055] In order to solve the problem of preoperative evaluation of the donor liver in the secondary branch area, the present invention provides an evaluation system and method for obtaining a simulated regional donor liver, which can accurately simulate the acquisition parameters of the S3+S4 liver segments before surgery (including at least one of the number and variation of blood vessels and bile ducts at the Glisson transection, the number of liver sections, the cutting path, the hepatic vein course and branches, etc.), and evaluate and make decisions on the preoperative use of small-volume donor livers; the donors evaluated by this system can provide small-volume donor livers for pediatric liver transplant recipients; this invention can screen the relatives of the children, and the relatives who pass the simulation system test may become qualified donors of small-volume donor livers; it solves the problem of preoperative screening of the donor liver in the secondary branch area.

[0056] According to the first aspect of the present invention, Figure 1 Schematically shows an evaluation system for obtaining a simulated regional donor liver according to an embodiment of the present invention. As Figure 1 shown, the evaluation system for obtaining a simulated regional donor liver includes a local coordinate system establishment module 100, an artery and bile duct number confirmation module 200, a comparison module 300, a separation path confirmation module 400, a liver segment separation module 500, and a separated liver segment evaluation module 600.

[0057] The local coordinate system establishment module 100 performs three-dimensional watershed analysis on the scanned image of the target liver obtained according to the portal vein branch situation to establish a local coordinate system for different liver segments and corresponding ducts; it includes:

[0058] Perform three-dimensional reconstruction on the scanned images of the target liver to obtain three-dimensional stereoscopic images corresponding to different liver segments. Specifically, input the liver image data (MR, CT, color Doppler ultrasound) of the donor into the evaluation system. The system performs segmentation processing on the scanned images of the target liver according to the artificial intelligence algorithm (U-Net network model) to obtain the three-dimensional data of the images of different liver segments.

[0059] Perform three-dimensional watershed analysis on the three-dimensional stereoscopic images according to the portal vein branch situation to establish local coordinate systems for different liver segments and the corresponding ducts. Specifically, perform three-dimensional reconstruction on the image data of the whole liver ducts and different liver segments to obtain three-dimensional stereoscopic images corresponding to different liver segments. According to the portal vein branch situation, perform three-dimensional watershed analysis on the liver segments: According to the characteristics of various ducts (arteries, veins, bile ducts), identify the position information of the key feature points corresponding to each duct in the scanned images. Based on the dynamic three-dimensional liver segment watershed data analysis, establish local coordinate systems for the blood vessels and bile ducts on the transverse section of the hepatic pedicle of the S3+S4 liver segments. Among them, the liver is divided into eight segments (S1 to S8 segments, I to VIII segments) using the liver segmentation method (eight-segment method).

[0060] The artery and bile duct number confirmation module 200 determines the number of arteries and bile ducts covered by the watershed boundary between the S3+S4 liver segments and the S2 liver segment according to the local coordinate system. Specifically, according to the watershed module of the three-dimensional reconstruction system, mark the coordinates of the generated watershed range of the S3+S4 liver segments, as Figure 2 shown. Using the same method, mark the coordinates of the S2 watershed range, so as to determine the watershed boundary between the S3+S4 liver segments and the S2 liver segment (as Figure 2 shown by the dashed line a in), take the dashed line a as the cut-off line (as Figure 3 shown), determine the number of arteries and bile ducts covered by the dashed line a ( Figure 3 in, artery 1, bile ducts 2 and 3), and mark the coordinates of the arteries and bile ducts.

[0061] The comparison module 300 compares the number of arteries and bile ducts with the preset value. If the number of arteries and bile ducts is within the preset value range, the target liver can be used as a donor liver. Specifically, if the sum of the number of arteries and bile ducts ≤ 3 (preset value), it means that the target liver can be used as a donor liver and can enter the following steps. Otherwise, it is not recommended to be used as a donor liver.

[0062] The separation path confirmation module 400 determines the separation path of the S3+S4 liver segments according to the local coordinate system. Specifically, calculate the optimal separation path of the S3+S4 liver segments through the path planning algorithm.

[0063] The hepatic segment separation module 500 establishes a separation device model based on the parameters of the separation device. The separation device model performs a simulated separation operation according to the separation path to obtain a separated hepatic segment model of the S3+S4 hepatic segments. Specifically, a corresponding separation device model is established in advance by inputting the relevant parameters (such as length, thickness, angle, etc.) of the separation device (membrane separator, separation forceps, etc.). The separation device model can correspond to different types of separation devices, and then the separation device model performs a simulated separation operation according to the separation path calculated above. The above operations include:

[0064] Determine the spatial distance between the Glisson hepatic pedicle of the S3+S4 hepatic segments and the Laennec membrane on the liver surface according to the coordinates of the S3+S4 hepatic segments, compare it with the separation device model, and confirm the separation path. Specifically, in the marked three-dimensional coordinate system, determine the coordinates of the common trunk of the S3+S4 hepatic segments, calculate the spatial distance between the Glisson hepatic pedicle of the S3+S4 hepatic segments and the Laennec membrane on the liver surface. The spatial distance is the distance from the hepatic pedicle of the S3+S4 hepatic segments and the S2 hepatic segments extending from the sagittal hepatic pedicle (taking the minimum distance as the standard). This distance represents the length of the common trunk of the S3+S4 hepatic segments. Compare this spatial distance with the separation device model to evaluate whether the separation device can perform an effective separation, which can be used as a reference for subsequent actual surgeries, thereby improving the success rate of interspace separation, shortening the operation time, and at the same time, the separation path can be adjusted or a suitable separation device model can be matched according to the comparison result;

[0065] Locate the position coordinates of the hepatic pedicle of the S3+S4 hepatic segments as the blocking position of the separation device model for blocking simulation. Calculate the flow void range of the basin corresponding to the blocking position as the ischemic line according to the basin algorithm, and mark the coordinates of the ischemic line. Specifically, in the marked three-dimensional coordinate system, locate the position coordinates of the hepatic pedicle of the separated S3+S4 hepatic segments, and then use the separation device model to simulate clamping the hepatic pedicle for blocking simulation; the basin corresponding to the blocking position in the system can calculate the flow void range of the basin corresponding to the proposed blocking position according to the coordinate information of the blocking position according to the basin algorithm of the system, perform color marking, simulate the ischemic line, and mark the coordinates of the ischemic line;

[0066] Determine the avascular area in the hepatic segment according to the coordinates of the ischemic line;

[0067] Determine the separation plane of the S3+S4 hepatic segments according to the avascular area and the ducts. It includes:

[0068] Locate the position coordinates of the confluence of the roots of the left hepatic vein and the middle hepatic vein. Use the Laennec membrane space on the surface of the hepatic vein at this point as the separation path. Simulate the separation between the avascular area directly in front of the main trunk of the left hepatic vein and the liver parenchyma using a separation device model, and simulate cutting off the branches that drain into the left hepatic vein. Locate and mark the coordinates of the main trunk and main branches of the left hepatic vein, and at the same time confirm the coordinates of the opening of the umbilical fissure vein. The coordinates of the main trunk, main branches of the left hepatic vein and the opening of the umbilical fissure vein constitute the parameter information of the left hepatic splitting plane; specifically, in the marked three-dimensional coordinate system, locate the position coordinates of the confluence of the roots of the left hepatic vein and the middle hepatic vein. Simulate using a separation device model to enter the Laennec membrane space on the surface of the hepatic vein at this point, separate the avascular area directly in front of the main trunk of the left hepatic vein from the liver parenchyma, and cut off the surface liver parenchyma to expose the main trunk of the left hepatic vein and mark its coordinate range; Search for the branches that drain into the left hepatic vein on the right side of the main trunk of the left hepatic vein and simulate cutting them off, locate the coordinates of the main branches, and judge whether the main trunk of the left hepatic vein can be reserved for the S2 liver segment (compare with the parameter coordinates of the S2 liver segment drainage area to judge whether it is within the range, if it is within the range, it means it can be), and whether the blood of the S3 liver segment can flow back through the umbilical fissure vein (compare with the parameter coordinates of the S3 liver segment drainage area to judge whether it is within the range, if it is within the range, it means it can be), and determine the coordinates of the opening of the umbilical fissure vein; The coordinate parameters of the above key feature points constitute the parameter information of the left hepatic splitting plane; its section length starts from the coordinate of the confluence of the vein roots + the length of the middle hepatic vein measured by the system; and

[0069] According to the positioning coordinates of the roots of the left hepatic vein and the middle hepatic vein, use the separation device model with the Laennec membrane space on the surface of the hepatic vein at this point as the separation path to simulate the separation between the avascular area directly in front of the main trunk of the middle hepatic vein and the liver parenchyma, and simulate cutting off the reflux branches of the S5 and S8 liver segments that drain into the middle hepatic vein, and position and mark the coordinates of the main trunk and main branches of the middle hepatic vein. The coordinates of the main trunk and main branches of the middle hepatic vein constitute the parameter information of the right hepatic splitting plane; specifically, in the marked three-dimensional coordinate system, according to the positioning coordinates of the roots of the left hepatic vein and the middle hepatic vein in the above process, in the same way, simulate using the separation device model to separate the avascular area directly in front of the main trunk of the middle hepatic vein from the liver parenchyma, and cut off the surface liver parenchyma to expose the main trunk of the middle hepatic vein and mark its coordinate range; search for the right side of the main trunk of the middle hepatic vein and simulate cutting off the reflux branches of the S5 and S8 liver segments that drain into the middle hepatic vein, position the coordinates of the main branches, and judge whether the branches of the main trunk of the middle hepatic vein can be reserved for the S4 segment according to the coordinate parameters (compare with the parameter coordinates of the drainage area of the S4 liver segment to judge whether it is within the range, and if it is within the range, it means it can be); if it can be reserved, simulate splitting the left and right half livers, and combine the coordinate information of the root of the middle hepatic vein determined in the above process to evaluate whether the separation device can expose the confluence of the middle hepatic vein and the left hepatic vein by 360 degrees during the operation, and determine the coordinate range of the exposed segment. The coordinate parameters of the above key feature points constitute the parameter information of the right hepatic splitting plane; its section length starts from the coordinate of the confluence of the vein roots + the length of the right hepatic vein measured by the system; and

[0070] Locate the position coordinates of the hepatic pedicle of the S3+S4 liver segments, determine the coordinates on the surface of the left hepatic pedicle, use the Laennec membrane space at this point as the separation path, and use the separation device model to enter the plane between the S4 liver segment, the caudate lobe and the inferior vena cava, and determine the coordinates where the left and right planes converge here; this convergence plane is based on the left hepatic pedicle, V 4a draining into the middle hepatic vein, V 4b draining into the middle hepatic vein, and the coordinate position information of the three points is determined, and at the same time, it also constitutes the parameter information of the dorsal hepatic splitting plane. Specifically, in the marked three-dimensional coordinate system, according to the position coordinates of the S3 and S4 hepatic pedicles in the above process, determine the coordinates on the surface of the left hepatic pedicle, find the Laennec membrane space, and simulate entering the plane between the S4 segment, the caudate lobe and the inferior vena cava from this space, and determine the coordinates where the left and right planes converge here; this convergence plane is based on the left hepatic pedicle, V 4a draining into the middle hepatic vein, V 4b draining into the middle hepatic vein, and the coordinate position information of the three points is determined, and at the same time, it also constitutes the parameter information of the dorsal hepatic splitting plane; if the S4 segment needs to be thinned, determine the sagittal part S 4bThe branch coordinates on the dorsal side of the liver segment are determined, and the spatial coordinate range for the separation device to enter the Laennec membrane space of this branch during the operation is evaluated, so as to judge whether the S4 segment can be thinned, providing additional guarantee for meeting the requirements of a thin abdominal cavity for children.

[0071] The separated liver segment evaluation module 600 establishes a separated liver segment evaluation model, inputs the separated liver segment model into the separated liver segment evaluation model, and outputs an evaluation result. Specifically, a mathematical model is established for evaluation according to each step, and the mathematical model is W = F1*S1 + F2*S2 + …… F n *S n , where W is the total score, F is the score for each step, S is the weight for each step, the system evaluates and scores each step, outputs a comprehensive score, combines the basic conditions such as the psychology and body of the donor, and through the comparison of artificial intelligence big data, outputs an evaluation result, which is used to guide clinicians to decide whether the donor is suitable for donating a small-volume donor liver to a recipient with a low-month-old child.

[0072] The donors who pass the above evaluation can enter the actual steps of obtaining the donor liver, such as severing the hepatic pedicle, perfusing the donor liver, and trimming the donor liver off the stage.

[0073] According to the second aspect of the present invention, Figure 4 Schematically shows an evaluation method for simulated regional donor liver acquisition according to an embodiment of the present invention. This evaluation method for simulated regional donor liver acquisition is used to control the above-mentioned evaluation system for simulated regional donor liver acquisition, including:

[0074] S100: Perform three-dimensional watershed analysis on the scanned image of the target liver obtained according to the portal vein branch situation to establish local coordinate systems for different liver segments and corresponding ducts; specifically, it includes: performing three-dimensional reconstruction on the scanned image of the target liver obtained to obtain three-dimensional stereoscopic images corresponding to different liver segments; performing three-dimensional watershed analysis on the three-dimensional stereoscopic images according to the portal vein branch situation to establish local coordinate systems for different liver segments and corresponding ducts.

[0075] S200: Determine the number of arteries and bile ducts covered by the watershed boundary between the S3+S4 liver segment and the S2 liver segment according to the local coordinate system.

[0076] S300: Compare the number of arteries and bile ducts with a preset value. If the number of arteries and bile ducts is within the preset value range, the target liver can be used as a donor liver.

[0077] S400: Determine the separation path of the S3+S4 liver segment according to the local coordinate system.

[0078] S500: Establish a separation device model according to the parameters of the separation device. The separation device model performs a simulated separation operation according to the separation path to obtain a separated liver segment model of the S3+S4 liver segment after simulated separation.

[0079] The separation device model performs a simulated separation operation according to the separation path, and the separated liver segment model of the S3+S4 liver segments after the simulated separation includes:

[0080] Determine the spatial distance between the Glisson hepatic pedicle of the S3+S4 liver segments and the Laennec membrane on the liver surface according to the coordinates of the S3+S4 liver segments, compare it with the separation device model, and confirm the separation path;

[0081] Locate the position coordinates of the hepatic pedicle of the S3+S4 liver segments as the blocking position of the separation device model for blocking simulation, calculate the flow void range corresponding to the blocking position according to the watershed algorithm as the ischemic line, and mark the coordinates of the ischemic line;

[0082] Determine the avascular area in the liver segment according to the coordinates of the ischemic line;

[0083] Determine the separation plane of the S3+S4 liver segments according to the avascular area and the ducts.

[0084] Determining the separation plane of the S3+S4 liver segments according to the avascular area and the ducts includes:

[0085] Locate the position coordinates of the confluence of the roots of the left hepatic vein and the middle hepatic vein. Use the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, and use the separation device model to simulate the separation between the avascular area directly in front of the main trunk of the left hepatic vein and the liver parenchyma, and simulate the cutting of the branches that drain into the left hepatic vein, and locate and mark the coordinates of the main trunk and the main branches of the left hepatic vein. At the same time, confirm the coordinates of the opening of the umbilical fissure vein. The coordinates of the main trunk, the main branches of the left hepatic vein and the opening of the umbilical fissure vein constitute the parameter information of the left hepatic splitting plane; and

[0086] According to the positioning coordinates of the roots of the left hepatic vein and the middle hepatic vein, use the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, and use the separation device model to simulate the separation between the avascular area directly in front of the main trunk of the middle hepatic vein and the liver parenchyma, and simulate the cutting of the reflux branches of the S5 and S8 liver segments that drain into the middle hepatic vein, and locate and mark the coordinates of the main trunk and the main branches of the middle hepatic vein. The coordinates of the main trunk and the main branches of the middle hepatic vein constitute the parameter information of the right hepatic splitting plane; and

[0087] Determining the separation plane of the S3+S4 liver segments according to the avascular area and the ducts also includes: Locate the position coordinates of the hepatic pedicle of the S3+S4 liver segments, determine the coordinates on the surface of the left hepatic pedicle, use the Laennec membrane space at this point as the separation path, and use the separation device model to enter the plane between the S4 liver segment, the caudate lobe and the inferior vena cava, and determine the coordinates where the left and right planes converge here; This convergence plane is based on the left hepatic pedicle, V 4a draining into the middle hepatic vein, V 4bThe coordinate position information of the three points converging into the middle hepatic vein is determined, and at the same time, it constitutes the parameter information of the dorsal liver splitting plane.

[0088] S600: Establish a separated liver segment evaluation model, input the separated liver segment model into the separated liver segment evaluation model, and output the evaluation result.

[0089] The above are only some embodiments of the present invention. For those of ordinary skill in the art, without departing from the inventive concept of the present invention, several modifications and improvements can still be made, and these all belong to the protection scope of the present invention.

Claims

1. An evaluation system for simulating regional donor liver acquisition, characterized in that, include: A local coordinate system establishment module, which performs a three-dimensional flow domain analysis on the acquired scanned image of the target liver according to the portal vein branches to establish local coordinate systems for different liver segments and corresponding ducts; an artery and bile duct number confirmation module, which determines the number of arteries and bile ducts covered by the watershed boundary between the S3+S4 liver segment and the S2 liver segment according to the local coordinate system; a comparison module, wherein the comparison module compares the number of arteries and bile ducts with a preset value, and if the number of arteries and bile ducts is within the preset value range, the target liver can be used as a donor liver; a separation path confirmation module, which determines a separation path of the S3+S4 liver segment according to the local coordinate system; a liver segment separation module, wherein the liver segment separation module establishes a separation device model according to the parameters of the separation device, and the separation device model simulates the separation operation according to the separation path to obtain a separated liver segment model of the S3+S4 liver segment after simulated separation; The separated liver segment evaluation module establishes a separated liver segment evaluation model, inputs the separated liver segment model into the separated liver segment evaluation model, and outputs an evaluation result.

2. The evaluation system for obtaining a simulated regional graft liver according to claim 1, wherein The local coordinate system establishment module is set as: Performing three-dimensional reconstruction on the acquired scanned image of the target liver to obtain three-dimensional stereo images corresponding to different liver segments; A three-dimensional flow domain analysis is performed on the three-dimensional image according to the portal vein branches to establish local coordinate systems of the different liver segments and corresponding ducts.

3. The evaluation system for obtaining a simulated regional donor liver according to claim 1, wherein, The liver segment separation module is configured as follows: Determine the spatial distance between the Glisson's pedicle of the S3+S4 liver segment and the Laennec membrane on the liver surface based on the coordinates of the S3+S4 liver segment, compare the distance with the separation device model, and confirm the separation path; Locating the position coordinates of the liver pedicle of the S3+S4 liver segment as the blocking position of the separation device model to perform blocking simulation, calculating the flow range of the watershed corresponding to the blocking position as the ischemic line according to the watershed algorithm, and marking the coordinates of the ischemic line; determining an avascular area in a liver segment according to the coordinates of the ischemic line; The separation plane of the S3+S4 liver segment is determined according to the avascular area and the duct.

4. The evaluation system for obtaining a simulated regional graft liver according to claim 3, wherein The liver segment separation module is further configured to: Locating the coordinates of the confluence of the left hepatic vein and the middle hepatic vein roots, using the Laennec membrane space on the surface of the hepatic vein at this point as a separation path, using the separation device model to simulate the separation between the avascular area directly in front of the left hepatic vein trunk and the liver parenchyma, and simulating the severing of the branches that flow into the left hepatic vein, and locating and marking the coordinates of the left hepatic vein trunk and major branches, while confirming the coordinates of the umbilical fissure vein opening. The coordinates of the left hepatic vein trunk, major branches, and umbilical fissure vein opening constitute parameter information of the left hepatic splitting plane; and According to the positioning coordinates of the roots of the left hepatic vein and the middle hepatic vein, using the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, the separation device model is used to simulate the separation between the avascular area directly in front of the main trunk of the middle hepatic vein and the liver parenchyma, and to simulate the cutting of the reflux branches of the S5 and S8 hepatic segments that drain into the middle hepatic vein, and to position and mark the coordinates of the main trunk and main branches of the middle hepatic vein. The coordinates of the main trunk and main branches of the middle hepatic vein constitute the parameter information of the right hepatic splitting plane.

5. The evaluation system for obtaining a donor liver in a simulation area according to claim 4, characterized in that, The hepatic segment separation module is further set as: Locate the position coordinates of the hepatic pedicle of S3+S4 segments, determine the coordinates on the surface of the left hepatic pedicle, use the Laennec membrane space at this point as the separation path, and enter the plane between the S4 segment, the caudate lobe and the inferior vena cava using the said separation device model, and determine the coordinates where the left and right planes converge here; this convergence plane is based on the left hepatic pedicle, V 4a draining into the middle hepatic vein, V 4b The coordinate position information of the three points draining into the middle hepatic vein is determined, and at the same time, it also constitutes the parameter information of the dorsal liver splitting plane.

6. A method for evaluating the acquisition of a regional donor liver, characterized in that, Including: Performing three-dimensional watershed analysis on the scanned image of the target liver obtained according to the portal vein branch situation to establish local coordinate systems for different hepatic segments and corresponding ducts; Determining the number of arteries and bile ducts covered by the watershed boundary between the S3+S4 hepatic segments and the S2 hepatic segment according to the local coordinate system; Comparing the number of the arteries and bile ducts with a preset value. If the number of the arteries and bile ducts is within the preset value range, the target liver can be used as a donor liver; Determining the separation path of the S3+S4 hepatic segments according to the local coordinate system; Establishing a separation device model according to the parameters of the separation device. The separation device model performs a simulation separation operation according to the separation path to obtain the separated hepatic segment model of the S3+S4 hepatic segments after the simulation separation; Establishing a separated hepatic segment evaluation model, and inputting the separated hepatic segment model into the separated hepatic segment evaluation model to output an evaluation result.

7. The evaluation method for obtaining a simulated regional donor liver according to claim 6, wherein The performing three-dimensional watershed analysis on the scanned image of the target liver obtained according to the portal vein branch situation to establish local coordinate systems for different hepatic segments and corresponding ducts includes: Performing three-dimensional reconstruction on the scanned image of the target liver obtained to obtain three-dimensional stereoscopic images corresponding to different hepatic segments; Performing three-dimensional watershed analysis on the three-dimensional stereoscopic images according to the portal vein branch situation to establish the local coordinate systems for the different hepatic segments and corresponding ducts.

8. The evaluation method for obtaining a simulated regional graft liver according to claim 6, wherein The separation device model performing a simulation separation operation according to the separation path to obtain the separated hepatic segment model of the S3+S4 hepatic segments after the simulation separation includes: Determining the spatial distance between the Glisson hepatic pedicle of the S3+S4 hepatic segments and the Laennec membrane on the liver surface according to the coordinates of the S3+S4 hepatic segments, comparing it with the separation device model to confirm the separation path; Positioning the position coordinates of the hepatic pedicle of the S3+S4 hepatic segments as the blocking position of the separation device model for blocking simulation, calculating the watershed flow void range corresponding to the blocking position according to the watershed algorithm as the ischemic line, and marking the coordinates of the ischemic line; Determining the avascular area in the hepatic segment according to the coordinates of the ischemic line; Determining the separation plane of the S3+S4 hepatic segments according to the avascular area and the ducts.

9. The evaluation method for obtaining a donor liver in a simulated area according to claim 8, wherein The determining the separation plane of the S3+S4 hepatic segments according to the avascular area and the ducts includes: Locate the position coordinates of the confluence of the roots of the left hepatic vein and the middle hepatic vein. Using the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, simulate the separation between the avascular area directly in front of the main trunk of the left hepatic vein and the liver parenchyma using the separation device model, and simulate the cutting of the branches that drain into the left hepatic vein. Locate and mark the coordinates of the main trunk and main branches of the left hepatic vein, and at the same time confirm the coordinates of the opening of the umbilical fissure vein. The coordinates of the main trunk and main branches of the left hepatic vein and the opening of the umbilical fissure vein constitute the parameter information of the left liver splitting plane; and According to the positioning coordinates of the roots of the left hepatic vein and the middle hepatic vein, using the Laennec membrane space on the surface of the hepatic vein at this point as the separation path, simulate the separation between the avascular area directly in front of the main trunk of the middle hepatic vein and the liver parenchyma using the separation device model, and simulate the cutting of the reflux branches of the S5 and S8 liver segments that drain into the middle hepatic vein. Locate and mark the coordinates of the main trunk and main branches of the middle hepatic vein. The coordinates of the main trunk and main branches of the middle hepatic vein constitute the parameter information of the right liver splitting plane.

10. The evaluation method for obtaining a simulated regional graft liver according to claim 9, characterized in that, The determination of the dissection plane of the S3+S4 liver segment based on the avascular area and the duct also includes: locating the position coordinates of the hepatic pedicle of the S3+S4 liver segment, determining the coordinates on the surface of the left hepatic pedicle, using the Laennec membrane space at this point as the dissection path, and entering the plane between the S4 liver segment, the caudate lobe and the inferior vena cava with the dissection device model, and determining the coordinates where the left and right planes converge; this convergence plane is determined by the coordinate position information of the three points where the left hepatic pedicle, V 4a drains into the middle hepatic vein, V 4b drains into the middle hepatic vein, and the parameter information of the dorsal liver splitting plane is also constituted by these coordinates.

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