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目的探索色素型基底细胞癌(pigmented basal cell carcinoma,pBCC)的皮肤镜诊断指征和反射式共聚焦激光扫描显微镜(Reflectanceconfocal miscroscopy,RCM)的图像特征,并经三维可视化重构与建模后进行比对,验证两种影像学技术之间关系,为pBCC的皮肤镜诊断提供理论依据。方法选取来自我院就诊经皮肤镜和RCM诊断为pBCC后经病理验证的皮损样本。选择pBCC皮肤镜诊断指征典型图像,在同一靶目标区进行RCM检查,实时获取X、Y、Z三个方向连续扫描图像存储备查。采用三维可视化图像处理软件,先对RCM靶目标图像进行特征提取及无关组织透明化,使靶目标图像更加清晰,后将其连续扫描系列图像进行三维可视化重构与建模,观察靶目标图像的立体与空间信息、矢状面信息,肿瘤组织影像学形态与周围组织的关系,及对pBCC皮肤镜图像与RCM图像比对。结果皮肤镜和RCM分别同时确诊pBCC 37例;取得pBCC的皮肤镜诊断指征典型图像,包括:蓝灰色卵圆形巢、叶状结构、多发性蓝灰色小球、轮辐射状结构、溃疡和树枝状血管与RCM图像的三维可视化重构与建模结果。结论取得pBCC皮肤镜与RCM图像三维可视化重构与数据库建模后的满意结果,明确pBCC皮肤镜诊断指征与RCM图像之间的密切与对应关系,为pBCC皮肤镜诊断提供理论依据和提高其诊断符合率奠定扎实基础。
Objective To explore the dermoscopic diagnostic indications of pigmented basal cell carcinoma (pBCC) and the image features of Reflectance Confocal Laser Scanning Microscopy (RCM). After reconstructing and modeling with 3D visualization, Compare and verify the relationship between the two imaging techniques for the diagnosis of pBCC dermoscopy to provide a theoretical basis. Methods The pathological specimens of skin lesions confirmed by dermoscopy and RCM diagnosed as pBCC in our hospital were selected. Select pBCC dermatoscope typical indications indications, in the same target area for RCM inspection, real-time access to X, Y, Z three consecutive scan image storage for future reference. The three-dimensional visualization image processing software is used to extract the feature of the RCM target image and do not related to the transparency of the target to make the target target image clearer. After that, the serial images of the RCM are reconstructed and modeled by 3D visualization to observe the target target image Dimensional and spatial information, sagittal information, the relationship between tumor morphology and surrounding tissues, and the comparison between pBCC dermoscopic images and RCM images. Results 37 cases of pBCC were diagnosed simultaneously by dermoscopy and RCM respectively. The typical images of dermatoscope diagnosis of pBCC were obtained, including blue-gray ovary, leaf-like structure, multiple blue-gray globules, 3D visualization of dendritic vessels and RCM images and modeling results. Conclusion The results of 3D visualization reconstruction and database modeling of dermatoscope and RCM images of pBCC were satisfactory. The close and corresponding relationship between the diagnostic criteria of pBCC dermatoscope and the RCM images was clarified, which provided a theoretical basis for the diagnosis of pBCC dermatoscopy and the improvement of Diagnostic compliance rate to lay a solid foundation.