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光学分子影像外科学
$54.61
本书从当今外科领域肿瘤切缘和淋巴结清扫两大临床难点出发, 指出了现代手术中图像引导的重要性、 必要性和存在的问题, 阐述了光学分子成像的基本理论和成像机制, 光学成像技术和设备的研究进展、 外科手术术中使用的成像仪器、 荧光显影剂、 应用范围、 使用方法。
本书从当今外科领域肿瘤切缘和淋巴结清扫两大临床难点出发, 指出了现代手术中图像引导的重要性、 必要性和存在的问题, 阐述了光学分子成像的基本理论和成像机制, 光学成像技术和设备的研究进展、 外科手术术中使用的成像仪器、 荧光显影剂、 应用范围、 使用方法。 具体详细介绍了多种肿瘤前哨淋巴结示踪成像; 体内肿瘤成像; 以及胆管、 输尿管、 淋巴管、 血管和神经等结构在开放手术和内窥镜手术光学成像和术中识别实际临床操作要点。 希望使参考阅读者全面了解光学视觉技术、 荧光成像技术、 分子靶向技术的发展现状, 更好地促进这些多学科融合的先进技术应用到外科手术领域, 实现光学分子影像外科学学科的形成和发展。
杨晓峰,山西医科大学医院泌尿外科教授,1984年临汾卫生专科学校医疗专业毕业。1984年起,在山西临汾钢铁公司职工医院任外科医师;1990年起在山西医科大学临床学院读硕士研究生;1995年在湖南医科大学湘雅医院读博士研究生。
第 1 章 肿瘤外科手术切缘与残余肿瘤的科学问题 肿瘤外科安全手术切缘的判定 经尿道膀胱肿瘤切除术与肿瘤残余 喉癌手术与手术切缘 前列腺癌根治术与手术切缘 其他肿瘤手术与手术切缘 肿瘤手术切缘的分子边界研究进展 第 2 章 肿瘤外科手术淋巴结清扫的科学问题 膀胱癌手术的淋巴结清扫术 乳腺癌前哨淋巴结活检术与腋窝淋巴结清扫术 非小细胞肺癌纵隔淋巴结清扫术 睾丸生殖细胞肿瘤腹膜后淋巴结清扫术 胃癌淋巴结清扫术 第 3 章 术中图像引导外科的科学问题 图像引导外科技术 术中磁共振成像 膀胱肿瘤光学成像引导诊疗技术 ?? 第 4 章 术中光学分子成像的理论基础 医用光学理论基础 荧光成像的形成机制 体内光学分子探针的靶向载体 肿瘤靶向特异性光学分子探针的结构与设计 光学靶向分子探针介导内窥镜诊疗技术 第 5 章 光学分子影像成像机制 医学成像技术概况 分子影像概述 光学分子影像 影响活体光学成像的因素 医学内窥镜分子成像机制 活体显微镜成像机制 高分辨率光学显微术的成像机制 第 6 章 医学光学成像设备 光学成像设备的基础知识 活体光学成像对 CCD 的性能要求 活体体内光学成像技术 活体荧光成像系统技术性能 外科手术中荧光导航设备 第 7 章 光学成像技术在外科手术中的应用 外科手术中使用的光学成像设备 外科手术过程中使用的外源性荧光造影剂 光学成像治疗技术应用的范围 第 8 章 光学分子影像技术的发展与实践 光学分子影像技术的发展 光学分子影像技术的实践
前 言 外科学是主要研究如何利用外科手术方法去解除病人的病原 从而使 病人得到治疗的学科 主要包括术前诊断、 术中操作和术后处理 其中术 中操作及手术技能与手术治疗效果、 手术时间和手术后的并发症密切相关 传统的手术操作基本功包括切开、 止血、 结扎、 缝合、 游离和暴露等 6 大技 术 掌握这些技术 成为功底深厚、 娴熟精湛的外科医生需要经过多年的 不懈努力 同时如果外科医生能够熟练掌握先进的手术辅助器械 对于快 速、 准确、 微创治疗外科疾病非常必要 外科手术过程中使用的器械除各种组织镊、 手术剪、 解剖剪、 止血钳、 持针钳、 拉钩等外 还有各种光学设备 如无影灯、 内窥镜光学成像设备 这些设备在外科手术中发挥着越来越重要的作用 无论是开放手术 还是 微创内窥镜手术 明亮的视野、 清晰的图像对于提高手术质量非常必要 手术过程中 手术者不仅希望看清手术野的解剖学结构 还希望明确周围 或手术野下方的组织和结构 明确肿瘤的大小 了解肿瘤周围的重要器官 和血管 虽然术前各种影像学技术为制定手术计划提供了资料 但术中成 像也非常必要 目前常用的影像学技术包括 X 线、 超声成像 (USG)、 γ 闪烁成像、 X 线计算机体层成像 (CT)、 磁共振成像 (MRI)、 发射体层成像 (ECT)、 单 光子发射体层成像 ( SPECT)、 正电子发射体层成像 ( PET) 等成像技术 这些技术主要应用在术前诊断 而术中成像除超声、 X 线和 MRI 光学成像 也越来越重要 单纯白光在外科手术中主要是照明作用 随着对自体荧光和各种荧光染料的深入认识 荧光成像技术被引入外科手术 例如 以 5 ̄ALA 介导的 术中成像用于经尿道膀胱肿瘤的切除术和多种肿瘤外科肿瘤切除术中 能 够显著提高肿瘤和肿瘤边缘的识别 对于提高手术治疗效果发挥了一定的 作用 480nm 和 540nm 的窄谱成像能够提高内窥镜下肿瘤的识别率 近红 外荧光染料和技术的进步 逐渐形成了 “术中近红外荧光导航” 的手术技 术和设备 术中近红外荧光导航能够在开放手术中辅助外科医生识别肿瘤 边缘、 前哨淋巴结以及血管和神经等重要结构 显微内窥镜技术的发展使 医生在内窥镜诊疗过程中 以 “光学病理切片” 的形式识别癌细胞 光学 靶向分子探针和光学分子影像技术的发展 使外科医生在手术过程中 从 分子水平识别癌变细胞或组织 将更加有效地早期治疗外科手术需要治疗 的疾病 光学分子影像外科学研究的内容主要是荧光染料、 靶向特异的光学分 子探针、 光学分子成像设备和术中操作技术 这些技术从 2005 年初步应用 于临床以来 发展十分迅猛 应用于多种开放手术和内窥镜诊断和治疗、 腹腔镜手术和机器人手术中 目前国内外有 15 种光学成像设备应用于临床 医学的各个学科 光学分子影像外科学将成为一门重要的学科 成为外科 学领域一个重要分支 本书的出版将有助于光学分子影像外科学的发展
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