剖宫产瘢痕妊娠数字化三维模型在其子宫动脉栓塞术中的应用

Application of Digital 3D Model of Cesarean Scar Pregnancy in Uterine Artery Embolization

目的:探讨剖宫产瘢痕妊娠(CSP)数字化三维模型的构建方法及其在CSP子宫动脉栓塞术(UAE)中的应用和意义。方法:5例CSP患者在UAE术前行双源CT血管造影(CTA)扫描,获取CTA横断面图像后,利用Mimics10.01软件对骨盆和盆腔动脉系统进行三维重建。将构建的CSP数字化三维模型用于指导UAE手术操作,并与数字减影血管造影(DSA)结果进行对比。结果:①病灶的血供来源:2例由双侧子宫动脉和卵巢动脉共同供血,3例仅由双侧子宫动脉供血;②血供的分布:所有患者均双侧血供不均衡,其中3例以左侧为主,2例以右侧为主;③疗效和与DSA比较:5例患者均在三维模型的指导下成功行UAE,术后恢复好,均无明显副反应发生。5例患者的数字化三维模型与DSA对比相一致,1例患者DSA造影中未显示卵巢动脉供血。结论:构建的CSP数字化三维模型真实性、准确性高,可为剖宫产瘢痕妊娠子宫动脉栓塞术提供术前指导和术中参考,使之更加个体化和精确化。

Objective：To explore the method and significance of application of cesarean scar pregnancy （CSP） digital 3D model in uterine artery embolization （UAE）. Methods ,5 cases of patients with CSP were examined by dual-source CTA before UAE. After obtaining the CTA original images,we used Mimics10.01 software to reconstruct the digital 3D model. The, CSP digital 3D models were used to guide UAE operation, and their effect were compared with those of digital subtraction angiography （DSA）. Results.①Sources of blood supply, 2 cases were supplied by bilateral uterine artery and ovarian artery together,3 cases only by bilateral uterine artery; ②Distribution of blood supply, all patients were inequality, in which 3 cases were mainly supplied by the left side and 2 cases mainly by the right;③Comparison of the curative effect between digital 3D model and DSA= all patients were carry, out UAE successful in the guide of digital 3D model,and no significant side effects occured. Digital 3D model and DSA were similar in 4 cases, but ovarian artery was not seen by DSA in 1 case. Conclusions,The CSP digital 3D model is very precisely and truly,can make the CSP- UAE more individualization and precision,and provide guide to CSP- UAE before or during the opera- tion.