多模态医学影像融合技术3D打印心脏模型方法学及精准度研究

A preliminary methodology and precision study of producing 3D printing heart model by multimodel medical image fusion technology

目的采用超声瓣膜图像与CT心腔图像拼接融合,为3D打印心脏提供更丰富的解剖信息及新的图像处理方法。方法回顾性分析41例心房颤动患者经食管三维超声心动图(3D-TEE)及心脏CT的医学数字成像和通信(DICOM)图像,使用Mimics软件对数据进行后处理。单模态组只使用心脏CT作为数据源,多模态组使用CT和超声作为数据源。对3D重建瓣膜结构进行评分,并测量两组瓣环周长、面积等参数,将单模态组与多模态组两组图像重合,测量两者瓣环平面夹角,计算各测值的绝对差值,并行统计学分析。结果超声重建瓣膜评分均高于CT重建瓣膜;两组瓣环相关参数差异无统计学意义(P>0.05),且一致性良好;图像配准检验时二尖瓣及主动脉瓣瓣环平面夹角均值及标准差分别为(3.15±0.88)°、(2.87±0.76)°。结论超声瓣膜与CT心脏图像融合精准,且超声瓣膜形态显示更佳,有助于提高3D打印心脏模型的仿真性。

Objective To obtain abundant anatomical information using fusion of ultrasonic valve images and CT heart images and provide new methods of image processing for 3D heart printing . Methods Cardiac examinations of three-dimensional transesophageal echocardiography ( 3D-TEE) and DICOM images of 41 patients who had atrial fibrillation without structural cardiac diseases were analyzed retrospectively and the data afterward were processed by using Mimics software . For the single-mode image group ,only the heart CT were invoked as the data sources . For the multimodel image group ,CT and ultrasound images were invoked as the data sources . Valve structures of the 3D reconstructions were graded and the circumferences ,areas and other parameters of the two groups were measured . The images of two groups were overlapped ,and the angles between the two valve planes of each heart were evaluated and analysed . Results Score of valves reconstructed by ultrasound 3D construction was higher than those by CT reconstruction . Measurements of correlated parameters between the 3D-TEE group and the CT group showed no significant statistical difference ( P > 0 .05 ) , and the consistency was well . Ultrasound measurements of 3D reconstructed valves were well concordant with CT reconstructed valves by Bland-Altman analysis . Mean value and standard deviation of the angles between mitral valve annulus and aortic valve ring plane of each heart in the two group were ( 3 .15 ± 0 .88)°,( 2 .87 ± 0 .76)°,respectively . Conclusions Ultrasonic valve images can fuse precisely with CT images and it provides a better displayed morphology . This will help improving simulation quality of the 3D printed hearts .