通过3D打印技术制备颅脑实体模型

Preparation of simulate craniocerebral models via three dimensional printing technique

目的以3D打印技术制备颅脑实体模型，应用于术前手术计划及模拟手术。方法颅脑CT薄层扫描厚度为0.5 mm，MRI层厚1 mm，由CT、MRI、CT血管造影、功能性磁共振成像分别提供骨组织、脑组织及肿瘤、脑血管及动脉瘤、传导束及功能区等影像数据，通过mimics三维重建软件的识别，将不同灰度表示的组织抽离出来，重建成彩色的三维图像，通过3D打印制备颅脑实体模型进行术前设计及模拟手术。结果 利用3D打印颅脑模型可立体直观地显示鞍区各手术间隙的大小，有利于术前手术间隙的选择；脑动脉瘤成像模型可直观体现动脉瘤与周边组织关系，可直接应用于动脉瘤夹闭模拟手术，选择合适的动脉瘤夹；颅脑肿瘤模型可清晰显示肿瘤与传导束、功能区的空间关系，体现头颅标本无法显示的传导束及功能区位置，有利于功能保护。结论 3D打印颅脑实体模型有望极大地提高神经外科术前手术设计的质量，将虚拟可视化模型观察进展到实体模型模拟手术，并有利于颅脑功能解剖知识学习。

ObjectiveThree dimensional （3D） printing technique was used to prepare the simulate craniocerebral models, which were applied to preoperative planning and surgical simulation.MethodsThe image data was collected from PACS system. Image data of skull bone, brain tissue and tumors, cerebral arteries and aneurysms, and functional regions and relative neural tracts of the brain were extracted from thin slice scan （slice thickness 0.5 mm） of computed tomography （CT）, magnetic resonance imaging （MRI, slice thickness 1mm）, computed tomography angiography （CTA）, and functional magnetic resonance imaging （fMRI） data, respectively. MIMICS software was applied to reconstruct colored virtual models by identifying and differentiating tissues according to their gray scales. Then the colored virtual models were submitted to 3D printer which produced life-sized craniocerebral models for surgical planning and surgical simulation.Results3D printing craniocerebral models allowed neurosurgeons to perform complex procedures in specific clinical cases though detailed surgical planning. It offered great convenience for evaluating the size of spatial fissure of sellar region before surgery, which helped to optimize surgical approach planning. These 3D models also provided detailed information about the location of aneurysms and their parent arteries, which helped surgeons to choose appropriate aneurismal clips, as well as perform surgical simulation. The models further gave clear indications of depth and extent of tumors and their relationship to eloquent cortical areas and adjacent neural tracts, which were able to avoid surgical damaging of important neural structures.ConclusionAs a novel and promising technique, the application of 3D printing craniocerebral models could improve the surgical planning by converting virtual visualization into real life-sized models.It also contributes to functional anatomy study.