3D打印技术在大脑镰旁脑膜瘤切除术中的初步应用

Preliminary Application of 3D Printing Technology in the Surgical Treatment of Falx Meningioma

目的探究基于3D打印技术的大脑镰旁脑膜瘤实体解剖模型构建在大脑镰旁脑膜瘤切除术中的初步应用情况。方法选取2015年4—6月福建省立医院神经外科收治的大脑镰旁脑膜瘤患者3例,根据患者螺旋CT增强扫描所得的DICOM数据,针对颅骨、血管和肿瘤等组织结构采用不同的分割方法进行数据信息提取和重建,并在同一坐标系下实现装配和三者融合,形成三维可视化复合虚拟模型,再结合3D打印技术将三维可视化复合虚拟模型实体化。观察大脑镰旁脑膜瘤实体解剖模型构建情况及患者大脑镰旁脑膜瘤切除术的手术情况。结果 3例患者均构建出三维可视化复合虚拟模型,并成功制作出大脑镰旁脑膜瘤实体解剖模型,且其可清晰显示肿瘤与颅骨、大脑镰、上下矢状窦及周边血管的关系。手术医师利用该模型制定出完善的手术预案,术时根据大脑镰旁脑膜瘤实体解剖模型指导手术定位与实施,避开重要血管,达到SimpsonⅠ级切除,且患者术后无明显脑水肿、血肿及神经功能障碍,手术成功。结论基于3D打印技术的大脑镰旁脑膜瘤实体解剖模型能有效指导医务人员制定与完善手术方案,精准切除肿瘤,减少术中损伤,有助于患者康复。

Objective To explore the preliminary application of the construction of anatomic model of falx meningioma entity based on 3D printing technology in the surgical treatment of falx meningioma. Methods Three patients with falx meningioma admitted in Department of Neurosurgery of Fujian Provincial Hospital from April to June 2015 were selected. According to the DICOM data of patients obtained from enhanced spiral CT scanning,data information of skull,blood vessel and tumor were extracted and reconstructed with different segmentation methods. The assembly and integration of the three ones were achieved in the same coordinate system to form three - dimensional visual composite virtual models. Combined with 3D printing technology,three - dimensional visual composite virtual model was substantialized. The construction of anatomic model of falx meningioma entity and the operation of falx meningioma for patients were observed. Results The three - dimensional visual composite virtual models were constructed for three patients and the anatomic models of falx meningioma entity were made successfully,which could clearly show the relationship between tumor and skull,cerebral falx,superior sagittal sinus,inferior sagittal sinus and peripheral vessels. Surgeons could use this model to make perfect operation plan,guide surgical positioning and implementation according to anatomic model of falx meningioma entity during operation,avoid important blood vessels and reach Simpson Ⅰ grade excision. Moreover,patients had no obvious encephaledema,hematoma and dysneuria after operation. The operation was successful in three patients. Conclusion The anatomic model of falx meningioma entity based on 3D printing technology can effectively guide medical staff to make and improve operation plans,precisely remove tumor,reduce intra -operation injuries,and contributes to the rehabilitation of patients.