三维打印技术在狭颅症矫治手术中的应用

Application of three-dimensional printing technology in orthopedics of craniosynostosis

目的:运用三维(3D)打印技术建立具有精准解剖结构的狭颅症头颅3D模型和模拟术后头颅3D模型,探讨3D打印的3D头颅模型对临床诊断和手术计划制定的意义。方法:1例8个月患有严重狭颅症的儿童,行CT扫描后获得影像资料;使用mimics 18.0软件导入CT DICOM数据并对感兴趣区域做图像重建后处理,得到三维头颅重建模型;再运用3-Matic10.0软件对狭颅症头颅模型进行手术模拟操作,得到模拟术后的3D头颅重建模型;将患者3D头颅重建模型和模拟术后的3D头颅重建模型保存成STL格式;最后把数据导入OBJET 260 3D打印机后即完成建模过程。结果:依据3D打印模型模拟手术操作并设计手术方案,手术顺利实施,患儿在术后恢复了完美的头型。结论:3D打印技术能有效地进行辅助诊断并应用于狭颅症矫治术前手术方案的制定,为狭颅症患者带来个性化、精准化的治疗。

Objective To establish the three-dimensional （3D） models of craniosynostosis skull and postoperative skull with accurately anatomical structures by using 3D printing technology, and to explore the significance of the 3D printing skull model for the clinical diagnosis and surgical planning. Methods The image date of an eight-month-old child with severe craniosynostosis were obtained by CT scanning. The DICOM data of CT were imported into Mimics 18.0 software, and the image reconstruction was conducted for the region of interest, and then, the 3D reconstruction model of the malformed skull was obtained. After using 3-Matic 10.0 software to simulate the operation for the malformed skull model, the 3D model of the postoperative skull was obtained. The 3D reconstruction models of the malformed skull and the postoperative skull were saved in STL format. After the file data were imported into OBJET 260 3D printer, the 3D models of the malformed skull and the postoperative skull were completed. Results According to operation simulation and operation planning with these two 3D printing models, the operation was completed successfully, and the child recovered with a perfect head shape after the operation. Conclusion The 3D printing technology is effective in auxiliary diagnosis and preoperation plan design, providing an accurate and personalized treatment for patients with craniosynostosis.