3D打印在布-加综合征介入治疗中应用初步研究

Application of 3D-printing technique in interventional treatment of Budd-Chiari syndrome : a preliminary study

目的探讨3D打印模型在指导布-加综合征(BCS)血管内介入治疗中的临床应用及教学价值。方法选取1例典型下腔静脉型BCS患者,通过MR增强扫描提取DICOM格式原始MRA数据,Simpleware软件提取数字化数据并重建获得BCS 3D模型,3D打印机按1∶1比例打印出BCS 3D实体模型。经验丰富的主任医师对BCS 3D打印模型进行模拟介入治疗。结果成功获取BCS 3D打印模型。在模型上模拟手术操作,主任医师向低年资医师及医学生示范BCS介入治疗。BCS 3D打印模型能较好地模拟BCS介入治疗,指导教学实践促进医患沟通。结论 BCS 3D打印模型可真实地反映下腔静脉及肝静脉空间架构特征,对术者制定手术方案、模拟操作及指导教学实践具有参考价值;可直观地反映病变部位及形态,提高患者对疾病的认识,加强了医患沟通。

Objective To explore the clinical application of 3D-printing model in guiding intelwentional management of Budd-Chiari syndrome （BCS） and in teaching practice. Methods A patient with typical BCS of inferior vena cava type was selected. By using MR enhanced scanning, the original MRA data of DICOM format were extracted, and then the digital data were extracted and reconstructed to obtain 3D BCS model by Simpleware software. The 3D BCS entity model, using 1 ： 1 ratio, was printed out by a 3D printer. An experienced chief physician made a simulated interventional manipulation on this 3D BCS entity model. Results The BCS 3D model was successfully printed. Simulated operation could be easily performed on the 3D-printing model, in this way the chief physician could make a demonstration of interventional procedure of BCS to the junior doctors and medical students. Interventional therapeutic manipulation for BCS could be well demonstrated on the 3D-printing model of BCS, which was very helpful in guiding teaching practice and in promoting the communication between doctors and patients. Conclusion The BCS 3D-printing model can truly reflect the spatial architecture features of the inferior vena cava and the hepatic veins, which are vmy valuable for the making of surgical plan, for the demonstration of simulation operation, and for teaching practice. Moreover, 3D-printing model can stereoscopically display the location and morphology of the lesion, which can improve patient＇s understanding of the disease, thus, the communication between doctors and patients can be strengthened. （J Intervent Radiol, 2017, 26： 732-735）