3D打印技术辅助诊断和指导室间隔缺损手术

3D printing technique in diagnosis and preoperative guidance of ventricular septal defect

目的探讨运用3D打印技术构建三维心脏模型对结构性心脏病诊断及治疗的可行性与临床价值。方法基于1例室间隔缺损患儿的心脏CT影像数据,采用Mimics 17.0图形分割软件,以阈值法进行心肌分割,以动态区域生长法进行血池分割获得数字化三维心脏模型;采用PolyJet材料,以Objet500Connex3聚合物喷射成型3D打印机打印软质的实体心脏模型,并对心脏模型进行评估。结果 3D模型可清晰显示心脏内部解剖结构、空间关系以及室间隔缺损的三维形态。在打印出的实体心脏模型上测量室间隔缺损的轴位长度为4.85mm,与3D数字模型和CT图像中测量结果(轴位长度分别为4.86mm和4.84mm,矢状位长度分别为6.66mm和6.65mm)基本一致。结论将3D打印技术用于结构性心脏病有助于诊断和制定适当的手术方案;通过规范化的图像处理技术获取精确的心脏模型,使个性化精准诊疗结构性心脏病成为可能。

Objective To explore the feasibility and clinical value of 3D printing technique in construction 3D heart model for diagnosis and treatment of structural heart diseases.Methods Based on cardiac CT data of 1 child with ventricular septal defect（VSD）,the Mimics 17.0 segmentation software was used to perform myocardial segmentation by the threshold method and the blood pool segmentation by the dynamic region growing method to obtain a digital 3D heart model.PolyJet 3D printer（Objet500 Connex3）was utilized to print 3D physical heart model with PolyJet material.Then the quality of the heart model was evaluated.Results The 3D model could clearly show the internal anatomy and spatial relationship of the heart,as well as the 3D shape of VSD.The measured axial length of VSD on the printed solid heart model was4.85 mm,which was basically the same as the measurement results on the 3D digital model（the axial length was 4.86 mm and the sagittal length was 6.66 mm）and on the CT image（the axial length was 4.84 mm and the sagittal position length was 6.65 mm）.Conclusion The application of 3D printing technique for diagnosis and treatment of structural heart disease can helps to diagnose and formulate suitable surgical plan of structural heart disease.Using standardized image processing techniques to obtain accurate heart model makes the accurate diagnosis and treatment of structural heart disease become possible.