多耗材3D打印颅内动脉瘤模型及辅助临床手术应用

Multi-consumable 3D printing of intracranial aneurysm model and application of auxiliary clinical surgical approach

目的通过3D打印技术多种耗材打印出血管、脑组织、颅骨和颅内动脉瘤复合模型并指导术中动脉瘤夹闭的应用。方法收集2018年11月至2019年11月河北医科大学第二医院30例颅内动脉瘤患者CT血管造影(CTA)及磁共振成像(MRI)影像数据,应用Mimics 18.0软件将薄层扫描数据转换成三维图像,导入到Geomagic Studio 2015软件进一步精细化处理,重建同一坐标下的血管、脑组织、颅骨和动脉瘤的三维复合虚拟模型,将3D虚拟模型数据输入到3D打印机,采用多种耗材同时打印出复合模型。结果 30例患者均利用3D打印技术按照1∶1的比例成功打印出颅内血管、脑组织、颅骨和颅内动脉瘤,不同类型的耗材在同一复合模型中具有不同的特性,使其具有真实的触感。应用辅助临床手术,均获得成功。结论多耗材打印3D模型是拥有着高仿真度及个体化特征的物理模型,有利于术前手术方案的制定,尤其是为难治的多发动脉瘤和巨型动脉瘤选择最好的手术入路及合适的动脉瘤夹,为临床手术提供了依据。

Objective To print the composite model of blood vessel,brain tissue,skull and intracranial aneurysm by 3D printing and to guide the application of aneurysm clamping during operation.Methods The CT angiography(CTA)data and nuclear magnetic resonance imaging(MRI)image data of patients with intracranial aneurysm in the second Hospital of Hebei Medical University were collected.The thin layer scanning data were converted into three dimensional images by Mimics 18.0 software and introduced into Geomagic Studio 2015 software for further fine processing to reconstruct the three dimensional composite virtual model of blood vessel,brain tissue,skull and aneurysm in the same coordinate.The 3D virtual model data were input into 3D printer,and a variety of consumables were used to print the composite model at the same time.Results Intracranial blood vessels,brain tissue,skull and intracranial aneurysm were successfully printed in all 30 patients according to the proportion of 1∶1 by 3D printing technique.Different types of consumables had different characteristics in the same composite model,so that they had real touch.The application of auxiliary clinical surgery was successful.Conclusion 3D model is a physical model with high degree of simulation and individualized characteristics,which can be used to design surgical scheme before operation,select the best surgical approach and suitable aneurysm clip,especially to the refractory multiple aneurysm and giant aneurysm,which provides a theoretical basis for clinical surgery.