3D打印技术在冠状动脉异常诊断和术前规划中的应用

Application of 3Dprinting technology in diagnosis and preoperative planning of coronary artery abnormalities

目的:探讨使用3D打印技术打印的3D心脏模型诊断和指导冠状动脉异常矫治手术的可行性和临床价值。方法:基于3例冠状动脉异常的心脏CT数据,包括右冠状动脉-左室瘘1例,左、右冠状动脉共同起源于右冠状窦合并左、右冠状动脉-肺动脉瘘1例、左冠状动脉起源于肺动脉1例。采用Mimics 19.0软件对患者CT进行图像分割,建立STL格式的3D心脏模型,显示冠状动脉与主动脉和肺动脉的空间关系。使用3D打印机打印心脏冠脉模型,对心脏冠脉模型进行评估。结果:3例3D心血管实体模型可清晰显示左右冠状动脉与肺动脉、主动脉间的空间关系,冠状动脉瘘的大小、位置,且实体模型与数据模型吻合,并无明显差异。手术全部顺利完成,恢复良好,无严重并发症出现。结论:将3D打印技术应用于冠状动脉异常有助于诊断和制定适合的手术计划,使得医师可以个性化精准诊疗冠状动脉异常的解剖结构,指导手术更顺利安全进行,有显著的临床应用价值。

Objective: To explore the feasibility and clinical value of 3 D printed heart model in the diagnosis and guidance of coronary artery abnormalities surgery. Methods: This study mainly based on cardiac CT data of 3 patients with coronary artery abnormalities, including 1 case of right coronary artery-left ventricular fistula, 1 case of left and right coronary artery all originating from right coronary sinus combined with left coronary artery-pulmonary artery fistula and right coronary artery-pulmonary artery fistula, and 1 case of Anomalous left coronary artery from the pulmonary artery(ALCAPA). Mimics 19.0 software was used to segment CT images and established a 3 D heart model in STereoLithography. It formated to display the spatial relationship between coronary arteries, aorta and pulmonary artery. The coronary artery model was printed by 3 D printer and evaluated. Results: These 3 D printed heart models of three cases can clearly show the spatial relationship between coronary arteries and pulmonary arteries, and the size and the location of coronary artery fistula. What’s more, there was no significant difference between this model and data model. All surgery operations were completed successfully and patients were recovered well without serious complications. Conclusion: The application of 3 D printing technology on coronary artery anomalies is valuable to diagnosis and formulate appropriate surgical plan.