Phase II Clinical Study of Three-Dimensional Printed Coplanar Template Combined with CT-Guided Percutaneous Core Needle Biopsy of Pulmonary Nodules in Elderly Patients

Background: As the population age structure gradually ages, more and more elderly people were found to have pulmonary nodules during physical examinations. Most elderly people had underlying diseases such as heart, lung, brain and blood vessels and cannot tolerate surgery. Computed tomography (CT)-guided percutaneous core needle biopsy (CNB) was the first choice for pathological diagnosis and subsequent targeted drugs, immune drugs or ablation treatment. CT-guided percutaneous CNB requires clinicians with rich CNB experience to ensure high CNB accuracy, but it was easy to cause complications such as pneumothorax and hemorrhage. Three-dimensional (3D) printing coplanar template (PCT) combined with CT-guided percutaneous pulmonary CNB biopsy has been used in clinical practice, but there was no prospective, randomized controlled study. Methods: Elderly patients with lung nodules admitted to the Department of Oncology of our hospital from January 2019 to January 2023 were selected. A total of 225 elderly patients were screened, and 30 patients were included after screening. They were randomly divided into experimental group (Group A: 30 cases) and control group (Group B: 30 cases). Group A was given 3D-PCT combined with CT-guided percutaneous pulmonary CNB biopsy, Group B underwent CT-guided percutaneous pulmonary CNB. The primary outcome measure of this study was the accuracy of diagnostic CNB, and the secondary outcome measures were CNB time, number of CNB needles, number of pathological tissues and complications. Results: The diagnostic accuracy of group A and group B was 96.67% and 76.67%, respectively (P = 0.026). There were statistical differences between group A and group B in average CNB time (P = 0.001), number of CNB (1 vs more than 1, P = 0.029), and pathological tissue obtained by CNB (3 vs 1, P = 0.040). There was no statistical difference in the incidence of pneumothorax and hemorrhage between the two groups (P > 0.05). Conclusions: 3D-PCT combined with CT-guided percutaneous CNB can improve the puncture accuracy of elderly patients, shorten the puncture time, reduce the number of punctures, and increase the amount of puncture pathological tissue, without increasing pneumothorax and hemorrhage complications. We look forward to verifying this in a phase III randomized controlled clinical study. .

THE ANALYSES OF THE THREE-DIMENSIONAL STRESS STRUCTURE NEAR THE CRACK TIP OF MODE I CT SPECIMENS IN ELASTICPLASTIC STATE(Ⅰ)--THE ANALYSES OF CONSTRAINT PARAMETERS AND FRACTURE PARAMETERS

In the present paper,three dimensional analyses of some general constraint parameters and fracture parameters near the crack tip of Mode I CT specimens in two different thicknesses are carried out by employing ADINA program.The results reveal that the constraints along the thickness direction are obviously separated into two parts:the keeping similar high constraint field(Z_(1))and rapid reducing constraints one(Z_(2)).The two fields are experimentally confiremed to correspond to the smooth region and the shear lip on the fracture face respectively.So the three dimensional stress structure of Mode I specimens can be derived through discussing the two fields respectively.The distribution of the Crack Tip Opening Displacement(CTOD)along the thickness direction and the three dimensional distribution of the void growth ratio(V_(g))near the crack tip are also obtained.The two fracture parameters are in similar trends along the thickness direction,and both of them can reflect the effect of thickness and that of the loading level to a certain degree.

Three-dimensional Imaging of Multi-slice Spiral CT in Bronchial Artery Correlative Study on Blood Supply of Central Lung Cancer and Its Clinical Significance

Objective: To evaluate three-dimensional bronchial artery imaging charactersin central lung cancer and applied values with multi-slice spiral CT (MSCT) to provide theoreticalevidence on blood supply and intervention therapy. Methods: Eighteen patients with central lungcancer underwent MSCT with real time helical thin-slice CT scanning. Three-dimensional bronchialartery reconstruction was done at the console work-station. The space anatomical characters ofbronchial artery were observed through different rotations. Results: For 6 cases, thethree-dimensional images of bronchial artery (33.33%) could exactly show the origins, the routes(lung inner segment and mediatism segment) and the diameters of bronchial arteries. Vision rate ofbronchial arteries was the highest in pulmonary artery stricture and truncation groups, and thevessels' diameter became larger apparently. These characters demonstrated blood supply of this kindof central lung cancer come from bronchial artery. Volume rendering images were the best ones amongthree-dimensional images. Conclusion: Three-dimensional imaging with MSCT in bronchial artery canreveal the anatomical characters of bronchial artery and provide theoretical evidence on bloodsupply and intervention therapy of central lung cancer.

Numerical simulation of asphalt mixture based on three-dimensional heterogeneous specimen

In order to verify the validity of finite element numerical simulation method for asphalt mixture, which consists of aggregates, mastic （where mastic is a kind of fine mixture composed of asphalt binder mixed with fines and fine aggregates） and air voids, based on three-dimensional （3D） heterogeneous specimen, X-ray computerized tomography （X-ray CT） was used to scan the asphalt specimens to obtain the real internal microstrnctures of asphalt mixture. CT images were reconstructed to build up 3D digital specimen, and the viscoelastic properties of mastic were described with Burgers model The uniaxial creep numerical simulations of three different levels of aggregate gradation were conducted. The simulation results agree well with the experimental results. The numerical simulation of asphalt mixture incorporated with real 3D microstructure based on finite element method is a promising application to conduct research of asphalt concrete. Additionally, this method can increase the mechanistic understanding of global viscoelastic properties of asphalt mixtures by linking the real 3D microstructure.

Diameters and form of skull base foramen ovale measured by three-dimensional spiral CT thin-slice scan in healthy adults

BACKGROUND： The accurate measurements of various data of the bone diameters of foramen ovale of living person can change the methods of puncturing trigeminal gasserian ganglion via foramen ovale for treating trifacial neuralgia from the experience of puncture operator only to puncture by taking the objective data of measurement as the evidence, which is good for improving the accuracy of puncturing trigeminal ganglion and reducing side effects. OBJECTIVE ： To observe the forms of foramen ovales in healthy adults displayed by volume rendering and multi-planar reconstruction after three-dimensional spiral CT thin-slice scan of skull base, and measure the longitudinal diameter and transverse diameter. DESIGN ： A repetitive observation and measurement SETTINGS ： Department of Neurosurgery and Department of Medical Imaging, Foshan Hospital of Traditional Chinese Medicine. PARTICIPANTS： Fifty healthy adults （100 sides）, who were examined with three-dimensional spiral CT scan, were randomly selected from the Department of Medical Imaging, Foshan Hospital of Traditional Chinese Medicine from January 2005 to January 2006, including 26 males and 24 females, aged 25-68 years with an average of 48 years old. They were all informed and agreed with the examination. METHODS ： The subjects were examined with the Philips 16-slice spiral CT-Mx 8000 IDT CT apparatus （Philips Company, Holland）, the scanning ranged from 2 cm below the canthomeatal line to the level of suprasellar cistem. The width of collimator was 0.75 mm, pitch was 0.663; tube current was 350 mA, voltage was 120 kV, resolution was 512×512 matrix; slice thickness of reconstruction was 1 mm, and interval was 0.5 mm. After the three-dimensional spiral CT thin-slice scan of skull base, the image post-processing techniques including volume rendering and multi-planar reconstruction were applied to observe the forms of foramen ovales, and measure the size, longitudinal diameter and transverse diameter of the foramen ovales. The figures of the foramen ovales were drawn with mouse along the boundary of bone porous margin and soft tissue. According to the indications, the diameters were measured with computer to observe the forms of foramen ovales. MAIN OUTCOME MEASURES ： The longitudinal diameter, transverse diameter and form of foramen ovales were observed. RESULTS： All the 50 healthy adults （100 sides） were involved in the analysis of results. （1） It was observed in the volume rendering images that foramen ovales had four forms of oval shape （77 sides）, kidney shape （12 sides）, round shape （7 sides）, ribbon shape （4 sides）. （2） The longitudinal diameters of left and right foramen ovales were （7.67±1.32） and （7.98±1.45） mm, and the transverse diameters were （4.04±0.83）, （4.09±1.07） mm; There was no obvious difference between left and right longitudinal diameters （t = 1.63, P = 0.11 ）, and left and right transverse diameters were close （t = 0.45, P= 0.65）. CONCLUSION ： The non-invasive techniques of volume rendering and multi-planar reconstruction after three-dimensional spiral CT thin-slice scan can clearly display the formand size of foramen ovale in healthy adults.

Digital measurement of bone tumor volume by CT three-dimensional reconstruction technology

Objective To discuss the measurement of bone tumor volume on the basis of three dimensional images segmentation technology. Methods Twenty patients with lacunar bone tumor from Tianjin Hospital and Tongji Hospital were included in the

小尺寸CT试样断裂行为的GTN细观损伤模型研究

基于国产A508-Ⅲ钢的单轴拉伸测试,构建了Ramberg-Osgood力学本构模型和GTN(Gurson-Tvergaard-Needleman)细观损伤模型,并对模型参数进行了标定,开展了不同温度下小尺寸CT(1/6CT)试样的断裂韧性测试,采用规则化方法计算得到裂纹扩展阻力曲线(J-R曲线),分析了测试温度对材料断裂性能的影响。结果表明,随着温度从-100℃度降低至-130℃,断口韧窝区的宽度由43μm缩减至10μm,平均韧窝尺寸从0.3μm缩小至0.05μm,材料的塑性变形能力随着温度的降低而脆化。基于构建的力学本构模型和GTN细观损伤模型,采用有限元法分析了1/6CT试样从裂纹萌生、扩展至失效断裂的过程。结果表明,J-R曲线随着温度的下降而降低,断裂韧性(J_(IC)值)和裂纹扩展量(Δa)的降幅分别为43%和3%,相对误差不超过5%。这表明,基于GTN细观损伤模型的数值方法是研究小尺寸CT试样断裂行为的一种简便、有效的方法。

A three-dimensional digital visualization model of cervical nerves in a healthy person

Three-dimensional reconstruction nerve models are classically obtained from two-dimensional images of ＂visible human＂ frozen sections. However, because of the flexibility of nerve tissues and small color differences compared with surrounding tissues, the integrity and validity of nerve tissues can be impaired during milling. Thus, in the present study, we obtained two-dimensional data from a healthy volunteer based on continuous CT angiography and magnetic resonance myelography. Semi-automatic segmentation and reconstruction were then conducted at different thresholds in different tissues using Mimics software. Small anatomical structures such as muscles and cervical nerves were reconstructed using the medical computer aided design module. Three-dimensional digital models of the cervical nerves and their surrounding structures were successfully developed, which allowed visualization of the spatial relation of anatomical structures with a strong three-dimensional effect, distinct appearance, clear distribution, and good continuity, precision, and integrality. These results indicate the validity of a three-dimensional digital visualization model of healthy human cervical nerves, which overcomes the disadvantages of milling, avoids data loss, and exhibits a realistic appearance and three-dimensional image.

Three-Dimensional Computerized Tomography-Assisted Identification of Necrotic Volume, Distribution, Shape and Prognosis of Collapse in ONFH

Objective: We constructed 3D-model of ONFH in computer according to three-dimensional computerized tomography (3D-CT) data. We determined the location and volume of necrosis to investigate its clinical efficacy. Method: Totally 92 hips (59 cases) with ONFH (44 males, 15 females) were included, with mean age of 37.5 years (range from 26 to 58). Totally 20 cases (35 hips) were induced by corticosteroid (CTSs), 31 (49 hips) induced by alcohol, 4 (4 hips) induced by trauma and 4 (4 hips) idiopathic. All the hips were categorized into stage ARCO II. Finally diagnosed by MRI, all hips were scanned by CT to acquire data in DICOM format. The images were imported into software to extract 3D-shape of femoral heads, necrotic foci, their volumes and distribution in each quadrant. Deviation of volumes between digital image and biopsy specimen was analyzed by SAS9.1 package. Correlativity between collapse and volume of necrosis under specific pathogeneses was also analyzed. Among the cases necessitating total hip arthroplasty (THA) due to advancing to ARCO III, we randomly selected 8 of them to perform 3D-CT scanning thrice prior to surgical operation. Total femoral heads harvested were torn asunder. Cubic capacity of femoral heads and necrotic foci were hereby measured and compared with those acquired from digital models. Result: Through the digital model, necrotic foci were found mainly locating within the super lateral portion of femoral head, coinciding with those observed in biopsy specimen. Average volumetric ratio of digitally acquired necrosis focus/femoral head in 58 collapsed hips was 36.8%. The ratio of the 34 hips without collapse was 17.3%. In collapsed femoral heads, the distribution of necrosis focus was 23.4% in quadrant 1 (q1), 23.6% in q2, 12.1% in q3, 14.4% in q4, 9.0% in q5, 11.8% in q6, 1.6% in q7 and 3.9% in q8. In femoral heads without collapse, the distribution was 34.2% in q1, 29.6% in q2, 11.8% in q3, 11.3% in q4, 6.0% in q5, 6.0% in q6, 0.5% in q7 and 0.4% in q8. As for the average cubic capacities of femoral heads and necrotic foci, those acquired from the digital model and biopsy specimen had no significant difference in matched-pairs test (t = -1.49, P = 0.179 for femoral heads and t = -1.52, P = 0.172 for necrotic foci). There was significant difference (F = 2.720, P = 0.035 P was respectively 0.0001 and 0.0005). Decision tree model showed that 94.6% (53/56) hips would progress into collapse if the volumetric ratio of necrotic tissue was over 23.48%. Otherwise, if distribution in q2 was over 45.13%, 83.3% (5/6) hips would progress into collapse. No collapse (0/30) would occur if the distribution of necrotic tissue in q2 was under 45.13%. Conclusion: Digital 3D-model reconstructed from CT scanning can precisely incarnate spatial orientation of necrotic foci in femoral head. Multinomial logistic regression and decision-making tree shows that volumetric ratio of necrotic tissues plays an important role in anticipating collapse of femoral head.

Permeability differences based on three-dimensional geometrical information of void spaces

In this study,the permeabilities of Berea and Otway sandstones were measured under different confining pressures,and porosity was investigated through mercury intrusion porosimetry(MIP).The total porosities of the Berea and Otway sandstones were approximately 17.4%and 25%,respectively.Pore size distributions of each sandstone were almost the same,but the pores in the Otway sandstone were slightly narrower.However,the permeability of the Otway sandstone was smaller than that of the Berea sandstone by one order of magnitude.Three-dimensional(3D)void geometry and geometrical properties of the void spaces relevant to flow were compared to obtain the relation between the permeability differences and porosities of the two sandstones.The 3D geometrical analysis using microfocus X-ray computed tomography(CT)was performed,and the pore geometries of both sandstones were compared using the 3D medial axis(3DMA)method.Pore and throat radii,pore coordination number,tortuosity,number of connecting paths,connecting path volume,and other factors were determined using 3DMA.The Otway sandstone was characterized by a small effective throat/pore radius ratio.Based on the fluid flow mechanism,the lower effective throat/pore radius ratio results in a lower permeability induced by the fluid energy loss,which means that the 3D geometrical shape of void spaces affects the permeability value.

基于X-CT技术的沥青混合料三维数值化试样重建

为了对沥青混合料内部结构进行三维重构,采用德国Compact-225型工业X-CT扫描混合料试件,实现试件的三维可视化,计算出集料、砂胶、空隙的体积组成。采用自行编写的程序,实现了由三维可视化模型向三维数值化模型的转化。提出了边界空隙率的概念,通过设置一定的边界空隙率,使模型的边界空隙分布符合实际试样的空隙分布。建立了基于实际试样真实内部微细观分布的数值化试样,弥补了传统的数值方法采用统计学原理或采用对试件损伤研磨建立三维细观模型的不足,为数值化测试奠定了重要基础。

镍基单晶合金CT试样裂纹尖端应力结构及晶体滑移特性

针对3种不同晶体取向([001],[011],[111])的镍基单晶合金DD3紧凑拉伸(CT)试样,利用考虑有限变形和晶格转动效应的率相关晶体滑移有限元程序对其裂纹尖端三维应力场进行了弹塑性模拟计算分析,深入考察了裂尖等效应力和滑移系分切应力分布以及滑移系激活规律,并对裂纹扩展路径进行了理论预测和试验研究。结果表明,裂纹尖端应力结构有较大的变化,呈现复杂的变化规律,对此试样的晶体取向有较大的影响;裂纹尖端自由表面形成具有特定矢量方向的滑移带,裂纹启裂和扩张途径与该滑移带有关,晶体学结构分析表明其特征敏感于晶体取向。裂纹尖端的等效应力、最大分切应力沿厚度方向分布均为在试样心部较为均匀,而在外表面处则下降较快,有限元计算和实验测定结果证实这两部分分别与试样断口上的纤维区和剪切唇区相对应。

CT检测技术在土样初始损伤研究中的应用

对用短时压实法制成的两种粉质粘土试样进行CT扫描,获得了两种试样中土颗粒和水的标称质量吸收系数.通过CT扫描结果,对试样的初始损伤进行评价.整体来看,试样的CT数方差不大,密度分布比较均匀,比分层击实法制成的试样的均匀性好,且粘粒含量高,用短时击实法较容易获得初始损伤较小的试样.对密度分布进行具体分析发现:轴向看,试样两端密度大,中间密度小;径向看,周边密度大,中心密度小;径向的总体均匀性比轴向的好.

试件尺寸对X-CT测试效果影响规律研究

针对具体X-CT设备,研究了试件尺寸(放大倍率)对测试效果的影响规律。研究结果表明:当样品直径过大时,其空间分辨率和缺陷辨别能力将严重变差,直接带来二维切片质量和孔洞检测能力的下降。所检试件尺寸的增大,将以测试质量的下降为代价,因此,本设备所测试块尺寸建议不超出50 mm。

渗透环境下化学腐蚀裂隙岩石破坏过程的CT试验研究

通过CT扫描试验研究渗透及无渗透环境下受化学腐蚀及未受化学腐蚀预制裂隙砂岩的三轴压缩破坏过程,分析试件破坏过程中各层面的CT数变化规律,并对渗透环境下不同试验阶段试验参数的变化规律以及渗透环境对砂岩强度的影响进行分析。试验结果表明,在微裂隙扩展与主裂隙贯通的过程中,对于无渗透环境,由于微裂隙发育导致裂尖处有所密合,之后随着试件的破裂CT数逐步减小;而对于渗透环境,由于孔隙水压力作用,在此过程中裂尖处无密合现象,而是继续开裂,CT数继续减小直至破坏。试件破坏后,无渗透环境下试件破坏时产生的裂隙较单一,而渗透环境下由于渗透作用和孔隙水压力作用,试件破坏时产生的裂隙相对来说较复杂,说明渗透环境对试件的破坏损伤作用较大。在试件变形从应力–应变曲线的线性阶段开始到裂尖破裂阶段,渗透环境的影响对应力以及变形所经历的时间大小起主要决定作用;在试件变形从裂尖破裂到裂隙贯通阶段,应力以及变形所经历的时间受化学腐蚀程度和渗透环境共同影响。渗透环境对砂岩强度的影响非常明显,无渗透环境下试件的强度远大于渗透环境下试件的强度,如试件经浓度为0.01 mol/L,pH值为2的NaCl溶液腐蚀后,其强度只有无渗透环境下的16.6%。

离体猪肺动脉性纹理和静脉性纹理CT研究

目的 评估CT能否区分正常离体猪肺动脉性纹理和静脉性纹理。方法 对正常成年新鲜猪肺共 3 0只(左肺 14只 ;右肺 16只。运用螺旋CT进行扫描 ,并应用三维重建MIP等技术对其动静脉性纹理分析 ,应用标本动静脉分别解剖 ,血管铸形标本制作等进行证实。结果 离体猪肺皆分左、舌、右三肺 ;左肺 :上、中、下叶均有占85 .7% ,仅有上、下叶占 14.3 % ;右肺 :上、中、下均有占 93 .75 % ,仅有上、下叶占 8.3 %。通过薄层SpiralCT扫描及MIP技术重建 ,可较好地进行分段及亚段 ;应用经Kassab等人改良的Strahler氏分级系统来评价猪肺动静脉的分级、直径大小 ,发现在CT上能分辨 6～ 7级 ,但只能测量至 4～ 5级 ;段级以上和亚段级以下至 6～ 7级动静脉走行位置和发出角度有差异。结论 螺旋CT可较好辨识至 6～ 7级离体猪肺的动脉和静脉 。

CT试样焊缝界面裂纹蠕变断裂参量估算的数值模拟研究

针对双材料紧凑拉伸试样,提出了加权平均C的概念,即双材料CT(Compact Tension)试样的C总是可以通过对由其母材和焊材组成的均质CT试样C的加权平均计算而得到,进而基于美国ASTM标准E1457,提出了一个双材料CT试样C的估算式,以用于简单估算特定材料CT试样的C值。采用ABAQU S软件,通过有限元法模拟分析裂纹处于焊缝界面的双材料CT试样和分别由其母材和焊材组成的均质CT试样的蠕变断裂性能,验证了加权平均C概念的正确性,同时也验证了上述估算双材料CT试样C方法的可行性。

基于三维CT试样的X65钢裂纹扩展规律研究

海底管道是运输石油、天然气等战略资源最为安全和经济的方式,X65钢作为管道钢的主要制造材料,其稳定性和安全性备受关注。针对X65钢的疲劳裂纹扩展问题,建立三维紧凑拉伸(CT)试样的有限元模型,分别用扩展有限元法(XFEM)和专业裂纹扩展仿真软件模拟裂纹准静态和动态扩展过程,通过疲劳试验对模拟结果进行验证。结果表明:基于裂纹动态扩展的数值模拟结果更接近实际情况,通过疲劳试验测得的K值与裂纹动态扩展模拟值相差小于3%,而与XFEM和解析公式值在裂纹扩展后期相差6.8%。针对现行规范解析公式基于平面假设问题,提出一种适用于三维应力状态的标准CT试样裂尖应力强度因子计算改进公式,得到基于Paris公式的裂纹扩展速率线性拟合参数lgC=-8.222 3,m=2.966 4。

铸造E级钢CT试样疲劳裂纹扩展试验与仿真分析

为准确获取铸造E级钢材料的断裂力学参数,并研究该材料的裂纹扩展规律和影响因素,开展了铸造E级钢CT试样的疲劳裂纹扩展试验,并将材料的裂纹扩展速率采用Paris公式进行表征;以CT试样裂纹扩展计算模型为例,采用M积分数值方法计算了5组试样疲劳裂纹扩展长度与载荷循环周期结果,仿真与试验相对误差在10%以内,具有较好的一致性。通过进一步对比分析试验与仿真的误差原因,载荷幅值为主要误差要素,初始裂纹位置、扩展速率参数、裂纹长度参量影响较小,从而为复杂结构三维疲劳裂纹扩展规律的预测提供参考。

CT尸体标本扫描在解剖实验教学中的应用效果

通过应用X线计算机断层摄影(computed tomography,CT)扫描尸体标本构建新型解剖学实验教学模式,既可增加学生通过传统的解剖教学方法获得解剖知识,同时还能加强学生对基础解剖知识与临床CT影像知识的联系,提高学生的学习兴趣和将来进行临床实践操作的信心。该教学模式具有向基础或临床实验教学推广的价值。