Knox K, Kerber Charles W, Singel S A, Bailey M J, Imbesi S G
Departments of Radiology/Neurosurgery, University of California-San Diego, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103, USA.
Catheter Cardiovasc Interv. 2005 May;65(1):47-53. doi: 10.1002/ccd.20333.
Our goal was to develop and prove the accuracy of a system that would allow us to re-create live patient arterial pathology. Anatomically accurate replicas of blood vessels could allow physicians to teach and practice dangerous interventional techniques and might also be used to gather basic physiologic information. The preparation of replicas has, until now, depended on acquisition of fresh cadaver material. Using rapid prototyping, it should be able to replicate vascular pathology in a live patient. We obtained CT angiographic scan data from two patients with known arterial abnormalities. We took such data and, using proprietary software, created a 3D replica using a commercially available rapid prototyping machine. From the prototypes, using a lost wax technique, we created vessel replicas, placed those replicas in the CT scanner, then compared those images with the original scans. Comparison of the images made directly from the patient and from the replica showed that with each step, the relationships were maintained, remaining within 3% of the original, but some smoothing occurred in the final computer manipulation. From routinely obtainable CT angiographic data, it is possible to create accurate replicas of human vascular pathology with the aid of commercially available stereolithography equipment. Visual analysis of the images appeared to be as important as the measurements. With 64 and 128 slice detector scanners becoming available, acquisition times fall enough that we should be able to model rapidly moving structures such as the aortic root.
我们的目标是开发并证明一种系统的准确性,该系统能让我们重现真实患者的动脉病变情况。血管的解剖学精确复制品可使医生教授和练习危险的介入技术,还可能用于收集基本生理信息。到目前为止,复制品的制备依赖于获取新鲜尸体材料。利用快速成型技术,应该能够复制真实患者的血管病变。我们从两名已知动脉异常的患者那里获取了CT血管造影扫描数据。我们获取这些数据,然后使用专有软件,通过一台商用快速成型机制作了一个3D复制品。从这些原型出发,我们采用失蜡法制作血管复制品,将这些复制品放入CT扫描仪中,然后将这些图像与原始扫描图像进行比较。直接从患者和复制品获得的图像比较显示,每一步操作后,两者的关系都得以保持,与原始图像的偏差在3%以内,但在最后的计算机处理过程中出现了一些平滑现象。借助商用立体光刻设备,从常规获取的CT血管造影数据中有可能创建人体血管病变的精确复制品。图像的视觉分析似乎与测量同样重要。随着64层和128层探测器扫描仪的出现,采集时间大幅缩短,我们应该能够对诸如主动脉根部等快速移动的结构进行建模。