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三维打印有助于胸外科的解剖研究、器械开发、模拟和规划。

Three-dimensional printing to facilitate anatomic study, device development, simulation, and planning in thoracic surgery.

机构信息

Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY.

Department of Biomedical Engineering, Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo, Buffalo, NY.

出版信息

J Thorac Cardiovasc Surg. 2015 Apr;149(4):973-9.e1. doi: 10.1016/j.jtcvs.2014.12.059. Epub 2015 Jan 8.


DOI:10.1016/j.jtcvs.2014.12.059
PMID:25659851
Abstract

BACKGROUND: The development and deployment of new technologies in additive 3-dimensional (3D) printing (ie, rapid prototyping and additive manufacturing) in conjunction with medical imaging techniques allow the creation of anatomic models based on patient data. OBJECTIVE: To explore this rapidly evolving technology for possible use in care and research for patients undergoing thoracic surgery. METHODS: Because of an active research project at our institution on regional lung chemotherapy, human pulmonary arteries (PAs) were chosen for this rapid prototyping project. Computed tomography (CT) and CT angiography in combination with segmentation techniques from 2 software packages were used for rapid generation and adjustment of the 3D polygon mesh and models reconstruction of the PAs. The reconstructed models were exported as stereolithographic data sets and further processed by trimming, smoothing, and wall extrusion. RESULTS: Flexible 3D printed replicas of 10 patient PAs were created successfully with no print failures; however, 1 initial test print with a 1 mm mural thickness was too fragile so the whole group was printed with a 1.5 mm wall. The design process took 8 hours for each model (CT image to stereolithographic) and printing required 97 hours in aggregate. Useful differences in anatomy were defined by this method, such as the expected greater number of proximal branches on the left versus right (2.5 ± 1.1 vs 1.0 ± 0.0; P = .001). CONCLUSIONS: Reconstructed models of pulmonary arteries using 3D rapid prototyping allow replication of sophisticated anatomical structures that can be used to facilitate anatomic study, surgical planning, and device development.

摘要

背景:与医学成像技术相结合的新型增材 3 维(3D)打印(即快速原型制造和增材制造)技术的发展和应用,使得基于患者数据创建解剖模型成为可能。

目的:探索这一快速发展的技术,以便在接受胸外科手术的患者的护理和研究中可能得到应用。

方法:由于我们机构正在进行一项关于区域性肺化疗的主动研究项目,因此选择人类肺动脉(PA)进行这项快速原型制作项目。使用来自 2 个软件包的计算机断层扫描(CT)和 CT 血管造影以及分割技术,快速生成和调整 3D 多边形网格,并重建 PA 的模型。将重建的模型导出为立体光刻数据集,并进一步进行修剪、平滑和壁面挤压处理。

结果:成功地制作了 10 个患者 PA 的柔性 3D 打印复制品,没有打印失败;然而,初始测试打印的壁厚度为 1 毫米,结果太脆弱,因此整个组都打印为 1.5 毫米壁。每个模型的设计过程耗时 8 小时(从 CT 图像到立体光刻),总打印时间为 97 小时。通过这种方法定义了有用的解剖差异,例如预期左肺近端分支的数量会多于右肺(2.5±1.1 比 1.0±0.0;P=0.001)。

结论:使用 3D 快速成型技术重建肺动脉模型,可以复制复杂的解剖结构,用于促进解剖学研究、手术规划和器械开发。

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