Olivieri Laura J, Krieger Axel, Loke Yue-Hin, Nath Dilip S, Kim Peter C W, Sable Craig A
Division of Cardiology, Children's National Medical Center, Washington, District of Columbia; Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, District of Columbia.
Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, Washington, District of Columbia.
J Am Soc Echocardiogr. 2015 Apr;28(4):392-7. doi: 10.1016/j.echo.2014.12.016. Epub 2015 Feb 7.
With the advent of three-dimensional (3D) printers and high-resolution cardiac imaging, rapid prototype constructions of congenital cardiac defects are now possible. Typically, source images for these models derive from higher resolution, cross-sectional cardiac imaging, such as cardiac magnetic resonance imaging or computed tomography. These imaging methods may involve intravenous contrast, sedation, and ionizing radiation. New echocardiographic transducers and advanced software and hardware have optimized 3D echocardiographic images for this purpose. Thus, the objectives of this study were to confirm the feasibility of creating cardiac models from 3D echocardiographic data and to assess accuracy by comparing 3D model measurements with conventional two-dimensional (2D) echocardiographic measurements of cardiac defects.
Nine patients undergoing 3D echocardiography were identified (eight with ventricular septal defects, one with three periprosthetic aortic valve leaks). Raw echocardiographic image data were exported anonymously and converted to Digital Imaging and Communications in Medicine format. The image data were filtered for noise reduction, imported into segmentation software to create a 3D digital model, and printed. Measurements of the defects from the 3D model were compared with defect measurements from conventional 2D echocardiographic data. Meticulous care was taken to ensure identical measurement planes.
Long- and short-axis measurements of eight ventricular septal defects and three perivalvar leaks were obtained. Mean ± SD values for the 3D model measurements and conventional 2D echocardiographic measurements were 7.5 ± 6.3 and 7.1 ± 6.2 mm respectively (P = .20), indicating no significant differences between the standard 2D and 3D model measurements. The two groups were highly correlated, with a Pearson correlation coefficient of 0.988. The mean absolute error (2D - 3D) for each measurement was 0.4 ± 0.9 mm, indicating accuracy of the 3D model of <1 mm.
Three-dimensional printed models of echocardiographic data are technically feasible and may accurately reflect ventricular septal defect anatomy. Three-dimensional models derived from 3D echocardiographic data sets represent a new tool in procedural planning for children with congenital heart disease.
随着三维（3D）打印机和高分辨率心脏成像技术的出现，现在可以对先天性心脏缺陷进行快速原型构建。通常，这些模型的源图像来自更高分辨率的横断面心脏成像，如心脏磁共振成像或计算机断层扫描。这些成像方法可能涉及静脉造影剂、镇静和电离辐射。新型超声心动图换能器以及先进的软件和硬件已为此目的优化了三维超声心动图图像。因此，本研究的目的是确认从三维超声心动图数据创建心脏模型的可行性，并通过将三维模型测量结果与心脏缺陷的传统二维（2D）超声心动图测量结果进行比较来评估准确性。
确定了9例接受三维超声心动图检查的患者（8例室间隔缺损，1例人工主动脉瓣周围三处漏血）。超声心动图原始图像数据被匿名导出并转换为医学数字成像和通信格式。对图像数据进行滤波以降低噪声，导入分割软件以创建三维数字模型并进行打印。将三维模型的缺陷测量结果与传统二维超声心动图数据的缺陷测量结果进行比较。非常小心地确保测量平面相同。
获得了8例室间隔缺损和3例瓣周漏的长轴和短轴测量值。三维模型测量值和传统二维超声心动图测量值的平均值±标准差分别为7.5±6.3和7.1±6.2毫米（P = 0.20），表明标准二维和三维模型测量值之间无显著差异。两组高度相关，Pearson相关系数为0.988。每次测量的平均绝对误差（二维 - 三维）为0.4±0.9毫米，表示三维模型的精度<1毫米。
超声心动图数据的三维打印模型在技术上是可行的，并且可以准确反映室间隔缺损的解剖结构。从三维超声心动图数据集导出的三维模型是先天性心脏病患儿手术规划中的一种新工具。
