三维可视化和三维打印能否改善肝段解剖学教学？一项随机对照研究。

Do Three-dimensional Visualization and Three-dimensional Printing Improve Hepatic Segment Anatomy Teaching? A Randomized Controlled Study.

作者信息

Kong Xiangxue, Nie Lanying, Zhang Huijian, Wang Zhanglin, Ye Qiang, Tang Lei, Li Jianyi, Huang Wenhua

机构信息

Department of Anatomy, Guangdong Province Key Laboratory of Medical Biomechanics, School of Basic Medicine Science, Southern Medical University, Guangzhou, Guangdong, China.

Department of Traumatic Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

J Surg Educ. 2016 Mar-Apr;73(2):264-9. doi: 10.1016/j.jsurg.2015.10.002.

DOI:10.1016/j.jsurg.2015.10.002

PMID:26868314

Abstract

INTRODUCTION

Hepatic segment anatomy is difficult for medical students to learn. Three-dimensional visualization (3DV) is a useful tool in anatomy teaching, but current models do not capture haptic qualities. However, three-dimensional printing (3DP) can produce highly accurate complex physical models. Therefore, in this study we aimed to develop a novel 3DP hepatic segment model and compare the teaching effectiveness of a 3DV model, a 3DP model, and a traditional anatomical atlas.

MATERIALS AND METHODS

A healthy candidate (female, 50-years old) was recruited and scanned with computed tomography. After three-dimensional (3D) reconstruction, the computed 3D images of the hepatic structures were obtained. The parenchyma model was divided into 8 hepatic segments to produce the 3DV hepatic segment model. The computed 3DP model was designed by removing the surrounding parenchyma and leaving the segmental partitions. Then, 6 experts evaluated the 3DV and 3DP models using a 5-point Likert scale. A randomized controlled trial was conducted to evaluate the educational effectiveness of these models compared with that of the traditional anatomical atlas.

RESULTS

The 3DP model successfully displayed the hepatic segment structures with partitions. All experts agreed or strongly agreed that the 3D models provided good realism for anatomical instruction, with no significant differences between the 3DV and 3DP models in each index (p > 0.05). Additionally, the teaching effects show that the 3DV and 3DP models were significantly better than traditional anatomical atlas in the first and second examinations (p < 0.05). Between the first and second examinations, only the traditional method group had significant declines (p < 0.05).

CONCLUSION

A novel 3DP hepatic segment model was successfully developed. Both the 3DV and 3DP models could improve anatomy teaching significantly.

摘要

引言

肝段解剖学对医学生来说很难学。三维可视化（3DV）是解剖学教学中的一种有用工具，但目前的模型无法体现触觉特性。然而，三维打印（3DP）可以制作出高度精确的复杂实体模型。因此，在本研究中，我们旨在开发一种新型的3DP肝段模型，并比较3DV模型、3DP模型和传统解剖图谱的教学效果。

材料与方法

招募一名健康受试者（50岁女性），进行计算机断层扫描。经过三维（3D）重建后，获得肝脏结构的计算3D图像。将实质模型划分为8个肝段，以制作3DV肝段模型。通过去除周围实质并保留段间隔来设计计算3DP模型。然后，6名专家使用5点李克特量表对3DV和3DP模型进行评估。进行了一项随机对照试验，以评估这些模型与传统解剖图谱相比的教育效果。

结果

3DP模型成功展示了带有间隔的肝段结构。所有专家都同意或强烈同意3D模型为解剖学教学提供了良好的真实感，3DV和3DP模型在各指标上无显著差异（p>0.05）。此外，教学效果表明，在第一次和第二次考试中，3DV和3DP模型明显优于传统解剖图谱（p<0.05）。在第一次和第二次考试之间，只有传统方法组有显著下降（p<0.05）。