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先天性心脏病患者特异性三维打印的临床价值:定量和定性评估。

Clinical value of patient-specific three-dimensional printing of congenital heart disease: Quantitative and qualitative assessments.

机构信息

Department of Medical Radiation Sciences, Curtin University, Perth, Australia.

Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

PLoS One. 2018 Mar 21;13(3):e0194333. doi: 10.1371/journal.pone.0194333. eCollection 2018.


DOI:10.1371/journal.pone.0194333
PMID:29561912
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5862481/
Abstract

OBJECTIVE: Current diagnostic assessment tools remain suboptimal in demonstrating complex morphology of congenital heart disease (CHD). This limitation has posed several challenges in preoperative planning, communication in medical practice, and medical education. This study aims to investigate the dimensional accuracy and the clinical value of 3D printed model of CHD in the above three areas. METHODS: Using cardiac computed tomography angiography (CCTA) data, a patient-specific 3D model of a 20-month-old boy with double outlet right ventricle was printed in Tango Plus material. Pearson correlation coefficient was used to evaluate correlation of the quantitative measurements taken at analogous anatomical locations between the CCTA images pre- and post-3D printing. Qualitative analysis was conducted by distributing surveys to six health professionals (two radiologists, two cardiologists and two cardiac surgeons) and three medical academics to assess the clinical value of the 3D printed model in these three areas. RESULTS: Excellent correlation (r = 0.99) was noted in the measurements between CCTA and 3D printed model, with a mean difference of 0.23 mm. Four out of six health professionals found the model to be useful in facilitating preoperative planning, while all of them thought that the model would be invaluable in enhancing patient-doctor communication. All three medical academics found the model to be helpful in teaching, and thought that the students will be able to learn the pathology quicker with better understanding. CONCLUSION: The complex cardiac anatomy can be accurately replicated in flexible material using 3D printing technology. 3D printed heart models could serve as an excellent tool in facilitating preoperative planning, communication in medical practice, and medical education, although further studies with inclusion of more clinical cases are needed.

摘要

目的:目前的诊断评估工具在展示先天性心脏病(CHD)的复杂形态方面仍然不够理想。这在术前规划、医疗实践中的沟通以及医学教育方面带来了诸多挑战。本研究旨在探讨 CHD 的 3D 打印模型在上述三个领域的维度准确性和临床价值。

方法:使用心脏计算机断层血管造影(CCTA)数据,以 Tango Plus 材料打印出一名 20 个月大的右心室双出口男婴的患者特异性 3D 模型。采用 Pearson 相关系数评估 CCTA 图像在 3D 打印前后类似解剖位置的定量测量值之间的相关性。通过向六位医疗专业人员(两位放射科医生、两位心脏病专家和两位心脏外科医生)和三位医学学者分发调查问卷,对 3D 打印模型在这三个领域的临床价值进行定性分析。

结果:CCTA 和 3D 打印模型之间的测量值具有极好的相关性(r=0.99),平均差异为 0.23 毫米。六位医疗专业人员中有四位认为该模型有助于术前规划,而他们均认为该模型将在增强医患沟通方面具有极大价值。三位医学学者均认为该模型有助于教学,认为学生能够更快地学习病理学,理解也会更加深入。

结论:3D 打印技术可以在灵活的材料上准确复制复杂的心脏解剖结构。3D 打印心脏模型可以成为促进术前规划、医疗实践中的沟通以及医学教育的极好工具,尽管还需要进一步的研究,纳入更多的临床病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/995c4c0e3980/pone.0194333.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/60102e49b165/pone.0194333.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/f1e784d2c7ed/pone.0194333.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/0c03bc0365ea/pone.0194333.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/01fffa92ff11/pone.0194333.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/def39b28ec19/pone.0194333.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/1c17379b4471/pone.0194333.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/995c4c0e3980/pone.0194333.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/60102e49b165/pone.0194333.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/f1e784d2c7ed/pone.0194333.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/0c03bc0365ea/pone.0194333.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/01fffa92ff11/pone.0194333.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/def39b28ec19/pone.0194333.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/1c17379b4471/pone.0194333.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c782/5862481/995c4c0e3980/pone.0194333.g007.jpg

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本文引用的文献

[1]
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[2]
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Three-dimensional printing in congenital heart disease: A systematic review.

J Med Radiat Sci. 2018-9

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Three-dimensional printed models for surgical planning of complex congenital heart defects: an international multicentre study.

Eur J Cardiothorac Surg. 2017-12-1

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BMC Med Educ. 2017-3-11

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