Allan Amee, Kealley Catherine, Squelch Andrew, Wong Yin How, Yeong Chai Hong, Sun Zhonghua
Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, Australia.
Discipline of Exploration Geophysics, Western Australian School of Mines, Minerals, Energy and Chemical Engineering, Curtin University, Perth, Western Australia, Australia.
Quant Imaging Med Surg. 2019 Jan;9(1):86-93. doi: 10.21037/qims.2018.12.01.
3D printing has shown great promise in medical applications, with increasing reports in liver diseases. However, research on 3D printing in biliary disease is limited with lack of studies on validation of model accuracy. In this study, we presented our experience of creating a realistic 3D printed model of biliary ducts with congenital cyst. Measurements of anatomical landmarks were compared at different stages of model generation to determine dimensional accuracy.
Contrast-enhanced computed tomography (CT) images of a patient diagnosed with congenital cyst in the common bile duct with dilated hepatic ducts were used to create the 3D printed model. The 3D printed model was scanned on a 64-slice CT scanner using the similar abdominal CT protocol. Measurements of anatomical structures including common hepatic duct (CHD), right hepatic duct (RHD), left hepatic duct (LHD) and the cyst at left to right and anterior to posterior dimensions were performed and compared between original CT images, the standard tessellation language (STL) image and CT images of the 3D model.
The 3D printing model was successfully generated with replication of biliary ducts and cyst. Significant differences in measurements of these landmarks were found between the STL and the original CT images, and the CT images of the 3D printed model and the original CT images (P<0.05). Measurements of the RHD and LHD diameters from the original CT images were significantly larger than those from the CT images of 3D model or STL file (P<0.05), while measurements of the CHD diameters were significantly smaller than those of the other two datasets (P<0.05). No significant differences were reached in measurements of the CHD, RHD, LHD and the biliary cyst between CT images of the 3D printed model and STL file (P=0.08-0.98).
This study shows our experience in producing a realistic 3D printed model of biliary ducts and biliary cyst. The model was found to replicate anatomical structures and cyst with high accuracy between the STL file and the CT images of the 3D model. Large discrepancy in dimensional measurements was noted between the original CT and STL file images, and the original CT and CT images of the 3D model, highlighting the necessity of further research with inclusion of more cases of biliary disease to validate accuracy of 3D printed biliary models.
3D打印在医学应用中显示出巨大潜力，有关肝脏疾病的报道日益增多。然而，3D打印在胆道疾病方面的研究有限，缺乏对模型准确性验证的研究。在本研究中，我们介绍了创建先天性囊肿胆管逼真3D打印模型的经验。在模型生成的不同阶段比较解剖标志的测量值，以确定尺寸准确性。
使用一名被诊断为胆总管先天性囊肿伴肝内胆管扩张患者的增强计算机断层扫描（CT）图像创建3D打印模型。使用类似的腹部CT协议在64层CT扫描仪上扫描3D打印模型。对包括肝总管（CHD）、右肝管（RHD）、左肝管（LHD）和囊肿在内的解剖结构进行左右和前后尺寸测量，并在原始CT图像、标准镶嵌语言（STL）图像和3D模型的CT图像之间进行比较。
成功生成了具有胆管和囊肿复制的3D打印模型。在STL与原始CT图像之间，以及3D打印模型的CT图像与原始CT图像之间，这些标志的测量值存在显著差异（P<0.05）。原始CT图像中RHD和LHD直径的测量值显著大于3D模型或STL文件的CT图像中的测量值（P<0.05），而CHD直径的测量值显著小于其他两个数据集的测量值（P<0.05）。3D打印模型的CT图像与STL文件之间在CHD、RHD、LHD和胆囊肿的测量值上没有显著差异（P=0.08 - 0.98）。
本研究展示了我们制作逼真的胆管和胆囊肿3D打印模型的经验。发现该模型在STL文件和3D模型的CT图像之间能够高精度地复制解剖结构和囊肿。在原始CT与STL文件图像之间，以及原始CT与3D模型的CT图像之间，尺寸测量存在较大差异，这突出了进一步纳入更多胆道疾病病例进行研究以验证3D打印胆道模型准确性的必要性。
