Kiraly Laszlo, Kiraly Balint, Szigeti Krisztian, Tamas Csaba Zsolt, Daranyi Sandor
Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi.
Department of Public Health, Semmelweis University, Budapest, Hungary.
Quant Imaging Med Surg. 2019 Jan;9(1):115-126. doi: 10.21037/qims.2018.12.05.
Education and training of morphology for medical students, and professionals specializing in pediatric cardiology and surgery has traditionally been based on hands-on encounter with congenitally malformed cardiac specimens. Large international archives are no longer widely available due to stricter data protection rules, a reduced number of autopsies, attrition rate of existing specimens, and most importantly due to a higher survival rate of patients. Our Cardiac Archive houses about 400 cardiac specimens with congenital heart disease. The collection spans almost 60 years and thus goes back to pre-surgical era. Unfortunately, attrition rate due to desiccation has led to an increased natural decay in recent years. The present multi-institutional project focuses on saving the collection by digitization. Specimens are scanned by high-resolution micro-CT/MRI. Virtual 3D-models are segmented and a comprehensive database is built. We now report an initial feasibility study with six test specimens that provided promising results, however, adequate presentation of the intracardiac anatomy, including septa and cardiac valves requires further refinements. Computer assisted design methods are necessary to overcome consequences of pathological examination, shrinkage and/or distortion of the specimens. For a next step, we anticipate an expandable web-based virtual museum with interactive reference and training tools. Web access for professional third parties will be provided by registration/subscription. In a future phase, segmental wall motion data could be added to virtual models. 3D-printed models may replace actual specimens and serve as hands-on surgical training to elucidate complex morphologies, promote surgical emulation, and extract more accurate procedural knowledge based on such a collection.
医学生以及小儿心脏病学和外科专业人员的形态学教育与培训传统上是基于对先天性心脏畸形标本的实际接触。由于更严格的数据保护规则、尸检数量减少、现有标本的损耗率，以及最重要的是患者存活率提高，大型国际档案库已不再广泛可用。我们的心脏档案库收藏了约400个先天性心脏病心脏标本。该收藏跨越了近60年，因此可以追溯到手术前时代。不幸的是，近年来由于干燥导致的损耗率使得自然腐烂加剧。目前的多机构项目专注于通过数字化来保存这些收藏。标本通过高分辨率微型计算机断层扫描/磁共振成像进行扫描。对虚拟三维模型进行分割，并建立一个综合数据库。我们现在报告一项对六个测试标本的初步可行性研究结果，该研究取得了有前景的成果，然而，要充分展示心脏内部解剖结构，包括隔膜和心脏瓣膜，还需要进一步完善。必须采用计算机辅助设计方法来克服病理检查、标本收缩和/或变形带来的影响。下一步，我们预计会有一个可扩展的基于网络的虚拟博物馆，具备交互式参考和培训工具。专业第三方可通过注册/订阅来访问该网站。在未来阶段，可以将节段性壁运动数据添加到虚拟模型中。三维打印模型可能会取代实际标本，并作为实践手术培训工具，以阐明复杂的形态学特征，促进手术模拟，并基于这样的收藏提取更准确的手术知识。
