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用于脑活检的 3D 打印个体化立体定向平台的概念 - 犬尸体研究。

A concept for a 3D-printed patient-specific stereotaxy platform for brain biopsy -a canine cadaver study.

机构信息

Fraunhofer Institute for Machine Tools and Forming Technology, Nöthnitzer Straße 44, D-01187 Dresden, Germany.

Department of Neurosurgery, University Clinic of Leipzig, Faculty of Medicine, Liebigstraße 20, D-04103 Leipzig, Germany.

出版信息

Res Vet Sci. 2019 Jun;124:79-84. doi: 10.1016/j.rvsc.2019.02.007. Epub 2019 Feb 25.

Abstract

The treatment of intracranial lesions requires a precise diagnosis with subsequent identification of an adequate therapeutic approach. Stereotactic tumor biopsy may be considered the safest neurosurgical procedure in terms of anticipated results and potential surgical complications. The aim of the present paper was to demonstrate a new method of stereotactic biopsy, based on a patient-specific 3D printed platform in dogs. The system was tested on two canine cadavers, a small (Shih Tzu) and a large (Labrador) breed. Imaginary biopsy targets were defined in a superficial (caudate nucleus) and a deep (piriform lobe) position. Based on 3 Tesla MRI, individualized stereotactic platforms were designed using a semi-automatic approach, and manufactured additively using ABS M30. A pre- and intra-operative CT was performed to compare the planned vs. the realized needle position for precision analyses of the procedure. The target points varied with a precision between 0.09 mm and 0.48 mm. Manufacturing time required 480 to 700 min per platform. The presented patient-specific stereotactic system seems a suitable instrument for application in small animal neurosurgery. In particular, the implementation of relevant stereotactic data may help performing the procedure in rapid sequence and with higher precision than currently-used systems. Required adjustments and adaptions to the respective anatomical conditions are omitted and make the procedure reliable and safe.

摘要

颅内病变的治疗需要精确的诊断,随后确定适当的治疗方法。立体定向肿瘤活检可以被认为是最安全的神经外科手术,就预期结果和潜在的手术并发症而言。本文的目的是展示一种新的基于患者特定的 3D 打印平台的立体定向活检方法,在犬类中进行测试。该系统在两只犬类尸体上进行了测试,一只体型较小(西施犬),一只体型较大(拉布拉多犬)。在想象中,将活检靶标定义为浅层(尾状核)和深层(梨状叶)位置。基于 3T MRI,使用半自动方法设计个体化的立体定向平台,并使用 ABS M30 进行增材制造。进行了术前和术中 CT 检查,以比较计划与实际的针位,以便对该过程进行精确分析。目标点的精度在 0.09 毫米到 0.48 毫米之间变化。每个平台的制造时间需要 480 到 700 分钟。所提出的患者特定的立体定向系统似乎是小动物神经外科应用的合适工具。特别是,相关立体定向数据的实施可以帮助以比当前使用的系统更高的精度快速执行该过程。省略了对相应解剖条件的必要调整和适应,使该过程可靠且安全。

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