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三维打印技术在苗勒管异常评估中的个性化医疗作用

Personalized medicine in the evaluation of Müllerian anomalies: the role of three-dimensional printing technology.

作者信息

Garcia de Paredes Jessica, Gosnell Jordan, Thakur Mili, Cordoba Marcos

机构信息

Department of Obstetrics, Gynecology and Women's Health, Corewell Health, Grand Rapids, Michigan.

Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, Michigan.

出版信息

F S Rep. 2024 May 16;5(3):279-284. doi: 10.1016/j.xfre.2024.05.003. eCollection 2024 Sep.

DOI:10.1016/j.xfre.2024.05.003
PMID:39381655
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11456633/
Abstract

OBJECTIVE

To present the comprehensive methodology for generating personalized three-dimensional (3D) printed uterine models from 3D ultrasound (US) volumes in individuals diagnosed with Müllerian anomalies and discuss potential applications in the field of reproductive endocrinology and infertility.

DESIGN

Pilot study.

SETTING

Single large university-affiliated teaching hospital.

PATIENTS

Patients with the presence of a Müllerian anomaly between the ages of 18 and 45 years attending the maternal-fetal medicine as well as reproductive endocrinology and infertility outpatient offices from 2018 to 2023 were included in the study.

INTERVENTIONS

Subjects underwent 3D US transvaginal scanning for the collection of data. The 3D US volumes were acquired, edited, and exported from a US cart Voluson E10 system (GE Healthcare, Chicago, IL). High-definition virtual models were created and modified, making them suitable for printing using Materialise 3-Matic Medical (Materialise NV, Leuven, Belgium). The models were printed on a J5 MediJet 3D printer (Stratasys, Rehovot, Israel). Colors were set to mimic a realistic appearance, and shore values were set before printing.

MAIN OUTCOME MEASURES

Successful creation and utilization of personalized 3D-printed uterine models for individuals with Müllerian anomalies.

RESULTSS

Three-dimensional models were created for a uterus without anomalies, 2 variations of a partial septum, a unicornuate, and a didelphys uterus. Models were used as a tactile and customized tool for patient education, counseling, and medical student and resident teaching. This technique illustrates that the creation of personalized 3D-printed uterine models for utilization in the fields of reproductive endocrinology and infertility is feasible.

CONCLUSIONS

We propose a novel use of individualized 3D-printed uterine models in the evaluation of individuals with Müllerian anomalies. These models may play a complementary role to standard imaging options in the assessment of these anomalies, with a special potential for application in highly complex or yet-to-be-determined types of anomalies.

摘要

目的

介绍从三维超声(US)容积为诊断为苗勒氏管异常的个体生成个性化三维(3D)打印子宫模型的综合方法,并讨论其在生殖内分泌学和不孕症领域的潜在应用。

设计

试点研究。

地点

一所大型大学附属教学医院。

患者

2018年至2023年在母胎医学以及生殖内分泌学和不孕症门诊就诊的18至45岁患有苗勒氏管异常的患者纳入研究。

干预措施

受试者接受经阴道三维超声扫描以收集数据。三维超声容积从超声设备Voluson E10系统(通用电气医疗集团,伊利诺伊州芝加哥)获取、编辑并导出。创建并修改高清虚拟模型,使其适合使用Materialise 3-Matic Medical(Materialise NV,比利时鲁汶)进行打印。模型在J5 MediJet 3D打印机(Stratasys,以色列雷霍沃特)上打印。打印前设置颜色以模仿逼真外观并设置邵氏硬度值。

主要观察指标

为患有苗勒氏管异常的个体成功创建并利用个性化3D打印子宫模型。

结果

为一个无异常的子宫、部分纵隔的2种变异、单角子宫和双子宫创建了三维模型。模型用作患者教育、咨询以及医学生和住院医师教学的触觉和定制工具。该技术表明为生殖内分泌学和不孕症领域创建个性化3D打印子宫模型以供使用是可行的。

结论

我们提出在评估苗勒氏管异常个体时创新性地使用个体化3D打印子宫模型。这些模型在评估这些异常情况时可能对标准成像方法起到补充作用,在高度复杂或尚未确定类型的异常情况中具有特殊的应用潜力。

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本文引用的文献

1
Individualized medicine using 3D printing technology in gynecology: a scoping review.3D打印技术在妇科领域的个性化医疗:一项范围综述
3D Print Med. 2023 Mar 17;9(1):6. doi: 10.1186/s41205-023-00169-9.
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Antenatal Three-Dimensional Printing for Ex Utero Intrapartum Treatment Procedures.产前三维打印在子宫外产时治疗程序中的应用。
Obstet Gynecol. 2022 Feb 1;139(2):313-316. doi: 10.1097/AOG.0000000000004650.
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ASRM müllerian anomalies classification 2021.美国生殖医学学会 Müllerian 畸形分类 2021 版
Fertil Steril. 2021 Nov;116(5):1238-1252. doi: 10.1016/j.fertnstert.2021.09.025.
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Comparison of segmentation software packages for in-hospital 3D print workflow.用于医院内3D打印工作流程的分割软件包比较
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Accuracy and dosimetric parameters comparison of 3D-printed non-coplanar template-assisted computed tomography-guided iodine-125 seed ablative brachytherapy in pelvic lateral recurrence of gynecological carcinomas.3D打印非共面模板辅助计算机断层扫描引导的碘-125粒子消融近距离放射治疗妇科癌盆腔侧方复发的准确性和剂量学参数比较
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Comparing three-dimensional models of placenta accreta spectrum with surgical findings.比较胎盘植入谱系的三维模型与手术结果。
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Three-Dimensional-Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas.三维打印子宫模型在剖宫产术中多发性子宫肌瘤复杂病例的手术规划中的应用。
Obstet Gynecol. 2019 Apr;133(4):720-724. doi: 10.1097/AOG.0000000000003107.
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