3D打印技术在精准肝切除术前评估的应用

发布时间：2018-08-13 12:38

【摘要】：目的探讨医学3D打印技术、三维重建技术在精准肝切除术前评估的应用价值。方法回顾性分析2016年1月至2016年12月在宁夏医科大学总医院肝胆外科6例复杂性肝脏肿瘤患者临床资料。其中男4例,女2例,平均年龄54岁。患者术前经64排上腹部增强CT扫描,获取薄层扫描DICOM数据,使用三维可视化软件(MI-3DVS)进行三维重建,将重建的STL格式文件数据导入3D打印机,采用树脂及石膏材料打印出1:1肝脏物理模型,分析肝脏解剖、术前评估并进行术前模拟,结合三维重建数据,在3D打印肝脏模型指导下行精准肝脏切除。结果全部患者进行了肝脏三维重建及肝脏3D打印,能清晰显示肝内脉管系统、肝脏及肿瘤组织解剖形态、肿瘤与肝内血管结构毗邻关系,准确计算肝脏体积、肿瘤体积等。根据三维重建及3D打印肝脏模型结果,6例患者均行精准肝切除,实际手术过程与术前手术规划完全符合(6/6),模拟切除肝脏体积与实际切除肝脏体积显著相关,无围手术期期死亡,无严重手术并发症。结论医学3D打印技术可应用于肝脏肿瘤的手术规划,在精准肝切除的术前评估有一定的指导意义。
[Abstract]:Objective to evaluate the value of 3 D printing and 3 D reconstruction in the evaluation of accurate hepatectomy. Methods from January 2016 to December 2016, the clinical data of 6 patients with complicated hepatic tumors in the Department of Hepatobiliary surgery, Ningxia Medical University General Hospital were retrospectively analyzed. There were 4 males and 2 females with an average age of 54 years. Before operation, the patients were scanned by 64 rows of enhanced upper abdomen CT to obtain thin layer scanning DICOM data, and 3D reconstruction was carried out by using 3D visualization software (MI-3DVS). The reconstructed STL format file data was imported into 3D printer. The 1:1 liver physical model was printed with resin and gypsum, and the liver anatomy was analyzed. The liver was evaluated and simulated before operation. Combined with 3D reconstruction data, the accurate liver resection was guided by 3D printed liver model. Results all the patients underwent 3D liver reconstruction and 3D printing, which could clearly display the intrahepatic vascular system, the anatomical morphology of liver and tumor tissue, the adjacent relationship between tumor and intrahepatic vascular structure, and accurately calculate the volume of liver and tumor. According to the results of 3D reconstruction and 3D printing liver model, all 6 patients underwent accurate hepatectomy. The actual operation process was in good agreement with the preoperative operation planning (6 / 6). The simulated liver volume was significantly correlated with the actual liver volume, and no perioperative death was found. There were no severe surgical complications. Conclusion Medical 3D printing technique can be used in the planning of liver tumor surgery, and it has certain guiding significance in preoperative evaluation of accurate hepatectomy.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7;TP391.73

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