CT和MRI图像配准融合联合3D打印技术在难治性骨盆肿瘤术前规划中的应用

发布时间：2018-03-29 02:33

  本文选题：磁共振成像　切入点：图像配准　出处：《上海交通大学学报(医学版)》2017年09期

【摘要】：目的·探讨CT、MRI图像配准融合联合3D打印技术,在辅助难治性骨盆肿瘤术前规划中的应用价值。方法·回顾性总结2014年3月至2016年12月于上海交通大学医学院附属第九人民医院接受治疗的难治性骨盆肿瘤病例,术前常规行薄层CT、MRI检查,借助Medraw软件实现CT、MRI图像快速配准融合,精确判定肿瘤安全边界,辅助设计并3D打印个体骨盆肿瘤模型、假体和(或)导板。结果·共纳入难治性骨盆肿瘤患者13例(软骨肉瘤8例、骨肉瘤合并动脉瘤样骨囊肿1例、未分化性肉瘤1例、纤维结缔组织增生性纤维瘤1例、孤立性纤维瘤/血管外皮瘤1例、转移性鳞癌1例),平均年龄(50.0±8.5)岁。基于Enneking分区:Ⅰ区2例、Ⅰ+Ⅱ区2例、Ⅱ+Ⅲ区1例、Ⅰ+Ⅱ+Ⅲ区3例、Ⅰ+Ⅱ+Ⅳ区1例、Ⅰ+Ⅱ+Ⅲ+Ⅳ区1例、Ⅰ+Ⅳ区1例、Ⅱ+Ⅳ区1例、Ⅳ区1例。肿瘤最大直径平均值(15.15±4.81)cm,均未累及盆腔大血管。结合术中肿瘤边界快速冰冻结果及假体安装情况,判断基于融合图像的术前评估、规划的虚拟手术方案与手术的实施一致。结论·薄层CT、MRI图像配准融合联合3D打印技术,可以精确判定难治性骨盆肿瘤边界,辅助临床设计个体化3D打印假体和导板,在难治性骨盆肿瘤术前规划中具有重要的临床应用价值。
[Abstract]:Objective to explore the technique of CT MRI image registration and fusion combined with 3D printing. Methods from March 2014 to December 2016, patients with refractory pelvic tumors received treatment at the Ninth people's Hospital affiliated to Shanghai Jiaotong University School of Medicine. TLC MRI was performed before operation, and Medraw software was used to realize fast registration and fusion of CT MRI images, to accurately determine the safety boundary of tumors, and to design and 3D print individual pelvic tumor models. Results 13 patients with refractory pelvic tumors (8 chondrosarcoma, 1 osteosarcoma with aneurysm cyst, 1 undifferentiated sarcoma, 1 fibrous connective tissue proliferative fibroma) were included. One case of solitary fibroma / hemangiopericytoma and one case of metastatic squamous cell carcinoma (mean age: 50.0 卤8.5) years. Based on Enneking, there were 2 cases in zone 鈪，

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