3D打印技术在骨肿瘤手术术前规划中的初步应用.pdfVIP

3D勿印拔术在机中建手术水前规划中的初步应用 孙涛①崔林江①窦超超① 摘要 目的:探讨3D打印技术在骨肿瘤术前规划中的应用方法及价值。方法:选取1例股骨下段肿瘤患者(软骨肉瘤) , 进行CT扫描股骨下段，层厚O.625rnrn ，得到二维原始图像以DlCOM格式输出，采用Mirnics三维重建软件，重建出股骨下段三 维模型，通过蒙版编辑(Edi t Masks) 重建股骨下段肿瘤的三维模型，通过布尔运算，得出股骨下段去除肿瘤的三维模型， 3D打印出股骨下段带肿瘤、去肿瘤及肿瘤的三维仿真模型。在重建的股骨下段三维模型基础上，进行肿瘤大小的测量，截 取植入骨块大小的估算，设计内固定铜板的预折弯、螺钉置入的最佳位置并精确测量螺钉的长度、角度等数据，初步指导 临床应用，并与术后影像学资料进行对比分析。结果:手术用时及出血量减少了近一半，实现了微创、精准的手术目标。 术后X光片检查显示，植骨块位置良好，恢复了骨肿瘤区域解剖结构，内固定物放置位置准确。结论: 3D打印模型能够很好 地显示骨肿瘤的解剖关系，可以有效帮助医生进行术前手术规划，初步临床应用效果良好。 关键词 3D打印三维重建手术规划骨肿瘤 Doi:l0.3969/j.issn.1673-7571.2016.09.025 [中图分类号] R319;R68 [文献标识码]A Primary Clinical Application of 3D Printing Technique in Bone Tumor Operation Design I SUN Tao , CUI Lin-jiang , DOU Chao-chaollChina Digital Medicine.-2016 11(9): 74 to 76 Abstract 0问jective: To explore the application method and value of 3D printing technology in preoperative planning of bone tumo r. Methods: The CT scanning of 1 patients suffered 丘om distal femoral chondrosarcoma were conducted , thickness 0.625mm , two-dimensional original image output in DICOM format , using Mimics three-dimensional reconstruction software , three- dimensional model reconstruction of femoral segr丑ent， through the mask editor (Edit Masks) 3D model reconstruction of distal femur tumor. Through Boolean operation , that the distal femur tumor removal of 3D model , 3D print out the femur with tumors , a 3D simulation model toωmor and tumor. In the reconstruction of the femur 3D model based on the measurement of tumor size , bone block size estimation of interception , pre bending plate design in the optimum position of screw placement and accurate measurement of the screw length , angle data , preliminary clinical applications , and postoperative imaging data were analyzed. Results: Operation time and the amount of bleeding were c