用于经皮肾镜取石术模拟的肾脏3D打印模型研究初探  

Application of 3D-printing kidney and stones for PCNL planning and teaching： a preliminary research

作　　者：汤润[1] 刘林[1] 时湛 苗龙[1] 孙晓青[1] 朱海涛[1] 

机构地区：[1]徐州医学院附属医院泌尿外科,221002

出　　处：《中华泌尿外科杂志》2015年第12期886-890,共5页Chinese Journal of Urology

基　　金：江苏省卫生科研项目（H201321）

摘　　要：目的 研究并设计可用于经皮肾镜取石术（PCNL）临床和教学的肾结石3D肾脏模型.方法 选取2015年3月1日至2015年6月1日5例肾结石患者CT尿路造影（CT urography,CTU）DICOM格式的原始CTU数据.使用Mimics软件对二维CT图像依次进行阈值选取、区域增长、处理模具、多层编辑修饰等过程,最终获得完整的肾脏3D模型,通过3D打印机打印出患者的3D肾脏模型,测量各模型的具体大小,分别将模型与患者的肾脏长径、横径和结石最长径进行配对t检验.由高年资主任医师和住院医师对打印出的肾脏模型进行模拟穿刺.结果 5例肾脏3D模型成功设计并打印.3D模型与患者肾脏长径的平均差值为0.283 cm,横径的平均差值为0.212 cm,结石最长径的平均差值为0.244 cm.肾脏3D模型大小与CT测定的肾脏基本吻合,差异无统计学意义（P＞0.05）.由主任医师在手术室模拟手术环境向住院医师示范穿刺肾脏模型,肾脏模型可成功用于模拟穿刺和教学示范.结论 3D打印出的肾脏真实还原了患者肾脏及结石的解剖细节,为医师提供了立体直观的观察器官解剖的方式,对于手术规划和教学模拟穿刺有积极意义.Objective To explore the possibility of three-dimensional （3D） kidney replications for clinical and teaching of percutaneous nephrolithotomy （PCNL）.Methods The CT urography （CTU） DICOM format data from 5 patients with kidney calculi were selected from March 1st to June 1st,2015.Thresholding technique,region growing technique,edit mask technique and multiple slice edit technique were used in sequence by Mimics software.And five 3D replications were printed by Object 500 3D printer.The sizes of the replications were measured and the replications were punctured.Results The 3D replications of the kidneys were successfully designed and printed.The average difference of the long axes between 3D replications and patients＇ kidneys was 0.283cm,the average difference of the diameters was 0.212cm,and the average difference of the diameter of the stones was 0.244cm.The sizes of the 3D replications were basically consistent with those of patients＇ kidneys.The simulative puncturing was successful.Conclusions After comparing the 3D replications with their original 2D CT images,the anatomical details are found basically the same.The 3D replications could provide 3D visual observations of organ anatomy for surgeons.

关 键 词：肾结石 肾造口术 经皮 3D打印 手术模拟 教学培训 

分 类 号：TP391.73[自动化与计算机技术—计算机应用技术] R699.2[自动化与计算机技术—计算机科学与技术]