3D打印技术在骨肿瘤手术术前规划中的初步应用  

Primary Clinical Application of 3D Printing Technique in Bone Tumor Operation Design

作　　者：孙涛[1] 崔林江[1] 窦超超 

机构地区：[1]青岛市中心医院(青岛大学医学院第二附属医院)骨科,山东省青岛市266042

出　　处：《中国数字医学》2016年第9期74-76,共3页China Digital Medicine

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0.625mm,得到二维原始图像以DICOM格式输出,采用Mimics三维重建软件,重建出股骨下段三维模型,通过蒙版编辑(Edit 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,设计内固定钢板的预折弯、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。Objective： To explore the application method and value of 3D printing technology in preoperative planning of bone tumor. Methods： The CT scanning of 1 patients suffered from distal femoral chondrosarcoma were conducted, thickness 0.625mnl, two-dimensional original image output in DICOM format, using Mimics three-dimensional reconstruction software, three-dimensional model reconstruction of femoral segment, 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 sinmlation model to tumor and tumor. In the reconstruction of the femur 3D model based on the lneasurement of tumor size, bone block size estimation of interception, pre bending plate design in tile optinmm 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 cut nearly in half, to achieve a minimally invasive, accurate operation goal. Postoperative X-ray examination show that bone graft in good position to restore the bone tumor regional anatomy, implant placement accuracy. Conclusion： 3D printing model can well show the anatomical relationship of bone tumor, can effectively help doctors to preoperative planning, preliminary clinical application effect is good.

关 键 词：3D打印 三维重建 手术规划 骨肿瘤 

分 类 号：R319[医药卫生—基础医学] R68