多模态影像融合技术联合3D打印技术在经蝶垂体腺瘤切除术中的应用  

Application of Multimodal Image Fusion Technology Combined with Three-Dimensional Printing Technology in Transsphenoidal Surgery for Pituitary Adenoma

作　　者：陈忠仪[1] 洪文瑶[1] 廖正俭[1] 郑诗豪[1] 黄绳跃[1] 刘宇清[1] CHEN Zhong-yi;HONG Wen-yao;LIAO Zheng-jian;ZHENG Shi-hao;HUANG Sheng-yue;LIU Yu-qing(Department of Neurosurgery of Fujian Provincial Hospita;Provincial School of Clinical Medicine of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建省立医院神经外科福建医科大学省立临床医学院,福州350001

出　　处：《实用临床医学（江西）》2018年第8期35-37,40,108,共5页Practical Clinical Medicine

基　　金：福建省自然科学基金(2015J01421);福建医科大学教育教学改革研究项目(J17011);福建省医学创新课题(2017CX-14)

摘　　要：目的探讨多模态影像融合技术联合3D打印技术在经蝶垂体腺瘤切除术中的应用价值。方法对5例垂体腺瘤患者应用MRI和CT多模态影像融合技术,对颅骨、血管和肿瘤等组织结构采用不同的分割方法进行数据信息提取和重建,并在同一坐标系下实现重组和融合,形成三维可视化复合虚拟模型,同时结合3D打印技术将三维可视化复合虚拟模型实体化,制定手术治疗方案。然后,对5例患者行经蝶垂体腺瘤切除术。结果 5例患者术前均构建出三维可视化复合虚拟模型。3D技术打印出垂体腺瘤实体模型,可清晰地显示肿瘤与颅骨、蝶窦、鞍底及鞍底硬膜、颈内动脉、海绵窦的关系,可清晰显示肿瘤与鞍区、垂体、周边动脉及静脉窦的关系。5例患者术后均顺利出院。5例患者均获随访,随访时间3~18个月,肿瘤均无复发。结论在经蝶垂体腺瘤术前应用多模态影像融合技术联合3D打印技术,能有效指导医生制定与完善手术方案,有助于精准切除肿瘤,并能取得较好的疗效。Objective To investigate the value of multimodal image fusion technology corn bined with three dimensional adenoma.Methods Both MRI （3D） printing technology in transsphenoidal surgery for pituitary and CT multimodal image fusion techniques were applied in 5 patients with pituitary adenomas.The segmentation and reconstruction of data were performed using different segmentation methods for tissue structures such as skull, blood vessels and tumors, and the reorganization and integration were achieved in the same coordinate system to form a 3D visualization composite virtual model.At the same time,3D printing technology was used to materialize the 3D visualization composite virtual model for formulating a surgical treatment plan. Then, transsphenoidal pituitary adenoma resection was performed in all patients.Results The 3D virtual composite virtual model was preoperatively constructed in all the 5 patients. The 3D technology printed out a solid model of pituitary adenoma,which clearly displayed the relationships of tumor to skull, sphenoid sinus, sellar floot, sellar floot dura mater, internal carotid artery and cavernous sinus,as well as to sellar region, pituitary, peripheral artery and venous sinus. All patients were discharged successfully and followed up for 3 18 months. No recurrence was found during the follow up period.Conclusion The preoperative application of combined multimodal image fusion and 3D printing technology can effectively guide doctors to make and perfect the surgical plan and helps to accurately resect the tumor in transsphenoidal surgery for pituitary adenoma.

关 键 词：垂体腺瘤 经蝶垂体腺瘤切除术 多模态影像融合技术 3D打印技术 三维可视化复合虚拟模型 实体解剖模型 

分 类 号：R651.1[医药卫生—外科学] R736.4[医药卫生—临床医学]