基于多模图像融合的3D打印胶质瘤实体模型制造与应用  

Manufacturing and application of 3D printed glioma solid model based on multi-modality image fusion

作　　者：刘宇清[1,2] 吴薇[3] 杨智坤 何炳蔚[4] 黄绳跃[1,2] 林伟[1,2] 张扬[1,2] 郑诗豪[1,2] LIU Yu-qing;WU Wei;YANG Zhi-kun;HE Bing-wei;HUANG Sheng-yue;LIN Wei;ZHANG Yang;ZHENG Shi-hao(Department of Neurosurgery,Fujian Provincial Hospital,Fuzhou 350001,China;Provincial Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;Surgical Intensive Care Unit,Fujian Provincial Hospital,Fuzhou 350001,China;College of Mechanical Engineering and Automation,Fuzhou University,Fuzhou 350116,China)

机构地区：[1]福建省立医院神经外科,福州350001 [2]福建医科大学省立临床医学院,福州350001 [3]福建省立医院重症医学三科,福州350001 [4]福州大学机械工程及自动化学院,福州350116

出　　处：《创伤与急诊电子杂志》2019年第2期61-67,共7页Journal of Trauma and Emergency(Electronic Version)

基　　金：福建省对外合作项目(编号：2019I0023);福建医科大学教育教学改革研究项目（编号：J17011）;福建省医学创新课题(编号：2017-CX-14)

摘　　要：目的研究基于多模图像融合的胶质瘤3D打印实体模型制造与应用。方法利用患者颅脑螺旋CT增强扫描和MRI增强扫描图像,针对颅骨、血管、肿瘤、脑组织、头皮等进行数据信息提取重建,并在同一坐标系下实现装配融合,分别建立CT和MRI图像的三维复合虚拟模型,再将二者融合配准,获得信息较为完整的颅脑三维虚拟模型,经3D打印制作出胶质瘤实体模型,应用于术前、术中参考。结果成功重建6位胶质瘤患者的颅脑实体模型,模型清晰显示肿瘤特征及其与周围颅骨、血管、脑组织、侧脑室的位置关系,将其应用于术前规划与术中参考,6例手术均获得成功,肿瘤影像学全切除率100%,术后1个月卡氏功能状态评分为(93.7±5.3)分,较术前(73.2±10.5)分高。结论基于多模图像融合的胶质瘤3D打印实体模型,对术者了解肿瘤特征、优化手术预案、术中准确定位、有效保护重要血管与脑功能区,提高肿瘤切除率、达到个性化的手术治疗等方面具有重要帮助。Objective To study the manufacturing and application of 3D printed glioma model based on multi-modality image fusion.Methods Images of patients obtained by enhanced spiral CT scan and enhanced MRI scan were used to reconstruct the models of skull,blood vessels,tumor,brain tissue and scalp.Then they were aligned in the same coordinate system to achieve a complete digital 3D brain model.The 3D model of glioma was printed and used for the preoperative planning and intraoperative reference.Results Glioma models of 6 patients were successfully reconstructed,clearly presenting the tumor characteristics and its relationship with the surrounding skull,blood vessels,brain tissue and lateral ventricle.After applying the models in preoperative planning and intraoperative reference,6 surgeries are all successful.Gross-total resection(GTR)under the usage of intraoperative ultrasonography was 100%.One month after operation, the KPS score was 93.7±5.3, which was higher than 73.2±10.5 before operation.Conclusions The 3D printed glioma model based on multi-modality image fusion is helpful forsurgeons in understanding the characteristics of glioma, optimizing surgical planning, preciselypositioning, effectively protecting important blood vessels and brain function areas, improvingrates of tumor resection, and achieving individualized surgical treatment.

关 键 词：多模 图像融合 胶质瘤 3D打印 实体模型 

分 类 号：R73[医药卫生—肿瘤]