3D打印技术在颅底肿瘤手术中的应用
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天津市环湖医院

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The application value of 3D printing technology in surgery of skull base tumor
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    目的 通过三维重建颅底肿瘤及周围的组织结构,获取颅底肿瘤及其周围结构的解剖参数,构铸并打印个体化三维模型,研究3D打印技术在颅底瘤变的手术治疗中的作用及应用价值。 方法 收集2019年5月--2021年1月天津市环湖医院收治的复杂颅底肿瘤(包括脑膜瘤、垂体瘤、嗅神经母细胞瘤、颅咽管瘤、神经鞘瘤、脊索瘤)患者的临床病例资料。 根据患者术前影像学(电子计算机断层扫描技术(computed tomography CT)、磁共振成像(magnetic resonance imaging MRI)、计算机断层扫描血管造影(computed tomography angiography CTA)、三维重建)的原始数据,利用“MINICS”软件读取患者影像学原始图像,应用3D打印软件及三维重建技术,个性化设计颅底占位的手术方案。 结果 三维重建并打印15例患者的颅底肿瘤及其周围结构的个体化模型。依据三维重建模型分析肿瘤周边重要血管的分布及走行,术中加以保护及预防损伤。15例患者均顺利完成手术,其中14例获得全切除,1例大部分切除(术后予放疗),其中14例患者术后恢复良好,未见肿瘤复发及术后并发症,1例大部切除的患者(梭形细胞恶性肿瘤)术后复发,予手术+放疗结合的综合性治疗后好转。 结论 利用3D技术打印的个体化颅底肿瘤三维模型,可用于设计和规划颅底肿瘤切除及术后修复重建,对于指导临床彻底切除肿瘤组织、保护毗邻神经、血管及术后修复缺损具有重要意义。

    Abstract:

    OOBJECTIVES: Through 3D reconstruction of skull base tumor and surrounding tissue structure, anatomical parameters of skull base tumor and surrounding structure were obtained, and individualized 3D model was constructed and printed to study the role and application value of 3D printing technology in surgical treatment of skull base tumor. METHODS: Clinical data of patients with complex cranial base tumors (including meningioma, pituitary tumor, olfactory neuroblastoma, craniopharyngioma, schwannoma and chordoma) admitted to Tianjin Huanhu Hospital from May 2019 to January 2021 were collected. According to the original data of patients' preoperative imaging (computed tomography CT, magnetic resonance imaging MRI, computed tomography angiography Angiography CTA and 3D reconstruction), "MINICS" software was used to read the original imaging images of patients, and 3D printing software and 3D reconstruction technology were used to personalized design the surgical plan of skull base occupation. RESULTS: Three-dimensional reconstruction and printing of individual models of skull base tumors and surrounding structures in the above 15 patients. The distribution and route of important blood vessels around the tumor were analyzed according to the 3D reconstruction model to protect and prevent injury during operation.15 patients were successfully completed surgery, of which 14 cases were obtained, subtotal resection in 1 case most resection (to postoperative radiotherapy), 14 patients recovered well after operation and no tumor recurrence and postoperative complications, most resection in 1 case (squamous cell carcinoma (SCC) of patients with postoperative relapse, to surgery plus radiotherapy combined with comprehensive improvement after treatment. CONCLUSIONS: Personalized 3D model of skull base tumor printed by 3D technology can be used to design and plan the resection of skull base tumor and postoperative repair and reconstruction, which is of great significance for guiding clinical complete resection of tumor tissue, protection of adjacent nerves and blood vessels, and postoperative repair of defects.

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  • 收稿日期:2022-05-25
  • 最后修改日期:2022-07-13
  • 录用日期:2022-07-15
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