3D打印技术在血管疾病诊治中的应用

正3D打印技术被制造业誉为第三次工业革命,在21世纪已经在许多领域都展现了巨大的价值和潜力,在医学领域如骨科、口腔科、整形外科、神经外科等都得到了广泛的应用。3D打印的开展应用也为血管疾病的诊治提供了新的方法,本文综述介绍3D打印技术在血管疾病诊治中的应用现状及未来发展趋势。1 3D打印技术的概念及种类3D打印技术(3DP)是一种快速成型技术,原理是将计算机辅助设计出的数字模型输入3D打印机中,通过逐     

3D打印在先天性心脏病诊疗中的应用

3D打印技术因具有标准化建模、个体化诊疗等优点,近年来在骨科、口腔科、神经外科等领域已开始逐步进行了临床应用。部分小儿先天性心脏病病变复杂,传统的二维图像难以清晰地显示复杂心内畸形的空间解剖结构,而精确评估心脏解剖结构及与周围组织关系对治疗方案的选择及改善预后至关重要。3D打印技术为该类复杂及疑难先天性心脏病的精准诊断和治疗提供了新的思路。3D打印病变心血管模型有助于人们了解心内畸形精确的解剖空间关系、设计最佳手术方案、选择个体化的介入治疗器械等。3D打印技术在先天性心脏病中的应用正逐渐成为当前的研究热点。本文针对3D打印技术在先天性心脏病诊疗中的应用及展望进行综述。     

3D打印在心血管疾病手术中的应用进展

近年来,3D打印在临床上已经广泛应用。本综述首先阐述在心血管疾病中3D打印模型的来源,然后重点介绍3D打印在先天性心脏病、心脏瓣膜病和肥厚型心肌病等诸多方面手术治疗中的应用,最后指出3D打印未来的发展方向,并对3D打印的应用进行讨论。     

3D打印技术在冠状动脉异常诊断和术前规划中的应用

目的:探讨使用3D打印技术打印的3D心脏模型诊断和指导冠状动脉异常矫治手术的可行性和临床价值。方法:基于3例冠状动脉异常的心脏CT数据,包括右冠状动脉-左室瘘1例,左、右冠状动脉共同起源于右冠状窦合并左、右冠状动脉-肺动脉瘘1例、左冠状动脉起源于肺动脉1例。采用Mimics 19.0软件对患者CT进行图像分割,建立STL格式的3D心脏模型,显示冠状动脉与主动脉和肺动脉的空间关系。使用3D打印机打印心脏冠脉模型,对心脏冠脉模型进行评估。结果:3例3D心血管实体模型可清晰显示左右冠状动脉与肺动脉、主动脉间的空间关系,冠状动脉瘘的大小、位置,且实体模型与数据模型吻合,并无明显差异。手术全部顺利完成,恢复良好,无严重并发症出现。结论:将3D打印技术应用于冠状动脉异常有助于诊断和制定适合的手术计划,使得医师可以个性化精准诊疗冠状动脉异常的解剖结构,指导手术更顺利安全进行,有显著的临床应用价值。     

3D 打印技术在治疗颅内动脉瘤和动静脉畸形中的应用

3D打印是通过对原型实施数字建模,在计算机控制下完成对象物品的复制或创制过程。3D打印可完成个体化复制,实现对象物品外形和结构的精准模拟。利用多种医学影像学检查结果实施数据建模,3 D打印技术在生物医学领域的应用具有突出优势。近年来,3 D打印技术在脑血管病的预防、治疗和康复等方面均有应用。文章对3D打印技术在颅内动脉瘤和动静脉畸形中的应用进行了简要综述,并对未来应用前景进行了展望。     

3D打印技术在颅内动静脉畸形血管内介入治疗中的初步应用

目的探讨3D打印技术在指导颅内动静脉畸形(AVM)血管内介入治疗中的临床应用价值。方法贯序交替选取2015年2月至5月广东省人民医院神经外科进行血管内介入治疗的AVM患者10例,其中5例为对照组,5例为进行3D打印模型试验组。对试验组5例AVM患者采用256层螺旋CT薄层增强扫描或3D-DSA旋转成像,提取检查结果的DICOM原始数据,应用薄层数据扫描获取5例AVM患者三维数据,通过Mimics 14.01软件进行数字化数据提取和重建,并按1∶1比例进行3D打印,获得实体模型。应用AVM实体模型指导与患者及其家属的术前谈话及手术方案设计,并与对照组结果进行对比。结果 3D打印模型试验组术前谈话时间(10.2±0.8)min较对照组术前谈话时间(15.0±1.3)min显著缩短,差异有统计学意义(P0.01);试验组患者及其家属满意度评分显著高于对照组[(9.3±0.6)分比(8.1±0.3)分,P0.01],试验组术中造影后至手术实施时间较对照组显著缩短[(5.7±0.4)min比(10.5±1.6)min,P0.01]。无一例手术相关并发症。结论 3D打印模型可以帮助术者更加直观地了解畸形团空间构筑学特征,指导术者进行手术方案的制定,同时应用3D打印实体模型可提高与AVM患者术前谈话效率及患者满意度。     

人工智能及3D打印技术在心血管疾病诊疗中的应用进展

在大数据和开放科学时代,人工智能和3D打印技术蓬勃发展,其在心血管医学领域的探索应用突飞猛进.现代影像及检验技术积累了充分的原始数据,是人工智能探索的基础;心血管系统腔内结构复杂多变,充分利用人工智能和3D打印技术可以革新当前诊疗习惯和模式,提升服务效率和水平.现就人工智能和3D打印技术在心血管医学领域的应用进展做一综...     

3D打印材料聚醚醚酮支架在耳廓再造中的应用前景

3D打印材料聚醚醚酮(PEEK)是一种在医学领域有许多潜在用途的聚合物,随着3D打印技术的逐渐兴起,不仅能针对患者的病情需求打印出个性化植入,而且PEEK具备作为植入物的必备性能,这两大优点表明其在耳廓的修复与重建领域中有望替代传统修复材料.该文对3D打印材料PEEK作为植入物所具备的优良性能,以及在耳廓再造领域的应用...     

3D打印技术在临床医学中的应用进展

近年来,3D打印技术迅速发展,在临床医学领域尤其在与再生重建相关的外科中应用广泛。3D打印技术可用于制备医学模型,进行手术策划,手术辅助器械和个性化内植入物,生物打印与组织工程等方面。本综述着重介绍了3D打印技术在临床医学中的应用,并分析目前存在的问题及展望发展前景。     

3D打印模型在泌尿外科血管相关性疾病教学中的应用探讨

评价3D打印模型在泌尿外科血管相关性疾病（胡桃夹综合征、腔静脉后输尿管）教学中的应用效果，探讨其可行性与有效性。将实习学员随机分为两组，分别采用传统教学法（对照组）和结合3D打印模型的教学法（试验组）进行教学，以理论和实践考核进行对比，并对结合3D打印模型的教学模式满意度予以问卷调查测评。试验组考核成绩优于对照组（P<0.05）。试验组问卷调查教学模式满意度的结果显示，96.67%的学生对结合3D打印模型的教学模式的总体评价是满意的。3D打印模型在泌尿外科血管相关性疾病教学中的应用，可以直观展示疾病模型，有助于加深学生对相关知识的理解、记忆，能够提高教学质量，是一种有效的教学方法。     

Application of 3D printing technology combined with PBL teaching model in teaching clinical nursing in congenital heart surgery: A case-control study

We aimed to explore the application of three-dimensional (3D) printing technology with problem-based learning (PBL) teaching model in clinical nursing education of congenital heart surgery, and to further improve the teaching quality of clinical nursing in congenital heart surgery. In this study, a total of 132 trainees of clinical nursing in congenital heart surgery from a grade-A tertiary hospital in 2019 were selected and randomly divided into 3D printing group or traditional group. The 3D printing group was taught with 3D printed heart models combined with PBL teaching technique, while the traditional group used conventional teaching aids combined with PBL technique for teaching. After the teaching process, the 2 groups of nursing students were assessed and surveyed separately to evaluate the results. Compared to the traditional group, the theoretical scores, clinical nursing thinking ability, self-evaluation for comprehensive ability, and teaching satisfaction from the questionnaires filled by the 3D printing group were all higher than the traditional group. The difference was found to be statistically significant (P < .05). Our study has shown the 3D printing technology combined with the PBL teaching technique in the clinical nursing teaching of congenital heart surgery achieved good results.     

Role of innovative 3D printing models in the management of hepatobiliary malignancies

Three-dimensional(3D) printing has recently emerged as a new technique in various liver-related surgical fields. There are currently only a few systematic reviews that summarize the evidence of its impact. In order to construct a systematic literature review of the applications and effects of 3D printing in liver surgery, we searched the PubMed, Embase and ScienceDirect databases for relevant titles, according to the PRISMA statement guidelines. We retrieved 162 titles, of which 32 met the inclusion criteria and are reported. The leading application of 3D printing in liver surgery is for preoperative planning. 3D printing techniques seem to be beneficial for preoperative planning and educational tools, despite their cost and time requirements, but this conclusion must be confirmed by additional randomized controlled trials.     

Artificial Neural Network Algorithms for 3D Printing

Additive manufacturing with an emphasis on 3D printing has recently become popular due to its exceptional advantages over conventional manufacturing processes. However, 3D printing process parameters are challenging to optimize, as they influence the properties and usage time of printed parts. Therefore, it is a complex task to develop a correlation between process parameters and printed parts’ properties via traditional optimization methods. A machine-learning technique was recently validated to carry out intricate pattern identification and develop a deterministic relationship, eliminating the need to develop and solve physical models. In machine learning, artificial neural network (ANN) is the most widely utilized model, owing to its capability to solve large datasets and strong computational supremacy. This study compiles the advancement of ANN in several aspects of 3D printing. Challenges while applying ANN in 3D printing and their potential solutions are indicated. Finally, upcoming trends for the application of ANN in 3D printing are projected.     

Artificial intelligence assisted display in thoracic surgery: development and possibilities

In this golden age of rapid development of artificial intelligence (AI), researchers and surgeons realized that AI could contribute to healthcare in all aspects, especially in surgery. The popularity of low-dose computed tomography (LDCT) and the improvement of the video-assisted thoracoscopic surgery (VATS) not only bring opportunities for thoracic surgery but also bring challenges on the way forward. Preoperatively localizing lung nodules precisely, intraoperatively identifying anatomical structures accurately, and avoiding complications requires a visual display of individuals’ specific anatomy for surgical simulation and assistance. With the advance of AI-assisted display technologies, including 3D reconstruction/3D printing, virtual reality (VR), augmented reality (AR), and mixed reality (MR), computer tomography (CT) imaging in thoracic surgery has been fully utilized for transforming 2D images to 3D model, which facilitates surgical teaching, planning, and simulation. AI-assisted display based on surgical videos is a new surgical application, which is still in its infancy. Notably, it has potential applications in thoracic surgery education, surgical quality evaluation, intraoperative assistance, and postoperative analysis. In this review, we illustrated the current AI-assisted display applications based on CT in thoracic surgery; focused on the emerging AI applications in thoracic surgery based on surgical videos by reviewing its relevant researches in other surgical fields and anticipate its potential development in thoracic surgery.     

3D Printing Provides a Precise Approach in the Treatment of Tetralogy of Fallot,Pulmonary Atresia with Major Aortopulmonary Collateral Arteries

Patients with tetralogy of Fallot, pulmonary atresia, and multiple aortopulmonary collateral arteries (Tet PA MAPCAs) have a wide spectrum of anatomy and disease severity. Management of these patients can be challenging and often require multiple high-risk surgical and interventional catheterization procedures. These interventions are made challenging by complex anatomy that require the proceduralist to mentally reconstruct three-dimensional anatomic relationships from two-dimensional images. Three-dimensional (3D) printing is an emerging medical technology that provides added benefits in the management of patients with Tet PA MAPCAs. When used in combination with current diagnostic modalities and procedures, 3D printing provides a precise approach to the management of these challenging, high-risk patients. Specifically, 3D printing enables detailed surgical and interventional planning prior to the procedure, which may improve procedural outcomes, decrease complications, and reduce procedure-related radiation dose and contrast load.     

Dynamic Properties and Fractal Characteristics of 3D Printed Cement Mortar in SHPB Test

Comparing with the traditional construction process, 3D printing technology used in construction offers many advantages due to the elimination of formwork. Currently, 3D printing technology used in the construction field is widely studied, however, limited studies are available on the dynamic properties of 3D printed materials. In this study, the effects of sand to binder ratios and printing directions on the fractal characteristics, dynamic compressive strength, and energy dissipation density of 3D printed cement mortar (3DPCM) are explored. The experiment results indicate that the printing direction has a more significant influence on the fractal dimension compared with the sand to binder ratio (S/B). The increasing S/B first causes an increase and then results in a decline in the dynamic compressive strength and energy dissipation of different printing directions. The anisotropic coefficient of 3DPCM first is decreased by 20.67%, then is increased by 10.56% as the S/B increases from 0.8 to 1.4, showing that the anisotropy is first mitigated, then increased. For the same case of S/B, the dynamic compressive strength and energy dissipation are strongly dependent on the printing direction, which are the largest printing in the Y-direction and the smallest printing in the X-direction. Moreover, the fractal dimension has certain relationships with the dynamic compressive strength and energy dissipation density. When the fractal dimension changes from 2.0 to 2.4, it shows a quadratic relationship with the dynamic compressive strength and a logarithmic relationship with the energy dissipation density in different printing directions. Finally, the printing mortar with an S/B = 1.1 is proved to have the best dynamic properties, and is selected for the 3D printing of the designed field barrack model.