中国组织工程研究

中国组织工程研究 ›› 2020, Vol. 24 ›› Issue (32): 5243-5248.doi: 10.3969/j.issn.2095-4344.2712

• 组织构建综述 tissue construction review • 上一篇    

3D打印技术治疗脑动脉瘤的应用前景

张耀春1，郑丽芳2，刘  融3   

  1. 1武汉科技大学临床学院，湖北省武汉市  430080；2深圳市盐田区人民医院，广东省深圳市  518000；3武汉科技大学附属普仁医院医学创新与转化研究所，湖北省武汉市  430081

  • 收稿日期:2019-07-24 修回日期:2019-07-27 接受日期:2020-01-18 出版日期:2020-11-18 发布日期:2020-09-26
  • 通讯作者: 刘融，博士，副主任医师，硕士生导师，武汉科技大学附属普仁医院医学创新与转化研究所，湖北省武汉市 430081
  • 作者简介:张耀春，男，湖北省黄冈市人，汉族，武汉科技大学临床学院在读硕士，主要从事神经病学方面的研究。 郑丽芳，女，1971年生，湖北省武汉市人，汉族，2008年华中科技大学同济医学院毕业，硕士，主任医师，主要从事脑血管病与神经心理方面的研究。
  • 基金资助:
    中国金属学会冶金安全与健康分会重点项目(18-02-21)；湖北省卫生计生委联合基金创新团队项目(WJ2018H0042)

Prospects for 3D printing in the treatment of cerebral aneurysm

Zhang Yaochun1, Zheng Lifang2, Liu Rong3   

  1. 1Clinical College of Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China; 2Shenzhen Yantian District People's Hospital, Shenzhen 518000, Guangdong Province, China; 3Institute of Medical Innovation and Transformation, Puren Hospital, Wuhan University of Science and Technology, Wuhan 430081, Hubei Province, China

  • Received:2019-07-24 Revised:2019-07-27 Accepted:2020-01-18 Online:2020-11-18 Published:2020-09-26
  • Contact: Liu Rong, MD, Associate chief physician, Master’s supervisor, Institute of Medical Innovation and Transformation, Puren Hospital, Wuhan University of Science and Technology, Wuhan 430081, Hubei Province, China
  • About author:Zhang Yaochun, Master candidate, Clinical College of Wuhan University of Science and Technology, Wuhan 430080, Hubei Province, China Zheng Lifang, Master, Chief physician, Shenzhen Yantian District People's Hospital, Shenzhen 518000, Guangdong Province, China
  • Supported by:
    the Key Project of Metallurgical Safety and Health Branch of China Metal Society, No. 18-02-21; the Hubei Provincial Health and Family Planning Commission Joint Fund Innovation Team Project, No. WJ2018H0042

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摘要：

文题释义：

脑动脉瘤：颅脑动脉瘤是指脑动脉内腔的局限性异常扩大造成动脉壁的一种瘤状突出，是造成蛛网膜下腔出血的首位病因，具有极高的致残率和致死率。

3D打印技术：是一项新兴技术，主要以三维CT数据建模，利用计算机辅助设计，打印出1∶1的解剖结构仿真模型。

背景：介入治疗可以作为无法手术切除脑动脉瘤患者的姑息性治疗手段，但是手术初期病灶的定位或者介入治疗时导管的走行等，仅通过二维图像无法得到准确而清晰的显示，并且与操作者自身的经验及对图像的理解力等因素有关。3D打印模型是具有高仿真度及个体化特征的物理模型，在医疗领域具有个性化、精准化等优点，目前广泛应用于骨科、口腔颌面外科等，但是在颅脑动脉瘤治疗中的应用较少有报道。

目的：归纳脑动脉瘤的分型及治疗现状，展望3D打印技术在脑动脉瘤治疗中的应用前景。

方法：通过计算机检索CNKI、万方数据库、PubMed数据库、EI数据库，检索词为“脑动脉瘤，临床分型，治疗，3D打印，Cerebral aneurysm，Clinical classification，treatment，3D printing”。检索出相关文献96篇，根据纳入和排除标准，归纳出51篇文献进行汇总、归纳，具体包括脑动脉瘤的分型、开颅手术及介入治疗、3D打印技术应用现状等相关内容。

结果与结论：①目前临床上常用的脑动脉瘤治疗手段各有其优势及局限性，在这种情况下提出3D可视化和3D打印技术，是对脑动脉瘤患者临床治疗的重要补充；②它可以通过放大、旋转、透明化等操作更直观、准确地显示器官解剖和空间结构，同时还可以准确定位动脉瘤发生部位、计算动脉瘤大小和体积、明确动脉瘤形态等，这对于颅脑动脉瘤的术前诊断、制定手术计划、手术中精确操作、提高手术成功率等方面具有重要的临床意义；③同时3D打印的实体模型在病情沟通、住院医师手术操作培训等方面也有广泛应用；④通过总结3D打印技术在脑动脉瘤治疗上的研究进展，对于三维可视化及3D打印技术的应用有了更清晰的认识，无论是结合流体力学进行血流动力学的研究还是在现有的治疗方案的基础上进行精细化处理，都推动了临床研究向前发展。

ORCID: 0000-0002-8030-7082(张耀春)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 脑动脉瘤, 临床分型, 治疗, 3D打印, 三维可视化

Abstract:

BACKGROUND: Interventional treatment can also be used as a palliative treatment for patients who cannot be surgically removed. However, the positioning of the lesion at the beginning of the operation or the catheter during the interventional treatment can only be accurately and clearly displayed through the two-dimensional image, and is related to the operator’s own experience and understanding of the image. The 3D printing model is a physical model with high simulation and individualized features, and has the advantages of individualization and precision in the medical field. It is currently widely used in orthopedics, oral and maxillofacial surgery, but the application in the treatment of craniocerebral aneurysms is rarely reported.

OBJECTIVE: To summarize the classification and treatment status of cerebral aneurysms, and to prospect the application prospect of 3D printing technology in the treatment of cerebral aneurysms.

METHODS: The authors retrieved CNKI, WanFang, PubMed, and EI database. The search terms were “cerebral aneurysm, clinical classification, treatment, 3D printing”. A total of 96 relevant literatures were retrieved, and 51 articles were summarized according to the inclusion and exclusion criteria. Specifically, it included the classification of cerebral aneurysms, craniotomy and interventional therapy, and the application status of 3D printing technology.

RESULTS AND CONCLUSION: At present, the treatment methods of cerebral aneurysms commonly used in clinical practice have their own advantages and limitations. In this case, 3D visualization and 3D printing technology are proposed, which is an important supplement for the clinical treatment of patients with cerebral aneurysms. It can display organ anatomy and spatial structure more intuitively and accurately through operations such as enlargement, rotation and transparency. At the same time, it can accurately locate the aneurysm site, calculate the aneurysm size and volume, and define the aneurysm morphology. This is significant in preoperative diagnosis, planning of surgery, precise operation during surgery, and improvement of surgical success rate for the brain aneurysm. Simultaneously, the solid model of 3D printing is also widely used in the aspects of disease communication and training of resident surgical operations. By summarizing the research progress of 3D printing technology in the treatment of cerebral aneurysms, we have a clearer understanding of the application of 3D visualization and 3D printing technology. Whether it is combined with fluid mechanics for hemodynamic research or refined treatment based on existing treatment schemes, it has promoted the development of clinical research.

Key words: cerebral aneurysm, clinical typing, treatment, 3D printing, 3D visualization

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