CN106361429A - Device and method for achieving preoperative assessment of congenital heart disease operation plan based on 3D printing - Google Patents
Device and method for achieving preoperative assessment of congenital heart disease operation plan based on 3D printing Download PDFInfo
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- CN106361429A CN106361429A CN201610987650.9A CN201610987650A CN106361429A CN 106361429 A CN106361429 A CN 106361429A CN 201610987650 A CN201610987650 A CN 201610987650A CN 106361429 A CN106361429 A CN 106361429A
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y30/00—Apparatus for additive manufacturing; Details thereof or accessories therefor
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y50/00—Data acquisition or data processing for additive manufacturing
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y80/00—Products made by additive manufacturing
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Abstract
The invention provides a device and method for achieving preoperative assessment of a congenital heart disease operation plan based on 3D printing. The method comprises the steps that normal person chest CT information is acquired, a normal person heart and lateral branch blood vessel stereo structure model is printed in a 3D mode, a normal person model is connected with an extracorporeal circulation machine to obtain normal person heart and lateral branch blood vessel physiological parameters, and then a standard contrast table is established; the normal person chest CT information is acquired, a doctor conducts simulated operation on a patient CT image, the normal person heart and lateral branch blood vessel stereo structure model after simulated operation is printed in a 3D mode, and the normal person model is connected with the extracorporeal circulation machine to obtain patient lateral branch blood vessel physiological parameters; the standard contrast table shows that the physiological parameter differences of a patient and a normal person are acceptable by the doctor. The risk brought by direct operative treatment performed by the doctor based on experiences is avoided, simulation of operative operation performed by the doctor is promoted, and the survival probability of the patient is improved.
Description
Technical field
The invention belongs to medical image processing technical field, relate generally to simulate surgical technic field, tool in medical image
Body is a kind of apparatus and method realizing congenital heart disease operation plan preoperative evaluation by 3d printing, circulates in vitro for detection
In, the physiological parameter of heart collateral blood vessels key position.
Background technology
Congenital heart disease abbreviation congenital heart disease.Congenital heart disease reason is a lot, and inherited genetic factorss only account for 8% about,
And account for 92% overwhelming majority and then cause for environmental factorss, such as forepart pregnant women when drug administration, infection virus, environmental pollution, penetrate
Beta radiation etc. all can make heart of fetus abnormal development, causes cardiovascular malformation.Congenital heart disease is the modal heart disease of children, seriously
Prestige rib children's health.In annual about 16,500,000 neonates of China, congenital heart disease sickness rate is 7%-8%, increases infant 140,000 every year newly left
The right side, sickness rate is in rising trend, and wherein 60% in < 1 years old dead, only 2～30,000 people really obtaining medical treatment.Due to congenital heart disease
Occurrence cause may with heredity especially chromosome translocation and distortion, intrauterine infection, heavy dose radiation contacts and medicine etc. because
Have pass, in view of the current medical level of China, children with CHD can obtain rehabilitation by treatment, but due to asymptomatic or because of skill
Art reason and delay treatment, miss best occasion for the treatment, cause patient to face the threat of death at any time.
For improving the chances of survival of patient, clinically, the blood of patient's heart different parts how is obtained using intubation intervention
The information such as stream, blood pressure, carrying out operative treatment to doctor provides foundation.
And be invasive by the equivalent whole process of the blood flow of intubation intervention acquisition Heart tissue, blood pressure.
In clinical practice, based on prior art it is impossible to intuitively or by analog form find treatment heart and side shoot
The optimal operation plan of blood vessel, conventional intubation intervention increased the misery of patient, and patients with congenital heart needs for diagnosis
High medical expense is paid in treatment, must endure as surgical diagnosis simultaneously and brings traumatic pain on body, each of which increases patient
Spirit and financial burden with household.
Content of the invention
It is an object of the invention to overcoming the deficiencies in the prior art, a kind of printing by 3d is provided to realize congenital heart disease operation side
The apparatus and method of case preoperative evaluation, be actually also made by 3d printing technique come to assess doctor's simulated surgical operation device and
Method, helps doctor accurately to judge, and enables the simulated operation of preoperative doctor.
The present invention is that a kind of printing by 3d realizes the device of congenital heart disease operation plan preoperative evaluation it is characterised in that wrapping
Include: digital sampling and processing, sham operated module, data 3d print module, extracorporeal circulation module, standard control table, trouble
Person's collateral blood vessels physiological parameter module, sham operated scheme module, gather human chest information respectively for normal person and patient
Data, from the human chest information data of normal person, by digital sampling and processing, data 3d print module, follows in vitro
Ring module, is stored in standard control table；Human chest information data from patient passes through digital sampling and processing, through doctor
Learn image segmentation algorithm dividing processing and obtain patient's heart and collateral blood vessels three-dimensional data, be input to sham operated module,
In sham operated module, according to digital sampling and processing, the patient's heart obtaining and collateral blood vessels stereochemical structure data doctor enter
Row simulated surgical operation, obtains the patient's heart after sham operated and collateral blood vessels data message, by the three-dimensional after sham operated
Data message input data 3d print module, the stereochemical structure model that 3d is printed is connected with cardiopulmonary bypass unit, collectively forms
Extracorporeal circulation module, is stored in patient's collateral blood vessels physiological parameter module by the physiological parameter that extracorporeal circulation module obtains；And then
It is transferred in standard control table, compares, revise with the data of normal people being stored in standard control table, its result exports mould
Intend operation plan module, from this sham operated scheme, not only can intuitively show the difference of dynamic circulation, facilitate doctor simultaneously
Carry out simulated surgical operation again and be simulated modification operation；
Digital sampling and processing, the human chest image information being collected using the partitioning algorithm segmentation of medical image,
Obtain human chest heart and collateral blood vessels image data information；
Sham operated module, display patient's heart and collateral blood vessels stereochemical structure data, and operating theater instruments, doctor is using aobvious
The operating theater instruments shown are simulated operation technique；
Extracorporeal circulation module, the stereochemical structure model that 3d prints is connected with cardiopulmonary bypass unit, and the overall dynamics of formation are followed
Ring model.
The present invention or a kind of printing by 3d realize congenital heart disease operation plan preoperative evaluation method, are printing skill by 3d
Art is assessed and is realized it is characterised in that comprising the following steps that on the device of doctor's simulated surgical operation
1 ＞ gathers the chest ct information of normal person, and the partitioning algorithm using medical image, is partitioned into normal person's chest heart
Dirty and collateral blood vessels ct data message, obtains Normal Human Heart and collateral blood vessels data；
2 ＞ will obtain Normal Human Heart and collateral blood vessels data, using 3d printing technique, print Normal Human Heart and side
Branch blood vessel stereochemical structure model；
The Normal Human Heart printed and collateral blood vessels stereochemical structure model are connected by 3 ＞ with cardiopulmonary bypass unit, just obtain
The overall dynamics circulation model of ordinary person's heart and collateral blood vessels, obtains Normal Human Heart and side shoot by overall dynamics circulation model
Blood vessel integrally circulate in side shoot node physiological parameter, set up Normal Human Heart and collateral blood vessels physiological parameter standard, be placed on mark
In quasi- synopsis；
4 ＞ gather the chest ct information of patient, and the partitioning algorithm using medical image, are partitioned into the chest heart of patient
And collateral blood vessels ct data message, obtain patient's heart and collateral blood vessels data；
5 ＞, are obtained to obtaining patient's heart and collateral blood vessels data simulation operation technique using sham operated module
Patient's heart after sham operated and collateral blood vessels data；
6 ＞, by patient's heart after the sham operated obtaining and collateral blood vessels data, using 3d printing technique, print simulation
Postoperative patient's heart and collateral blood vessels stereochemical structure model；
After the sham operated that 7 ＞ will print, patient's heart and collateral blood vessels stereochemical structure model are connected with cardiopulmonary bypass unit,
Obtain the overall dynamics circulation model of patient's heart and collateral blood vessels, patient's heart and side are obtained by overall dynamics circulation model
Branch blood vessel integrally circulate in side shoot node physiological parameter, the patient's heart obtaining and collateral blood vessels physiological parameter also input
To in standard control table；
8 ＞, in standard control table, show patient and normal human heart and collateral blood vessels physiology ginseng after sham operated
Difference between number, is supplied to doctor, and doctor, according to the difference between patient after sham operated and normal person's physiological parameter, judges
And choose whether row sham operated again, and if not needing, direct execution step 9；If needing row sham operated again, then return step
Rapid 5 heart to patient and the simulation operation adjustment operations of collateral blood vessels three-dimensional data again, until show in synopsis
Difference between patient and the physiological parameter of normal person is that doctor is acceptable, and the sham operated scheme now obtaining is most preferably square
Case；
In sham operated scheme module, display includes patient's heart and collateral blood vessels physiological parameter after sham operated to 9 ＞,
Shown with data mode, also include the stereochemical structure simulating postoperative patient's heart and collateral blood vessels data, mould illustrated above
Intend operation optimal case, the basis performed the operation as doctor, can intuitively show the difference of dynamic circulation it is also possible to directly perceived close
Key position physiological parameter.
Heart in human chest ct data and collateral blood vessels are split by the present invention, by 3d printing technique, print
Go out the stereochemical structure of heart and collateral blood vessels and be connected with extracorporeal circulation system, finally record heart collateral blood vessels key position
Physiological parameter.
The present invention has advantages below compared with prior art
1st, the present invention, in digital sampling and processing, using Medical Image Segmentation Techniques, splits patient's heart and side shoot
The ct image data of blood vessel, obtains patient's heart and its collateral blood vessels partition data, and the present invention, in data 3d print module, adopts
Use 3d printing technique, print the stereomodel of patient's heart and its collateral blood vessels, it is to avoid interventional therapy brings the pain of patient
Hardship, facilitates skilled physician directly to observe.
2nd, the present invention is provided with sham operated module in global schema, in sham operated module, according to the simulation handss of compiling
Art software, reads patient's heart and collateral blood vessels ct data message, and intuitively shows stereochemical structure, and doctor utilizes software to provide
Sham operated apparatus, operation technique is simulated to patient's heart and collateral blood vessels ct data, doctor is according to standard control table
Difference between patient and normal human heart and collateral blood vessels physiological parameter after the sham operated of middle display, chooses whether to go again
Sham operated, until the difference between the patient showing and the physiological parameter of normal person is that doctor is acceptable, now obtains
Sham operated scheme be preferred plan, the present invention is supplied to skilled physician and is simulated operation to patient's heart and collateral blood vessels
The chance for the treatment of, it also avoid bringing the misery of patient in actual surgery simultaneously, indirectly improves the probability of survival of patients.
3rd, the present invention is in vitro in loop module, according to extracorporeal circulation principle and statistical technique, normal by print
Human heart and collateral blood vessels stereomodel are connected with cardiopulmonary bypass unit, using the collateral blood vessels physiology ginseng of the normal person collecting
Number, sets up Normal Human Heart and collateral blood vessels physiological parameter standard, is placed in standard control table, Criterion synopsis, for doctor
Raw diagnosis and the heart of the patient of normal person's same age in standard control table and collateral blood vessels physiological parameter provide reference, ratio
Relatively, assessment.
Brief description
Accompanying drawing 1 is that the modularity of apparatus of the present invention constitutes schematic diagram；
Accompanying drawing 2 is the flow chart that the present invention assesses doctor's simulated surgical operation by 3d printing technique；
Accompanying drawing 3 is the anatomical structure schematic diagram of normal human's heart and its collateral blood vessels；
Accompanying drawing 4 is the principle schematic diagram. of cardiopulmonary bypass unit；
Accompanying drawing 5 be the present invention with extracorporeal circulation module build schematic diagram；
Accompanying drawing 6 is the measurement position schematic diagram of heart and collateral blood vessels main positions；
Accompanying drawing 7 is the patient's heart and collateral blood vessels 3d structure chart after the reconstruction that in the present invention, simulation surgical modules show；
Accompanying drawing 8 is the flow chart that in the present invention, doctor is simulated operation in sham operated module.
Specific embodiment
Below in conjunction with drawings and Examples, the present invention is described in detail:
Embodiment 1
At present, clinically, for obtaining the heart of patients with congenital heart and the physiological parameter data of collateral blood vessels, doctor
Congenital heart disease relevant parameter in the raw intervention method acquisition neonate using invasive, preoperative, doctor's its dynamic situation no directly perceived
Model, can not simulated surgical operation.
Development with computer science and technology and innovation, depend on the medical image processing technology of computer to obtain
Exhibition and raising, are greatly improved based on the cardiac segmentation technology of ct data, wherein utilize active contour model algorithm to split
The heart model obtaining, helps doctor to get information about conditions of patients.
For prior art, the present invention expands research and development, is provided using 3d technology and medical image cutting techniques
A kind of print, by 3d, the device realizing congenital heart disease operation plan preoperative evaluation, referring to Fig. 1, include: data acquisition process
Module, sham operated module, data 3d print module, extracorporeal circulation module, standard control table, patient's collateral blood vessels physiological parameter
Module, sham operated scheme module, the present invention is directed to normal person and patient gathers human chest information data, respectively from normal
The human chest information data of people, by digital sampling and processing, digital sampling and processing adopts active contour model to calculate
Method is split to the data of normal person's chest heart and collateral blood vessels, obtains heart and collateral blood vessels partition data, then will
Normal Human Heart and collateral blood vessels partition data input data 3d print module that segmentation obtains, using 3d printer, print
Normal Human Heart and collateral blood vessels stereochemical structure model, according to human heart anatomical structure referring to Fig. 3 and cardiopulmonary bypass unit principle
Referring to Fig. 4, the vessel branch of the heart that print the present invention and collateral blood vessels stereochemical structure model respectively with cardiopulmonary bypass unit
Corresponding vessel position connects, and referring to Fig. 5, collectively forms extracorporeal circulation module, obtains Normal Human Heart and collateral blood vessels physiology ginseng
Number data, then Normal Human Heart and collateral blood vessels physiological parameter data is stored in standard control table.Human body from patient
Chest information data pass through digital sampling and processing, through medical image partitioning algorithm dividing processing and obtain patient's heart and
Collateral blood vessels three-dimensional data, is input to sham operated module, and in sham operated module, doctor is simulated operation technique, will
Three-dimensional data information input data 3d print module after sham operated, patient's heart and side after the sham operated that 3d is printed
Branch blood vessel stereochemical structure model is connected with cardiopulmonary bypass unit, obtains patient's heart and collateral blood vessels physiological parameter number after sham operated
According to patient's heart and collateral blood vessels physiological parameter data being temporarily stored in patient's collateral blood vessels physiological parameter module, enter
And be transferred in standard control table, with the Normal Human Heart being stored in standard control table and collateral blood vessels physiological parameter data with phase
Same specification storage；And compare, revise with the data of normal people being stored in standard control table, its result exports simulation handss
Art scheme module, from this sham operated scheme, not only can intuitively show the difference of dynamic circulation, facilitate doctor to carry out simultaneously
Simulated surgical operation is simulated modification operation again.
Digital sampling and processing, the human body being collected using the active contour model partitioning algorithm segmentation in medical image
Chest Image information, obtains human chest heart and collateral blood vessels image data information.
Sham operated module, display patient's heart and collateral blood vessels stereochemical structure data, and operating theater instruments, doctor is using aobvious
The operating theater instruments shown are simulated operation technique.
Extracorporeal circulation module, the stereochemical structure model that 3d prints is connected with cardiopulmonary bypass unit, and the overall dynamics of formation are followed
Ring model.
Patient's collateral blood vessels physiological parameter module, obtains patient's heart and collateral blood vessels physiology ginseng by extracorporeal circulation module
Then the physiological parameter of patient is temporarily stored in patient's collateral blood vessels physiological parameter module by number, and then inputs standard control table.
Sham operated scheme module, shows that patient's heart and collateral blood vessels physiological parameter and doctor are in mould after sham operated
Intend operating the patient's heart changed and collateral blood vessels part in surgical modules.
The heart of patients with congenital heart and the physiological parameter data of collateral blood vessels can be obtained using the present invention in the preoperative,
Doctor need not obtain congenital heart disease relevant parameter in neonate using invasive intervention method, and preoperative, doctor also can be intuitively congenital
Property the heart of the cardiac and dynamic situation of collateral blood vessels, also need not carry out preoperative and create diagnosis.
Embodiment 2
Print the population structure realizing congenital heart disease operation plan preoperative evaluation device by 3d with embodiment 1, in the present invention
Middle heart and the collateral blood vessels stereochemical structure model blood vessel position corresponding with cardiopulmonary bypass unit printing normal person or patient using 3d
Put connection, be connected with cardiopulmonary bypass unit respectively particular by vessel branch.The stereochemical structure model that 3d prints with follow in vitro
Ring machine connects, and wherein connecting node exports 3mm, at a, superior vena cava distance referring to Fig. 6, respectively postcava apart from right atrium
Right atrium exports 3mm, and at b, right pulmonary artery exports 3mm apart from right ventricle, and at c, aorta exports 3mm apart from left ventricle, at d；
Left pulmonary artery exports 3mm apart from right ventricle, and at e, left pulmonary vein exports 3mm apart from left atrium, and at f, right pulmonary vein is apart from the left heart
Room exports 3mm, at g.
When in the present invention, 3d is printed stereochemical structure model and is connected with cardiopulmonary bypass unit, must have preferably close at junction point
Feng Xing, the intubation being derived from cardiopulmonary bypass unit during connection must be inserted into Ink vessel transfusing, and ventricle, atrium can not be inserted in intubation top, needs
Keep the distance within 3mm with ventricular chamber, atrial chamber, to obtain accurate collateral blood vessels physiological parameter.Embodiment 3
Print the population structure of the device realizing congenital heart disease operation plan preoperative evaluation by 3d with embodiment 1-2, this
The heart of normal human's chest and collateral blood vessels data that bright middle data 3d print module foundation digital sampling and processing obtains,
Print normal human's heart and collateral blood vessels stereochemical structure first, by normal human's heart and collateral blood vessels stereochemical structure and body
Outer circulation machine is attached, and constitutes extracorporeal circulation module, obtains Normal Human Heart by extracorporeal circulation module and collateral blood vessels are crucial
Position physiological parameter, Criterion synopsis, what this standard control heading was first stored in is the physiological parameter of normal person.
Then patient's heart and collateral blood vessels data pass through digital sampling and processing, the patient's heart after being split and
Collateral blood vessels data message, by the patient's heart after segmentation and collateral blood vessels data message input sham operated module, in simulation
In surgical modules, doctor is simulated operation technique to patient's heart and collateral blood vessels data, by three of patient after sham operated
Dimension data information input data 3d print module, patient's human heart that data 3d print module obtains according to sham operated module
And collateral blood vessels data, print simulation postoperative patients' human heart and collateral blood vessels stereochemical structure, the simulation that 3d is printed
Postoperative patients' heart and collateral blood vessels stereochemical structure model are connected with cardiopulmonary bypass unit, obtain patient's heart and collateral blood vessels are closed
Key position physiological parameter, is stored in heart and the collateral blood vessels physiological parameter module of patient, provides base for the optimal operation plan of doctor
Plinth reference.
The up-to-date rapid molding device of the technology such as 3d printing technique actually utilizes photocuring and ply of paper is folded.Continuously emerge
New material 3d print application is possibly realized in medical science, people begin to use novel biomaterial, and are applied to
In clinical practice, produce human tissue organ, carry out face's modification and beauty treatment etc., the present invention is printed using 3d printing technique
Heart and collateral blood vessels stereochemical structure.Realize the technical scheme of noinvasive Simulation Diagnosis.
In the present invention data 3d print module according to digital sampling and processing obtain the heart of normal human's chest and
Collateral blood vessels data, the Normal Human Heart of acquisition and collateral blood vessels data message are converted into 3d printer suitable format, are suitable for
Form has stl, obj, and the present invention uses stl form, then by the Normal Human Heart obtaining and the input of collateral blood vessels data message
3d printer, prints normal human's heart and collateral blood vessels stereochemical structure model；Normal human's heart and collateral blood vessels are stood
Body structural model is connected with cardiopulmonary bypass unit, and the normal human's heart being obtained by extracorporeal circulation module and collateral blood vessels physiology are joined
Number, sets up normal human's heart and collateral blood vessels standard control table；Then patient's heart and collateral blood vessels data are adopted by data
Collection processing module, patient's data message after being split, and then input sham operated module, in sham operated module, doctor
Operation technique is simulated to patient data, obtains patient's heart and collateral blood vessels data after sham operated, data 3d impression block
Patient's heart after sham operated and collateral blood vessels data message are converted into 3d printer suitable format by block, suitable format have stl,
Obj, the present invention uses stl form, then by the patient's heart obtaining and collateral blood vessels data message input 3d printer, prints
Go out patient's human heart and collateral blood vessels stereochemical structure model, by patient's human heart and collateral blood vessels stereochemical structure model and body
Outer circulation machine is attached, and obtains patient's heart and collateral blood vessels physiological parameter by extracorporeal circulation module, sets up the heart of patient
Dirty and collateral blood vessels physiological parameter module, provides base reference for the optimal operation plan of doctor.
Embodiment 4
The present invention or a kind of method realizing congenital heart disease operation plan preoperative evaluation by 3d printing, above-mentioned by 3d
Printing is realized realizing on congenital heart disease operation plan preoperative evaluation device, assesses doctor's simulated surgical operation by 3d printing technique
With embodiment 1-3, referring to Fig. 2, the method that the present invention measures heart collateral blood vessels parameter includes following step to equipments overall structure
Rapid:
1 ＞ gathers the chest ct information of normal person, and the partitioning algorithm using medical image, by data acquisition process mould
Block, is partitioned into normal person's chest heart and collateral blood vessels ct data message, obtains Normal Human Heart and collateral blood vessels data；This example
The medical image partitioning algorithm of middle employing is active contour model algorithm, and active contour model algorithm can split normal person's chest
Heart and collateral blood vessels ct information, obtain complete heart and collateral blood vessels data.
2 ＞ will obtain Normal Human Heart and collateral blood vessels data, using 3d printing technique, print particular by data 3d
Module, prints Normal Human Heart and collateral blood vessels stereochemical structure model；Used in this example, 3d printer is that aurora that is fertile, defeated
Entering Normal Human Heart in 3d printer and collateral blood vessels data form can be stl, obj, the normal person adopting in this example
Heart and collateral blood vessels data entry format are stl, and the printed material of employing is a kind of new bio-based and biodegradable
Material-polyester acid.
The Normal Human Heart printed and collateral blood vessels stereochemical structure model are connected by 3 ＞ with cardiopulmonary bypass unit, constitute body
Outer circulation module, is obtained the overall dynamics circulation model of Normal Human Heart and collateral blood vessels, referring to Fig. 5, is followed by overall dynamics
Ring model obtains Normal Human Heart and collateral blood vessels integrally circulate in side shoot node physiological parameter, set up Normal Human Heart and side
Branch blood vessel physiological parameter standard, is placed in standard control table, referring to Fig. 1；Move according to Normal Human Heart and collateral blood vessels in other words
Physiological parameter in state circulation forms canonical cycle model.
4 ＞ then gather the chest ct information of patient, and the partitioning algorithm using medical image, by data acquisition process
Module, is partitioned into chest heart and the collateral blood vessels ct data message of patient, obtains patient's heart and collateral blood vessels data.
5 ＞ will obtain patient's heart and collateral blood vessels three-dimensional data, be input to sham operated module, in sham operated module
In, show the stereochemical structure after patient's heart and collateral blood vessels data reconstruction, referring to Fig. 7.Doctor is according to simulation handss in the figure 7
The stereochemical structure of the patient's heart of display and collateral blood vessels data in art module, doctor is simulated operation to patient's ct image.
When the disease sites finding patient's heart and collateral blood vessels, doctor utilizes the mould providing in sham operated module taking Fig. 8-a as a example
Intend operating theater instruments, part between 1 and 2 in patient illness part in excision Fig. 8-a, select 1 and, sham operated mould again at 2 two points
Block automatically generates neovascularity referring to Fig. 8-b, and the neovascularity in Fig. 8-b completes to be connected with excision point 1 and 2, and sham operated result is joined
See Fig. 8-c, obtain the patient's heart after sham operated and collateral blood vessels three-dimensional data, that is, obtain simulating postoperative patient's heart and
The stereochemical structure of collateral blood vessels data.
6 ＞ will obtain patient's heart and collateral blood vessels data after sham operated, using 3d printing technique, is beaten by data 3d
Impression block, prints the patient's heart after sham operated and collateral blood vessels stereochemical structure model.
Patient's heart after the sham operated printing and collateral blood vessels stereochemical structure model are connected by 7 ＞ with cardiopulmonary bypass unit
Connect, referring to Fig. 5, obtain the overall dynamics circulation model of patient's heart and collateral blood vessels, obtained by overall dynamics circulation model
Patient's heart and collateral blood vessels integrally circulate in side shoot node physiological parameter, by the patient's heart obtaining and collateral blood vessels physiology
Parameter, also enters in standard control table.
8 ＞, in standard control table, show patient and normal human heart and collateral blood vessels physiology ginseng after sham operated
Difference between number, is supplied to doctor, and doctor, according to the difference between patient after sham operated and normal person's physiological parameter, selects
Whether again row sham operated, if not needing, direct execution step 9, by patient's heart and collateral blood vessels after the sham operated obtaining
Physiological parameter, the postoperative patient's heart of simulation simultaneously also doctor being obtained in sham operated module and collateral blood vessels data
Stereochemical structure is also communicated in sham operated scheme module, terminates heart collateral blood vessels parameter measurement, if needing row mould again
Intend operation, then the heart to patient and collateral blood vessels three-dimensional data are simulated operation adjustment operation to return to step 5 again, until right
It is that doctor is acceptable according to the difference between the patient showing in table and the physiological parameter of normal person, the simulation handss now obtaining
Art scheme is preferred plan.
In sham operated scheme module, display includes patient's heart and collateral blood vessels physiological parameter after sham operated to 9 ＞,
Shown with data mode, also include the stereochemical structure simulating postoperative patient's heart and collateral blood vessels data, mould illustrated above
Intend operation optimal case, the basis performed the operation as doctor, can intuitively show the difference of dynamic circulation it is also possible to directly perceived close
Key position physiological parameter.
Cardiopulmonary bypass unit in this example refers to temporarily replace human heart and lungs work with a kind of special device, referring to figure
4, carry out blood circulation and gas exchange.This device is referred to as the artificial heart and artificial lung, is also referred to as artificial heart-lung, the artificial heart
Lung device or extracorporeal circulation apparatuses.During extracorporeal circulation, venous blood introduces artificial lung through superior and inferior vena cave and carries out oxygen merging discharge two
Carbonoxide, the blood after oxygen closes keeps certain pressure to pump into internal Arterial system through the artificial heart again, thus when both ensure that operation
Peace and quiet, clearly surgical field of view, in turn ensure that the blood supply of other important organs beyond heart, be the development of cardiovascular injuries surgery
Important guarantee measure.
According to extracorporeal circulation principle and statistical technique, by the Normal Human Heart printed and collateral blood vessels stereomodel with
Cardiopulmonary bypass unit connects, and using the collateral blood vessels physiological parameter of the normal person collecting, sets up Normal Human Heart and collateral blood vessels
Physiological parameter standard, is placed in standard control table, Criterion synopsis, is that diagnosis patient is normal with standard control table
The heart of the patient of people's same age and collateral blood vessels physiological parameter provide reference, compare.
The present invention combines medical image processing technology, 3d printing technique, cardiopulmonary bypass unit, provides one kind can allow doctor
The raw platform being simulated operation and approach.3d first prints Normal Human Heart and collateral blood vessels stereochemical structure model, and with
Cardiopulmonary bypass unit connects, and detects Normal Human Heart and collateral blood vessels physiological parameter, Criterion synopsis；In sham operated module
Middle doctor is simulated operation technique to patient's heart and collateral blood vessels three-dimensional data, and then 3d prints patient after sham operated
Heart and collateral blood vessels stereochemical structure model, set up patient's heart and collateral blood vessels extracorporeal circulation by cardiopulmonary bypass unit, detection
Patient's heart and collateral blood vessels physiological parameter, in input synopsis, show the difference between physiological parameter and normal person,
The present invention establishes human heart and collateral blood vessels external dynamic circulation model, obtains blood flow with regard to Heart tissue, blood
The data messages such as pressure, are also convenient for doctor and are simulated again performing the operation, have evaluated the feasibility of sham operated scheme simultaneously.For doctor
Carrying out operative treatment provides foundation, realizes congenital heart disease operation plan preoperative evaluation.
Embodiment 5
Print by 3d and realize the apparatus and method of congenital heart disease operation plan preoperative evaluation with embodiment 1-4, the present invention from
In the overall dynamics circulation model of heart and collateral blood vessels, the heart obtaining and collateral blood vessels integrally circulate cardiac and side shoot section
The physiological parameter of point, referring to Fig. 6, during heart therein and collateral blood vessels integrally circulate, side shoot node includes, superior vena cava away from
Export 3mm from right atrium, at b, postcava exports 3mm apart from right atrium, at a, left pulmonary artery exports 3mm, e apart from right ventricle
Place, right pulmonary artery exports 3mm apart from right ventricle, and at c, left pulmonary vein exports 3mm apart from left atrium, and at f, right pulmonary vein distance is left
Atrium exports 3mm, and at g, aorta exports 3mm apart from left ventricle, at d；Overall dynamics cyclic module from heart and collateral blood vessels
In type, the heart obtaining and collateral blood vessels integrally circulate cardiac and the physiological parameter of side shoot node, and wherein physiological parameter includes
The blood flow rate of heart collateral blood vessels, blood stream pressure.
Skilled physician according to the difference between patient and Normal Human Heart and collateral blood vessels physiological parameter, in sham operated mould
Block doctor carries out the simulated surgical operation of kinds of schemes, until in synopsis the patient that shows and normal person physiological parameter it
Between difference be that doctor is acceptable, the sham operated scheme now obtaining be preferred plan.Present invention, avoiding doctor's foundation
Experience directly carries out the risk that operative treatment brings, and it also avoid the misery that interventional therapy brings patient, is that doctor provides trouble
Person's intuitively dynamic circulation situation, facilitates doctor's row simulated surgical operation again, to determine optimum operation plan, improves the life of patient
Deposit probability.
From overall angle, the technical scheme that the present invention takes is further described below below:
Embodiment 6
Print the apparatus and method realizing congenital heart disease operation plan preoperative evaluation by 3d with embodiment 1-5, comprising:
Step 1 is in digital sampling and processing, referring to Fig. 1, normal using the scanning of ct computed tomographic scanner
Human chest heart and collateral blood vessels, obtain normal person's chest heart and collateral blood vessels ct data message, according at medical image
Active contour model algorithm in reason, using computer compiling active contour model algorithm to normal person's chest heart and side shoot blood
Pipe image ct data is split, Normal Human Heart and collateral blood vessels ct data after being split.
Step 2, by Normal Human Heart and collateral blood vessels ct data input data 3d print module, referring to Fig. 1, in data 3d
The Normal Human Heart that obtains will be split and collateral blood vessels data is converted to huge shadow using compiled software in print module
(pmax) 3d printer proprietary format, huge shadow printer professional format is stl, and the printed material of huge shadow printer is polytetrafluoroethyl-ne
Alkene, prints Normal Human Heart and collateral blood vessels stereochemical structure model using huge shadow 3d printer.
Step 3, will print Normal Human Heart and collateral blood vessels stereochemical structure model is connected with cardiopulmonary bypass unit, referring to figure
4, Fig. 4 is the principle schematic diagram. of cardiopulmonary bypass unit, and in figure heavy black line is that with cardiopulmonary bypass unit, patient's heart is connected it
The extracorporeal circulation system obtaining afterwards.Fig. 6 gives the measurement position schematic diagram of human heart and collateral blood vessels main positions, Fig. 6
The middle human heart needing measurement and the main branch of collateral blood vessels have, superior vena cava, measuring node for b at, postcava, survey
Amount node for a at, left pulmonary artery, measuring node for e at, right pulmonary artery, measuring node for c at, left pulmonary vein, measuring node is
At f, right pulmonary vein, measuring node for g at, aorta, measuring node for d at；Again referring to Fig. 5, Fig. 5 is to follow in vitro in the present invention
Ring module build schematic diagram, by data 3d print module obtain Normal Human Heart and collateral blood vessels stereochemical structure model and body
Outer circulation machine connects, and constitutes extracorporeal circulation module, that is, obtains the overall dynamics circulation model of Normal Human Heart and collateral blood vessels, tool
Body Normal Human Heart and collateral blood vessels with the connection of cardiopulmonary bypass unit are, the superior vena cava intubation of cardiopulmonary bypass unit and the normal popular feeling
Dirty and collateral blood vessels stereochemical structure model superior vena cava is connected, and referring to Fig. 5, connecting node is at b；Under cardiopulmonary bypass unit
Cannulation of venae cava is connected with the postcava of Normal Human Heart and collateral blood vessels stereochemical structure model, referring to Fig. 5, connecting node
It is at a；The left pulmonary artery phase of the left pulmonary artery intubation of cardiopulmonary bypass unit and Normal Human Heart and collateral blood vessels stereochemical structure model
Connect, connecting node is at e；In the same manner, right pulmonary artery intubation is connected with right pulmonary artery, and connecting node is at c；Aortic cannulation
It is connected with aorta, connecting node is at d；Left pulmonary vein intubation is connected with left pulmonary vein, and connecting node is right lung at f
Venous cannulation is connected with right pulmonary vein, and connecting node is at g.The overall dynamics circulation model of Normal Human Heart and collateral blood vessels
It is: blood flows out to blood pump through aorta, flows to superior and inferior vena cava through blood pump, flow into right atrium through superior and inferior vena cava,
Flow into right ventricle again, flow out through left and right pulmonary artery, flow into artificial lung, through artificial lung, flow into left and right pulmonary vein, be back to the left heart
Room, then flow out aorta again through left ventricle.Connect Normal Human Heart and collateral blood vessels stereochemical structure model and cardiopulmonary bypass unit,
It is the formation of Normal Human Heart and collateral blood vessels overall dynamics circulation model, by Normal Human Heart and collateral blood vessels overall dynamics
Circulation model can directly obtain Normal Human Heart and collateral blood vessels physiological parameter, and heart and collateral blood vessels physiological parameter node divide
Not at node a, at node b, at node c, at node d, at node e, at node f, at node g, referring to Fig. 6.
Step 4, according to the Normal Human Heart obtaining in extracorporeal circulation module and collateral blood vessels physiological parameter data, statistics is simultaneously
Analysis Normal Human Heart and collateral blood vessels physiological parameter data, set up normal human's heart and collateral blood vessels physiological parameter standard,
And normal human's heart and collateral blood vessels physiological parameter standard are input in standard control table.
Step 5, gathers patient data, in digital sampling and processing, referring to Fig. 1, equally uses ct electronic computer
Tomoscanner scanning patient chest heart and collateral blood vessels, obtain patient chest heart and collateral blood vessels ct data message, according to
Active contour model algorithm in processing according to medical image, using computer compiling active contour model algorithm to the patient chest heart
Dirty and collateral blood vessels image ct data is split, the patient's heart after being split and collateral blood vessels ct data.
Step 6, by patient's heart and collateral blood vessels three-dimensional ct data input to sham operated module, in sham operated module
In, according to the stereochemical structure of the patient's heart of display and collateral blood vessels data in sham operated module, referring to Fig. 7, this stands doctor
Body structure needs to adjust visual angle according to doctor, checks the situation of different parts.
When finding the disease sites of patient's heart and collateral blood vessels, doctor utilizes sham operated module taking Fig. 8-a as a example
The sham operated apparatus of middle offer is simulated operation technique, and simulation removal of lesions being automatically generated using patient's initial data is replaced
Change-blood pipe, replacement blood vessel and focus blood vessel is replaced, obtains the patient's heart after sham operated and collateral blood vessels data.
Step 7, by patient's heart after sham operated and collateral blood vessels ct data input data 3d print module, referring to Fig. 1,
The form of data 3d print module automatic identification input data, and input data format conversion is huge shadow (pmax) 3d printer
Proprietary format, concrete form is stl, and the printed material of huge shadow printer is politef, is printed using huge shadow 3d printer
Go out to simulate postoperative patients' heart and collateral blood vessels stereochemical structure model.
Step 8, after printing sham operated, patient's heart and collateral blood vessels stereochemical structure model are connected with cardiopulmonary bypass unit
In succession, referring to Fig. 4, Fig. 6 and Fig. 5, Fig. 5 be in the present invention extracorporeal circulation module build schematic diagram, by data 3d print module
After the sham operated obtaining, patient's heart and collateral blood vessels stereochemical structure model are connected with cardiopulmonary bypass unit, constitute extracorporeal circulation mould
Block, that is, obtain the overall dynamics circulation model of patient's heart and collateral blood vessels after sham operated, physical simulation postoperative patients' heart
Normal Human Heart and the three-dimensional knot of collateral blood vessels in the connection of dirty and collateral blood vessels stereochemical structure model and cardiopulmonary bypass unit and step 3
Structure model is identical with the connection scheme of cardiopulmonary bypass unit.
Connect simulation postoperative patients' heart and collateral blood vessels stereochemical structure model and cardiopulmonary bypass unit, be the formation of simulating
Postoperative patients' heart and collateral blood vessels overall dynamics circulation model, after sham operated, patient's heart and collateral blood vessels are overall
Dynamic circulation model can directly obtain patient's heart and collateral blood vessels physiological parameter after sham operated, and doctor can be according to acquisition
After sham operated, patient's heart and collateral blood vessels physiological parameter understand the heartbeat of patient and blood circulation shape after sham operated
Condition.
Patient's heart after the sham operated of acquisition and collateral blood vessels physiological parameter are also inputted in standard control table, in standard
In synopsis, show the difference between patient and normal human heart and collateral blood vessels physiological parameter after sham operated, provide
To doctor, doctor, according to the difference between patient after sham operated and normal person's physiological parameter, chooses whether row sham operated again,
If not needing, direct execution step 9, terminating heart collateral blood vessels parameter measurement, if needing row sham operated again, then returning
Heart to patient and collateral blood vessels three-dimensional data are simulated operation adjustment operation, until showing in synopsis to step 6 again
Patient and the physiological parameter of normal person between difference be that doctor is acceptable, the sham operated scheme now obtaining is optimal
Scheme.
Step 9, in sham operated scheme module, after display sham operated patient's heart and collateral blood vessels physiological parameter and
Doctor operates the patient's heart changed and collateral blood vessels data in sham operated module, now obtains optimum sham operated side
Case, the basis performed the operation as doctor, can intuitively show the difference of dynamic circulation.
The present invention utilizes cardiopulmonary bypass unit and the data message of the normal person obtaining and patient to form dynamic circulation, will print
Normal Human Heart and collateral blood vessels stereochemical structure model be connected with cardiopulmonary bypass unit, obtain Normal Human Heart and collateral blood vessels life
Reason parameter, and Criterion synopsis.By print the patient's heart after sham operated and collateral blood vessels stereochemical structure model with
Cardiopulmonary bypass unit connect, obtain the collateral blood vessels physiological parameter of patient, with set up standard control table contrasted, doctor according to
The collateral blood vessels dynamic circulation model of patient and Normal Human Heart and collateral blood vessels physiological parameter canonical form established practice after sham operated
Difference between model circulation model, carries out the simulated surgical operation of kinds of schemes using sham operated module, until in synopsis
Difference between the patient showing and the physiological parameter of normal person is that doctor is acceptable, the operation side after now being optimized
Case.Present invention, avoiding the misery that interventional therapy brings patient, be that doctor provides patient's intuitively dynamic circulation situation, for doctor
Life provides the chance carrying out multiple sham operated, to determine optimum operation plan, improves the chances of survival of patient.
In brief, one kind that the present invention provides prints by 3d and realizes congenital heart disease operation plan preoperative evaluation device and side
Method, it realizes including, and gathers normal person's chest ct information；Print Normal Human Heart and collateral blood vessels stereochemical structure model with 3d
It is connected with cardiopulmonary bypass unit, obtain normal person's overall dynamics circulation model；Collection patient chest ct information, doctor is using simulation handss
In art module, the operating theater instruments of display are simulated operation technique to patient's heart and collateral blood vessels stereochemical structure data, print
Patient's heart and collateral blood vessels stereochemical structure model after sham operated；Patient's stereochemical structure mould after the sham operated that 3d is printed
Type is connected with cardiopulmonary bypass unit, obtains the overall dynamics circulation model of patient's heart and collateral blood vessels after sham operated, in standard
Show patient and the difference of normal human heart and collateral blood vessels physiological parameter after sham operated in synopsis, enter as doctor
The basis of row operation, intuitively shows dynamic circulation, is also convenient for doctor's simulated surgical operation.The present invention utilizes 3d printing technique to set up
Heart and collateral blood vessels stereochemical structure model are connected with cardiopulmonary bypass unit, help doctor to directly obtain heart and collateral blood vessels physiology
Parameter, it is to avoid be directly involved the uncertainty for the treatment of, solves the difficult problem that operative doctor can not be simulated performing the operation simultaneously.This
Invention is applied to operative doctor sham operated.
Claims (4)
1. a kind of device realizing congenital heart disease operation plan preoperative evaluation by 3d printing is it is characterised in that include: data is adopted
Collection processing module, sham operated module, data 3d print module, extracorporeal circulation module, standard control table, the life of patient's collateral blood vessels
Reason parameter module, sham operated scheme module, gather human chest information data for normal person and patient, respectively from normal
The human chest information data of people, by digital sampling and processing, data 3d print module, extracorporeal circulation module, is stored in mark
In quasi- synopsis；Human chest information data from patient passes through digital sampling and processing, splits through medical image and calculates
Method dividing processing simultaneously obtains patient's heart and collateral blood vessels three-dimensional data, is input to sham operated module, in sham operated module
In, doctor is simulated operation technique, and 3d is printed by the three-dimensional data information input data 3d print module after sham operated
The stereochemical structure model going out is connected with cardiopulmonary bypass unit, collectively forms extracorporeal circulation module, the life being obtained by extracorporeal circulation module
Reason parameter is stored in patient's collateral blood vessels physiological parameter module；And then be transferred in standard control table, and it is stored in standard control table
In data of normal people compare, revise, its result exports sham operated scheme module, from this sham operated scheme,
The difference of dynamic circulation not only can intuitively be shown, facilitate doctor to carry out simulated surgical operation again simultaneously and be simulated changing
Operation；
Digital sampling and processing, the human chest image information being collected using the partitioning algorithm segmentation of medical image, obtain
Human chest heart and collateral blood vessels image data information；
Sham operated module, display patient's heart and collateral blood vessels stereochemical structure data, and operating theater instruments, doctor is using display
Operating theater instruments are simulated operation technique, by the data transfer after sham operated to 3d print module；
Extracorporeal circulation module, the stereochemical structure model that 3d prints is connected with cardiopulmonary bypass unit, the overall dynamics cyclic module of formation
Type.
2. the device realizing congenital heart disease operation plan preoperative evaluation by 3d printing according to claim 1, its feature exists
In the heart of normal human's chest and collateral blood vessels number that described data 3d print module foundation digital sampling and processing obtains
According to printing normal human's heart and collateral blood vessels stereochemical structure first, by normal human's heart and collateral blood vessels stereochemical structure
It is attached with cardiopulmonary bypass unit, obtain Normal Human Heart and collateral blood vessels key position physiological parameter, Criterion synopsis；
Then data 3d print module foundation sham operated module obtains the heart of patient's human chest and collateral blood vessels data, print
Go out patient's human heart and collateral blood vessels stereochemical structure, be attached with cardiopulmonary bypass unit, obtain patient's heart and collateral blood vessels
Key position physiological parameter, is stored in heart and the collateral blood vessels physiological parameter module of patient.
3. a kind of by 3d print realize congenital heart disease operation plan preoperative evaluation method, described in claim 1 or 2 by
3d prints and realizes it is characterised in that comprising the following steps that on the device realizing congenital heart disease operation plan preoperative evaluation
1 ＞ gather normal person chest ct information, and using medical image partitioning algorithm, be partitioned into normal person's chest heart and
Collateral blood vessels ct data message, obtains Normal Human Heart and collateral blood vessels data；
2 ＞ will obtain Normal Human Heart and collateral blood vessels data, using 3d printing technique, print Normal Human Heart and side shoot blood
Pipe stereochemical structure model；
The Normal Human Heart printed and collateral blood vessels stereochemical structure model are connected by 3 ＞ with cardiopulmonary bypass unit, obtain normal person
The overall dynamics circulation model of heart and collateral blood vessels, obtains Normal Human Heart and collateral blood vessels by overall dynamics circulation model
In overall circulation, the physiological parameter of side shoot node, sets up Normal Human Heart and collateral blood vessels physiological parameter standard, is placed on standard pair
According in table；
4 ＞ gather the chest ct information of patient, and the partitioning algorithm using medical image, are partitioned into chest heart and the side of patient
Branch blood vessel ct data message, obtains patient's heart and collateral blood vessels data；
5 ＞, are simulated to obtaining patient's heart and collateral blood vessels data simulation operation technique using sham operated module
Postoperative patient's heart and collateral blood vessels data；
6 ＞, by patient's heart after the sham operated obtaining and collateral blood vessels data, using 3d printing technique, print sham operated
Patient's heart afterwards and collateral blood vessels stereochemical structure model；
After the sham operated that 7 ＞ will print, patient's heart and collateral blood vessels stereochemical structure model are connected with cardiopulmonary bypass unit, obtain
The overall dynamics circulation model of patient's heart and collateral blood vessels, obtains patient's heart and side shoot blood by overall dynamics circulation model
Pipe integrally circulate in side shoot node physiological parameter, the patient's heart obtaining and collateral blood vessels physiological parameter also enter into mark
In quasi- synopsis；
8 ＞ in standard control table, show after sham operated patient and normal human heart and collateral blood vessels physiological parameter it
Between difference, be supplied to doctor, doctor, according to the difference between patient after sham operated and normal person's physiological parameter, chooses whether
Row sham operated again, if not needing, direct execution step 9, if (row sham operated again) then return to step 5 heart to patient again
Dirty and collateral blood vessels three-dimensional data simulation operation adjustment operates, until the life of the patient showing in synopsis and normal person
Difference between reason parameter is that doctor is acceptable, and the sham operated scheme now obtaining is preferred plan；
9 ＞, in sham operated scheme module, show optimum operation plan, the basis performed the operation as doctor, display directly perceived
The difference of dynamic circulation.
4. the method realizing congenital heart disease operation plan preoperative evaluation by 3d printing according to claim 3, its feature exists
Integrally circulate cardiac in, the described heart obtaining from the overall dynamics circulation model of heart and collateral blood vessels and collateral blood vessels
And the physiological parameter of side shoot node, during heart therein and collateral blood vessels integrally circulate, side shoot node includes, superior vena cava away from
Export 3mm from right atrium, at b, postcava exports 3mm apart from right atrium, at a, left pulmonary artery exports 3mm, e apart from right ventricle
Place, right pulmonary artery exports 3mm apart from right ventricle, and at c, left pulmonary vein exports 3mm apart from left atrium, and at f, right pulmonary vein distance is left
Atrium exports 3mm, and at g, aorta exports 3mm apart from left ventricle, at d；The described overall dynamics from heart and collateral blood vessels are followed
In ring model, the heart obtaining and collateral blood vessels integrally circulate cardiac and the physiological parameter of side shoot node, physiological parameter therein
Include blood flow rate, the blood stream pressure of heart collateral blood vessels.
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| WO2020095078A1 (en) | 2018-11-09 | 2020-05-14 | Semmelweis Egyetem | Exoskeleton for assisting surgical positioning, method for producing the exoskeleton |
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