基于超声图像3D打印二尖瓣环模型可行性及精准度的初步研究

摘要

目的 初步评估基于三维经食管超声心动图(3D-TEE)二尖瓣环3D打印的可行性与3D打印模型的精准度.方法 回顾性研究二尖瓣轻度及以下反流患者25例,二尖瓣中重度反流患者10例,均已接受3D-TEE检查.选取处于舒张末期二尖瓣环3D-TEE图像,以Mimics软件对其进行后处理,获取二尖瓣环标准镶嵌语言格式文件,输出文件至3D打印机,打印出3D模型.在3D模型及相应3D-TEE图像中分别测量二尖瓣环前后直径、前外后内直径、球度指数、周长等参数.计算3D模型与3D-TEE图像中二尖瓣环各参数测值的绝对差值.结果 对所有患者二尖瓣环3D-TEE图像均成功进行了后处理,并通过高精度3D打印机打印出相应的模型;3D打印模型中二尖瓣环各参数测值与3D-TEE图像间差异均无统计学意义(P>0.05),且一致性高,所有测值均在一致性界值范围内;二尖瓣环3D打印模型与3D-TEE图像间各参数测值的绝对差值均较小.结论 以3D-TEE图像为数据源进行二尖瓣环3D打印可行且精准度较高.%Objective To evaluate the feasibility of three-dimensional (3D) printing of mitral annulus with transesophageal echocardiographic volume images as the data source ,and to assess the accuracy of the 3D printing mitral annulus models based on three dimensional transesophageal echocardiography ( 3D-TEE) images preliminarily . Methods A retrospective study was performed in 25 patients with mild or slight mitral regurgitation and 10 patients with moderate to severe mitral regurgitation . All the subjects were underwent 3D-TEE . The 3D-TEE volume images of mitral annulus at the end diastole were post-processed by Mimics software to create images of the mitral annulus in standard tessellation language format . The STL file was output to the 3D printer and the 3D printing models of mitral annulus were obtained . The mitral annulus size parameters including the diameter between anterior and posterior ,the diameter between anterolaterior and posteromedial ,sphericity index and mitral annulus circumference were measured from 3D printing models and 3D-TEE images ,respectively . From which the absolute difference of the measurements between 3D printing models and the 3D-TEE images were calculated . Results All of the 3D-TEE images were successfully post-processed ,and the corresponding 3D printing models were acquired by high-precision 3D printer . It showed no significant difference in all the mitral annulus size parameters between 3D printing modelsand3D-TEEimages(allP >0.05) .Morever,thesizeparameterswereconcordantwellbetweenthe two methods ,all of the data points fell within the limits of agreement . It showed little absolute difference in value of the mitral annulus size parameters between the 3D printing mitral annulus models and the 3D-TEE images . Conclusions It is technically feasible to print 3D models of mitral annulus using 3D-TEE images as the data source . 3D printing mitral annulus models based on transesophageal echocardiographic volume images have high precision .