【摘要】 目的研究3D打印技术在颅内肿瘤治疗中的应用效果。方法选取2017年1月至2019年1月间东莞市人民医院神经外科收治的60例经确诊为颅内肿瘤的患者作为研究对象,按照随机数表法将患者分为观察组和对照组,每组30例。对照组在治疗前采用磁共振成像(MRI)及CT进行影像学检查再制定手术方案;观察组在利用患者MRI和CT的医学成像通信(DICOM)数据的基础上对其肿瘤进行三维建模,采用3D打印技术重建患者肿瘤模型并制定手术方案。术后3 d对两组患者进行格拉斯哥昏迷指数(GCS)评分,利用MRI检查患者全切程度和脑梗塞发生率;通过CT灌注成像(CTP)观察患者的脑血容量(CBV)、脑血流量(CBF)、血流平均通过时间(MTT)、达峰时间(TTP)参数,同时用卡氏功能(KPS)评分对治疗效果进行评价。结果观察组患者的肿瘤完全切除率为90.00%,明显高于对照组的63.33%,差异有统计学意义(P<0.05);观察组患者中仅有1例在术后出现脑梗塞,对照组中有6例术后出现脑梗塞,差异具有统计学意义(P<0.05);观察组患者术后的CBV和CBF参数分别为(2.81±0.53) mL/100 g、(65.83±14.76) m L/min,明显高于对照组的(1.74±0.89) mL/100 g、(51.24±16.57) mL/min,差异均具有统计学意义(P<0.05);观察组患者术后的MTT和TTP参数分别为(43.50±5.43) s、(3.04±1.08) s,明显低于对照组的(51.94±6.31) s、(3.93±1.62) s,差异均具有统计学意义(P<0.05);观察组患者术后的KPS评分为(91.67±2.50)分,高于对照组的(81.33±3.75)分,差异具有统计学意义(P<0.05)。结论 3D打印技术能够有效模拟和反映患者颅内肿瘤的组织结构情况,方便主治医师制定更加合理有效的手术治疗方案,从而有效提升治疗效果、减少术后脑梗塞的发生情况,为颅内肿瘤的治疗提供更加安全可靠的临床依据。更多还原

【Abstract】 Objective To study the application effect of 3 D printing technology in the treatment of intracranial tumors. Methods Sixty patients diagnosed with intracranial tumors, who admitted to Department of Neurosurgery of Dongguan People’s Hospital from January 2017 to January 2019 were selected and divided into the observation group and control group according to random number table method, with 30 cases in each group. The control group was subjected to magnetic resonance imaging(MRI) and CT for imaging examination before treatment, and the observation group used the medical imaging communication(DICOM) data of the patient MRI and CT to model the tumor three-dimensionally, reconstructed the patient tumor model by 3 D printing technology and developed a surgical plan. Glasgow Coma Scale(GCS) scores were performed 3 days after surgery, and MRI was used to examine the degree of total stenosis and the incidence of cerebral infarction. The patient’s cerebral blood volume(CBV), cerebral blood flow(CBF),mean blood flow time(MTT), and peak time(TTP) parameters were observed by CT perfusion imaging(CTP). At the same time, the patient’s therapeutic effect was evaluated by Karnofsky performance status(KPS) score. Results The proportion of complete tumor resection in the observation group was 90.00%, which was significantly higher than63.33% in the control group(P<0.05). Only one patient in the observation group had cerebral infarction after operation,and 6 patients in the control group had postoperative cerebral infarction, the difference was statistically significant(P<0.05). The CBV and CBF index of the observation group were(2.81±0.53) mL/100 g and(65.83±14.76) mL/min, which were significantly higher than corresponding(1.74±0.89) mL/100 g and(51.24±16.57) mL/min of the control group(P<0.05). The MTT and TTP index of the observation group were(43.50±5.43) s and(3.04±1.08) s, which were significantly lower than corresponding(51.94±6.31) s and(3.93±1.62) s of the control group(P<0.05). The KPS score of the observation group was(91.67 ± 2.50) points, which was significantly higher than(81.33 ± 3.75) points of the control group(P<0.05). Conclusion 3 D printing technology can effectively simulate and reflect the tissue structure of the patient’s intracranial tumor, and facilitate the attending physician to develop a more reasonable and effective surgical treatment plan, thereby effectively improving the treatment effect, reducing the occurrence of postoperative cerebral infarction, and treating the intracranial tumor, which could provide a safer and more reliable clinical basis.更多还原