The Application Value Of 3D Technology In Assisting Pituitary Tumor Surgery And Clinical Teaching

Objective: To explore the application value of 3D technology in pituitary tumor surgery and clinical teaching.Methods: 1.Print 3D pituitary tumor model: 5 cases of pituitary tumor patients were recruited in the Department of Neurosurgery of our hospital.Each patient completed CTA and MRI examination in the imaging department of our hospital to obtain the image d ata of the patients,and then imported the original image data into the 3D reconstruction software mimics in DICOM format In 21.0,through the steps of threshold comparison,mask editing,intelligent filling,Boolean calculation,smooth mask,registration and fusion,3D visualization pituitary tumor model was reconstructed,saved as STL file and imported into 3D printer for pre printing segmentation,design and equal scale printing of pituitary tumor model;2.The model was used for preoperative planning,i ntraoperative guidance and disease diagnosis of pituitary tumor surgery Evaluation of the application value of the model:(1)evaluation of the effect of model assisted surgery: a total of 16 experts from the Department of Neurosurgery of the hospital were invited to conduct a randomized controlled trial to subjectively evaluate the value of 3D model and two-dimensional imaging data(CT and MRI)of pituitary adenoma for assisted surgery,including whether it is intuitive,accurate,practical,convenient for spatial conception and overall satisfaction(2)teaching evaluation: a randomized controlled trial was conducted to select 60 clinical medicine interns of grade 2018(Grade 5).The above 60 interns were randomly divided into control group A(n = 30)and experimental group In group B(n = 30),the teacher explained the clinical knowledge of pituitary adenoma with neurosurgery textbooks,two-dimensional imaging data(MRI,CT)and related laboratory data to the students in group A;while the students in group B used neurosurgery textbooks,two-dimensional imaging data(MRI,CT)and related laboratory data to explain the clinical knowledge with 3D pituitary adenoma model,and Kruskal wallish test was used to test the two groups Group A was evaluated subjectively and group B was evaluated objectively by t test.Results: 1 The model can be enlarged,reduced,rotated and observed from multiple angles;the skull can be transparent,and the morphology,anatomical position of pituitary adenoma and its relationship with adjacent blood vessels can be observed directly;2.The experiment successfully printed the complete skull base anatomy and intracranial arteriovenous and tumor information according to the ratio of 1:1 Combined solid model,the structure of each organ is real,vivid and three-dimensional,the model printing material is TPU polymer material,with high tension,high tension and other characteristics,strong toughness,the solid model can be disassembled and assembled freely,which is convenient for the application of auxiliary surgery(simulation surgery,surgical design,etc.);3 The evaluation of accuracy(P = 0.021),practicability(P = 0.005),convenience of space conception(P = 0.003)and overall satisfaction(P = 0.038)were better than two-dimensional image data CT and MRI;4.The results of teaching objective evaluation showed that there was no significant difference between the two groups in the pre-test scores(P > 0.05),but there was no significant difference in the post test scores(P > 0.05),However,the scores of post test were higher than those of pre test,and the difference was statistically significant(P < 0.05);the results of students’ subjective evaluation showed that although there was no significant difference in knowledge acquisiti on efficiency and overall satisfaction between the two groups(P > 0.05),there was no significant difference in strengthening clinical thinking and enhancing the understanding of pituitary tumor diagnosis and treatment(P > 0.05),However,the students in group B thought that the 3D pituitary tumor model directly showed the adjacent relationship between pituitary tumor and blood vessels(P = 0.012),the anatomical position of pituitary tumor(P = 0.004),the correct spatial understanding of the shape and size of pituitary tumor(P < 0.001),the creative thinking(P = 0.049)and the learning curve of pituitary tumor(P = 0.024)were improved,and the differences were statistically significant The significance of learning.Conclusion: 3D pituitary adenoma model was successfully established in this study.The model can clearly show the adjacent relationship between pituitary adenoma and internal carotid artery and cavernous sinus,and clearly sh ow the anatomical position of sphenoid sinus and sellar floor.Its accuracy and specificity provide a new auxiliary method for the study of surgical treatment of pituitary adenoma.The application of 3D pituitary tumor model in surgery evaluation and intraoperative guidance can help surgeons better understand and plan the size of pituitary tumor,adjacent relationship,operation risk,and the scope of sellar floor removal,which is helpful to reduce the operation time;the application of 3D pituitary tumor model in teaching is helpful to improve the learning curve of pituitary tumor,which is a good reference for only using textbooks and two-dimensional image data 3D technology has great application prospects in the field of clinical medicine.