Application Of 3D Technology In Clinical And Teaching Of Liver Tumors

Objectives: 3DV technology was used to construct a three-dimensional visualization model of liver with tumors,and surgical planning could be performed.The liver physical model was printed by 3DP(3D printing)technology and introduced into the liver teaching.Exploring the application value of 3D technology in liver surgery and teaching of residents who were in standardized training.Methods: 1.Patients with liver tumors hospitalized in the Department of Hepatobiliary Surgery,Affiliated Hospital of Hebei University from October 2016 to October 2018 were collected.According to the inclusion and exclusion criteria,36 cases were selected.They included 22 patients with primary liver cancer(61.11%),9 patients with cavernous hemangioma(25.00%),and 5 patients with focal nodular hyperplasia(13.89%),with an average age of 52.9 years(33-75 years).They consist of 22 males and 14 females.Some patients had symptoms such as abdominal distension and abdominal pain after meal.The rest were diagnosed by physical examination.All patients were well-prepared for blood routine,liver and kidney function,blood coagulation,ultrasound,chest X-ray,abdominal thin-slice CT plain and enhanced examination.According to the cases,the patients were randomly divided into 3DV group and control group.The 3DV group used 3DV technology to complete liver model reconstruction on the computer and plan the operation plan.The control group was planned according to the medical imaging examination.The application value of 3DV technique in liver tumor surgery was evaluated by comparing the operation time and intraoperative blood loss.2.The liver 3DV shell model and the three-network vascular bundle were printed by the UNIL LCD-SLA 3D printer.Then,a liver model mold was made.A liver physical model was made by infusion,assembly,and other ways.Sixty-six residents training in the hepatobiliary surgery of the Affiliated Hospital of Hebei University from December 2016 to December 2018 were randomly divided into the control group,the 3DP group and the MDT+3DP group,with 20 in each group.Different teaching methods were adopted,and the three groups of doctors were invited to take the examinations,and the teaching was evaluated in the form of questionnaires from the aspects of teaching quality,learning efficiency and satisfaction.The examination was conducted again after 2 months.Assessment of teaching effectiveness through subjective examinations and objective evaluation.Result:1.Three-dimensional visualization model of liver with high precision(hepatic blood vessels reaching 5-6 branches)and three mesh fusion(hepatic vein,hepatic artery,portal vein fusion)can be completed before operation.The operation time and intraoperative blood loss in the 3DV group were less than those in the control group.There were no significant differences in the postoperative hospital stay and the number of postoperative deaths between the two groups.2.The liver physical model with low cost,high precision,transparency,full color and triple mesh can be produced.Compared with the three-dimensional visualization model,the error is sub-millimeter.There was no significant difference between the 3DP group and the MDT+3DP group in the examination,and the scores were better than the control group.The comparison of different groups of questionnaires show the results of teaching quality scores:both the 3DP group and the MDT+3DP group were higher than the control group;MDT+3DP group was higher than 3DP group,learning efficiency score results: there was no difference between 3DP group and control group;MDT+3DP group was higher than both the control group and the 3DP group,satisfaction score: 3DP group had no difference with control group;MDT+3DP group was higher than both the control group and the 3DP group.After 2 months,the scores of MDT+3DP group were higher than those of 3DP group,the score of 3DP group was higher than that of the control group,and the score of MDT+3DP group was higher than that of the control group.Conclusion: 1.The computer constructs a three-dimensional visualization model of the liver,which can be rehearsed from multiple positions such as tumor location,vascular anatomy and spatial adjacency,reducing the operation time and intraoperative blood loss,and achieving accurate treatment,which is worthy of clinical promotion.2.Using the printing technology of the affiliated hospital of Hebei University,it is possible to produce a low-cost,high-precision,three-network fusion liver 3DP model,and provide a three-dimensional anatomical teaching aid for residents to make complex liver surgery teaching more convenient.The MDT model combined with the 3DP model can motivate learn enthusiasm of the physicians and deepen the understanding of complex liver diseases.What is more,has a good prospect in clinical teaching.