The Roles Of 3D Reconstruction And Printing Technology In Accurate Preoperative Evaluation Of Liver Surgery

Objective:In the past decade,3D reconstruction and printing technology has been widely used in liver surgery.The role of this technique in accurate preoperative evaluation of liver surgery is not clear.In this study,based on 2D thin-layer CT scanning image data,3D reconstruction is carried out to print out a 1:1 physical model of liver,which is used to understand the spatial relationship between liver and tumor,simulate hepatectomy and intraoperative navigation before operation,and evaluate the 3D reconstruction and printing technology outside the liver through statistics of relevant perioperative indicators The effect of preoperative accurate evaluation.Methods:1.Materials:?Philips 128 row spiral CT and its image processing workstation of image center of Luohu District People's Hospital of Shenzhen city;?3D reconstruction software(SYNAPSE VINCENT:FUJIFILM Medical Co.,Ltd.,Tokyo,Japan);?Hongrui hori3d printing slice software;?Hongrui 3D printer.2.Participants:since January 2016 to January 2019,there were totally 80 patients who received hepatectomy in our hospital and we used retrospective analysis to analysis the data.Among them,there were 56 male patients and 24 female patients with an average age of 66.5 years.According to different preoperative evaluation methods,we can divide those patients into two groups:preoperative 3D reconstruction and printing technology group(3D group,n=40)and preoperative 3D reconstruction and printing technology group(non 3D group,n=40).3.Acquisition of two-dimensional thin-layer CT scanning image:the imaging center of Luohu People's Hospital in Shenzhen used Philips 128 row spiral CT scanning to obtain the multi-phase data of two-dimensional thin-layer CT(1.0-1.5mm)of the liver,and the scanning parts were the upper abdomen of the patients.4.Transform 2D image data into 3D model:import multi-phase data of 2D thin slice CT DICOM into 3D reconstruction software for automatic reconstruction,and obtain 3D reconstructed image data.5.The 3D reconstructed image data information is imported into Hongrui 3D printer,and the printing parameters are adjusted to achieve 1:1 liver physical model printing.6.In 3D group,the 1:1 liver physical model made by 3D reconstruction and printing technology was used for preoperative evaluation,while in non 3D group,the 2-D thin-layer CT image data was used for preoperative evaluation.7.The perioperative observation indexes of 3D group and non 3D group were compared,including operation time,bleeding volume,the highest level of aspartate transaminase,postoperative hospital stay,complications and mortality of 30 and 90 days after operation.Results:The mean operation time of 40 patients in 3D group(244.33±24.865 min)was 16 min shorter than that in non 3D group(260.48±22.008 min),P=0.003,which has no statistically significance.The mean bleeding volume of 3D group was(344.70±22.070 ml)less than that of non 3D group(361.23±20.625 ml),P=0.001,which has no statistically significance.The results of the highest aspartate transaminase in 3D group were compared with those in non 3D group.The results showed that in 3D group(389.2±27.7 U/L)were lower than those in non 3D group(452.5±19.6 U/L),P value was 0.015,which has no statistically significance.The average hospitalization time of 40 patients in 3D group was(9.6±1.8 days),less than that in non 3D group(12.6 ± 2.2days),P=0.019,which has no statistically significance.The postoperative complications and biliary fistula in 3D group were compared with those in non 3D group(P=0.018 and 0.034,respectively).There was no significant difference between the two groups(P=0.203,greater than 0.05).There was no significant difference between 30 day mortality and 90 day mortality in the two groups(P=0.999,greater than 0.05).Conclusion:These results show that 3D reconstruction and printing technology can significantly shorten the operation time,reduce the amount of intraoperative bleeding,avoid the trauma of long-term operation and anesthesia,and reduce the incidence of postoperative complications and bile fistula,which is conducive to the recovery of liver function as soon as possible.It can provide reference for hepatectomy in the future.