3D打印技术在脑血管病中的应用进展

doi:10.3969/j.issn.1673-5765.2020.08.019

摘要/Abstract

摘要：

3D打印技术是以三维数学模型数据为基础，通过逐层叠加成实体模型的一种新型辅助技术。脑血管病解剖结构复杂、手术操作难度大、个体化治疗要求高。随着3D打印材料及技术的发展，3D打印技术在脑血管病领域得到了广泛的应用与发展，目前主要应用于制作脑动脉瘤、动静脉畸形、脑动脉狭窄的血管模型，临床上可协助医师模拟培训、制订手术计划、指导手术操作，提高手术效率、降低手术风险，未来可利用3D打印技术联合人造干细胞培养血管生物支架，为脑血管病治疗提供新的契机。

文章导读： 3D打印技术可还原脑血管疾病模型，应用于教学、脑血管疾病血管模型制作、手术演练以及脑血管3D生物支架研发等。

关键词: 3D打印技术; 脑血管病; 教学

Abstract:

3D printing is a new auxiliary technology based on 3D mathematical model data, which is superposed layer by layer into solid models. Cerebrovascular disease has the following features such as complex anatomical structure, difficult operation and high requirements of individualized treatment. With the development of printing material and technology, 3D printing technology has been widely applied and developed in the field of cerebrovascular disease. Currently, it is mainly used to make vascular models of cerebral aneurysm, arteriovenous malformation and cerebral artery stenosis. It can help doctors in simulation training, making operation plan, guiding operation, therefore it can improve operation efficiency and reduce operation risk. In the future, the vascular biological scaffold made by using 3D printing technology combined with stem cell culture, can provide a new opportunity for the treatment of cerebrovascular disease.

Key words: 3D printing; Cerebrovascular disease; Teaching

刘婷，杨德雨，刘莉，唐戈，刘曙东. 3D打印技术在脑血管病中的应用进展[J]. 中国卒中杂志, 2020, 15(08): 916-920.

LIU Ting, YANG De-Yu, LIU Li, TANG Ge,LIU Shu-Dong. Application of 3D Printing Technology in Cerebrovascular Diseases[J]. Chinese Journal of Stroke, 2020, 15(08): 916-920.

参考文献

[1] LIEW Y，BEVERIDGE E，DEMETRIADES A K，

et al. 3D printing of patient-specific anatomy：a tool

to improve patient consent and enhance imaging

interpretation by trainees[J]. Br J Neurosurg，2015，

29（5）：712-714.

[2] MARKL M，SCHUMACHER R，KÜFFER J，et

al. Rapid vessel prototyping：vascular modeling

using 3T magnetic resonance angiography and rapid

prototyping technology[J]. MAGMA，2005，18（6）：

288-292.

[3] D’URSO P S，THOMPSON R G，ATKINSON R

L，et al. Cerebrovascular biomodelling：a technical

note[J]. Surg Neurol，1999，52（5）：490-500.

[4] BACHHUBER M，ARNSTEN J H，WURM

G. Use of cannabis to relieve pain and promote

sleep by customers at an adult use dispensary[J]. J

Psychoactive Drugs，2019，51（5）：400-404.

[5] BENET A，PLATA-BELLO J，ABLA A A，et

al. Implantation of 3D-printed patient-specific

aneurysm models into cadaveric specimens：a new

training paradigm to allow for improvements in

cerebrovascular surgery and research[J/OL]. Biomed

Res Int，2015，2015：939387[2020-02-01]. https：//

doi.org/10.1155/2015/939387.

[6] LEAL A，SOUZA M，NOHAMA P. Additive

manufacturing of 3D biomodels as adjuvant in

intracranial aneurysm clipping[J/OL]. Artif Organs，

2019，43（1）：E9-E15[2020-02-01]. https：//doi.

org/10.1111/aor.13303.

[7] WURM G，LEHNER M，TOMANCOK B，et al.

Cerebrovascular biomodeling for aneurysm surgery：

simulation-based training by means of rapid

prototyping technologies[J]. Surg Innov，2011，18

（3）：294-306.

[8] THAWANI J P，PISAPIA J M，SINGH N，et

al. Three-dimensional printed modeling of an

arteriovenous malformation including blood flow[J/

OL]. World Neurosurg，2016，90：675-683[2020-02-

01]. https：//doi.org/10.1016/j.wneu.2016.03.095.

[9] LIU Y，GAO Q，DU S，et al. Fabrication of cerebral

aneurysm simulator with a desktop 3D printer[J/OL].

Sci Rep，2017，7：44301[2020-02-01]. https：//doi.

org/10.1038/srep44301.

[10] SULLIVAN S，AGUILAR-SALINAS P，SANTOS

R，et al. Three-dimensional printing and

neuroendovascular simulation for the treatment of

a pediatric intracranial aneurysm：case report[J]. J

Neurosurg Pediatr，2018，22（6）：672-677.

[11] NAGASSA R G，MCMENAMIN P G，ADAMS J W，

et al. Advanced 3D printed model of middle cerebral

artery aneurysms for neurosurgery simulation[J]. 3D

Print Med，2019，5（1）：11.

[12] MASHIKO T，OTANI K，KAWANO R，et al.

Development of three-dimensional hollow elastic

model for cerebral aneurysm clipping simulation

enabling rapid and low cost prototyping[J]. World

Neurosurg，2015，83（3）：351-361.

[13] FRÖLICH A M J，SPALLEK J，BREHMER L，et

al. 3D printing of intracranial aneurysms using

fused deposition modeling offers highly accurate

replications[J]. AJNR Am J Neuroradiol，2016，37

（1）：120-124.

[14] 倪慧霞，赵卫，胡继红，等. 基于CTA数据源3D打印

技术在神经介入教学中的应用[J]. 昆明医科大学学

报，2018，39（1）：136-139.

[15] 苏星，黄庆锋，孙树清. 3D打印技术在脑血管病临床

教学中的应用[J]. 交通医学，2016，30（5）：549-550.

[16] 王昊，叶迅，赵元立. 快速成型技术辅助医学影像技

术在教学医院神经外科研究生教学中的实践探索

[J]. 中国卒中杂志，2016，11（11）：1000-1002.

[17] WANG L，YE X，HAO Q，et al. Three-dimensional

intracranial middle cerebral artery aneurysm models

for aneurysm surgery and training[J/OL]. J Clin

Neurosci，2018，50：77-82[2020-02-01]. https：//doi.

org/10.1016/j.jocn.2018.01.074.

[18] ANDERSON J R，THOMPSON W L，ALKATTAN

A K，et al. Three-dimensional printing of

anatomically accurate，patient specific intracranial

aneurysm models[J]. J Neurointerv Surg，2016，8

（5）：517-520.

[19] 袁宇，翟贺鑫，史彦芳，等. 构建颅内动脉瘤3D模型

指导动脉瘤夹闭的诊治体会[J]. 中国神经精神疾病

杂志，2015，41（9）：573-574.

[20] 钱希颖，金立德，陶维华，等. 3D打印技术辅助脑动

脉瘤手术的临床应用[J]. 中华神经医学杂志，2016，

15（5）：483-485.

[21] 周路球，娄明武，陈国昌，等. 640层3D-CTA联合3D

打印脑动脉瘤成像的临床价值[J]. 南方医科大学学

报，2017，37（9）：1222-1227.

[22] 徐超，王波，韩建一，等. 3D打印辅助微导管塑形在

颅内动脉瘤栓塞术中应用[J]. 介入放射学杂志，2017，

26（1）：1-5.

[23] XU Y，TIAN W，WEI Z，et al. Microcatheter

shaping using three-dimensional printed models for

intracranial aneurysm coiling[J]. J Neurointerv Surg，

2020，12（3）：308-310.

[24] WEINSTOCK P，PRABHU S P，FLYNN K，et

al. Optimizing cerebrovascular surgical and

endovascular procedures in children via personalized

3D printing[J]. J Neurosurg Pediatr，2015，16（5）：

584-589.

[25] DONG M Q，CHEN G Z，LI J Y，et al. Threedimensional

brain arteriovenous malformation

models for clinical use and resident training[J/OL].

Medicine，2018，97（3）：e9516[2020-02-01].

https：//doi.org/10.1097/MD.0000000000009516.

[26] 陈光忠，李鉴轶，秦琨，等. 3D打印技术在颅内动静

脉畸形血管内介入治疗中的初步应用[J]. 中国脑血管

病杂志，2016，13（1）：25-28.

[27] XU W H，LIU J，LI M L，et al. 3D printing of

intracranial artery stenosis based on the source

images of magnetic resonance angiograph[J]. Ann

Transl Med，2014，2（8）：74.

[28] FENG Q M，JIANG W B，SUN K，et al. Mechanical

properties and in vivo performance of a novel

sliding-lock bioabsorbable poly-p-dioxanone stent[J].

J Mater Sci Mater Med，2011，22（10）：2319-2327.

[29] LIU Y Y，XIANG K，LI Y，et al. Composite

bioabsorbable vascular stents via 3D bio-printing

and electrospinning for treating stenotic vessels[J].

Journal of Southeast University（English Edition），

2015，31（2）：254-258.

[30] 张栋林，李丹，王敏娟. 缺血性脑卒中治疗中干细胞

移植的作用机制及应用价值[J]. 中国组织工程研究，

2018，22（33）：151-156.

[31] BENEDEK A，CERNICA D，MESTER A，et

al. Modern concepts in regenerative therapy for

ischemic stroke：from stem cells for promoting

angiogenesis to 3D-bioprinted scaffolds customized

via carotid shear stress analysis[J]. Int J Mol Sci，

2019，20（10）：2574.

[32] 洪文瑶，刘宇清，黄绳跃，等. 3D打印技术在颅内动

静脉畸形个体化治疗中的初步应用体会[J]. 中华神

经外科疾病研究杂志，2018，17（1）：74-75.

[33] WURM G，LEHNER M，TOMANCOK B，et al.

Cerebrovascular biomodeling for aneurysm surgery：

simulation-based training by means of rapid

prototyping technologies[J]. Surg Innov，2011，18

（3）：294-306.