Pelvicaliceal biomodeling as an aid to achieving optimal access in percutaneous nephrolithotripsy
Pelvicaliceal biomodeling as an aid to achieving optimal access in percutaneous nephrolithotripsy
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DOI：
10.1089/end.2006.20.92
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发表时间：
2006-02-01
影响因子：
2.7
通讯作者：
Magnusson, A
中科院分区：
文献类型：
--
作者：
Radecka, E;Brehmer, M;Magnusson, A
目的：前瞻性研究CT数据生成的三维立体骨成像生物模型对经皮肾镜碎石（PCNL）最佳入路的帮助。患者与方法：选择8例复杂性尿路结石患者。采用俯卧位对肾脏进行原生期和排泄期的多层螺旋CT扫描，模拟手术时的体位。从数据体中生成连续的重构切片。对感兴趣的数据进行处理，将其转换为可接受的生物模型生产格式。我们制作了盆骨系统和结石的精确塑料复制品，并将其用于形态学评估、术前计划、患者教育和手术导航。结果：调查结果基于主观意见而非客观数据。生物模型增强了在手术前可视化患者独特解剖结构的能力。这有助于计划和预演的泌尿系统手术。结论：虽然这项研究只是一个初步的调查，但我们假设生物建模具有允许成像数据以物理形式显示的优势。在困难的情况下，这项技术可以改善治疗，手术计划，以及与同事和患者的沟通。该技术的局限性包括制造时间和成本，但更准确的穿刺位置选择可以通过节省作业时间来降低成本。
Purpose: To investigate prospectively the benefits of three-dimensional stereolithographic biomodeling produced from CT data as an aid to achieving optimal access for percutaneous nephrolithotripsy (PCNL).Patients and Methods: Eight patients with complex urinary calculi were selected. Multislice CT scans of the kidney in native and excretory phases were acquired with the patient in the prone position to simulate the position during surgery. Contiguous reconstructed slices were produced from the data volume. The data of interest were processed to transform them into a format acceptable for production of a biomodel. Exact plastic replicas of the pelvicaliceal system and the calculi were created and used for morphologic assessment, pre-operative planning, patient education, and surgical navigation.Results: The survey results were based on subjective opinions rather than objective data. The biomodels enhanced the ability to visualize a patient's unique anatomy before surgery. This aided the planning and rehearsal of endourologic procedures.Conclusion: Although this study is only a preliminary investigation, we postulate that biomodeling has the advantage of allowing imaging data to be displayed in a physical form. In difficult cases, this technique may improve treatment, operative planning, and communication with colleagues and patients. The limitations of the technology include the manufacturing time and cost, but more accurate puncture-site selection may reduce costs by saving operating time.