Comparison of 3D printed anatomical model qualities in acetabular fracture representation.
Comparison of 3D printed anatomical model qualities in acetabular fracture representation.
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DOI：
10.21037/atm-21-5069
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发表时间：
2022-04
影响因子：
--
通讯作者：
Zuniga, Jorge
中科院分区：
文献类型：
--
作者：
Salazar, David A.;Cramer, Justin;Markin, Nicholas W.;Hunt, Nathaniel H.;Linke, Gabe;Siebler, Justin;Zuniga, Jorge
髋臼骨折占骨盆损伤的 10%，这在资源匮乏的发展中国家尤其难以治疗。 3D 打印之前已被证明是一种有益的手术规划方法，但是与购买 3D 打印机相关的高昂初始成本可能会阻止某些机构使用该技术。本研究的目的是使用不同成本的方法开发用于髋臼手术的 3D 打印模型，以确定模型准确性和整体质量的差异。使用 (I) 专有和开源分割软件以及 (II) 熔融沉积建模 (FDM) 和立体光刻 (SLA) 3D 打印方法，根据去识别的 CT 数据开发了五种髋臼骨折模型。在不同的打印方法之间比较了髂后下棘 (PIIS) 和坐骨棘之间的距离以及每个模型的独特骨折片段。然后将这些模型提供给 5 名医生，并与传统 2D 图像相比评估其整体准确性。打印方法不影响 PIIS 到坐骨棘的距离（P=0.263）。然而，不同 3D 打印模型的断裂碎片表示有所不同，其中最准确的模型是由高端树脂打印机生成的（P=0.007）。调查分析表明，低成本打印方法生成的模型在断裂区域的表示方面不那么准确（P=0.008）。使用传统方法和低成本方法开发的模型之间的差异略有不同，但在制定手术计划时仍然可以提供有用的信息。
Acetabular fractures account for 10% of pelvis injuries, which are especially difficult to treat in developing countries with less access to resources. 3D printing has previously been shown to be a beneficial method of surgical planning, however the steep initial costs associated with purchasing a 3D printer may prevent some facilities form utilizing this technique. The purpose of this study was to develop 3D printed models for acetabular surgery using methodologies of varying cost to determine differences in model accuracy and overall quality. Five acetabular fracture models were developed from de-identified CT data using (I) proprietary and open-source segmentation software and (II) fused deposition modeling (FDM) and stereolithography (SLA) 3D printing methods. The distance between the posterior inferior iliac spine (PIIS) and the ischial spine as well as a unique fracture fragment for each model was compared between the different printing methodologies. The models were then given to 5 physicians and assessed on their overall accuracy compared to traditional 2D images. Printing methodology did not affect the distance from PIIS to ischial spine (P=0.263). However, fracture fragment representation differed across 3D printed models, with the most accurate model produced by the high-end resin-based printer (P=0.007). The survey analysis showed that the low-cost printing methods produced models that were not as accurate in their representation of the fractured region (P=0.008). The differences between models developed using traditional methods and low-cost methods have slight differences but may still provide useful information when developing a surgical plan.
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