Abstract：
BACKGROUND: Herein, we present a proof-of-concept study of 3-dimensional (3D) pouchography using virtual and printed 3D models of ileal pouch-anal anastomosis (IPAA) in patients with normal pouches and in cases of mechanical pouch complications.
METHODS: We performed a retrospective, descriptive case series of a convenience sample of 10 pouch patients with or without pouch dysfunction who had CT scans appropriate for segmentation were identified from our pouch registry. The steps involved in clinician-driven automated 3D reconstruction are presented.
RESULTS: Three patients who underwent CT imaging and were found to have no primary pouch pathology, and seven patients with known pouch pathology identifiable with 3D reconstruction including pouch strictures, megapouch, pouch volvulus, and twisted pouches underwent 3D virtual modeling; one normal and one twisted pouch were 3D printed. We discovered that 3D pouchography reliably identified staple lines (pouch body, anorectal circular and transverse, and tip of J), the relationship between staple lines, and variations in pouch morphology, and pouch pathology.
CONCLUSIONS: Three-dimensional reconstruction of IPAA morphology is highly feasible using readily available technology. In our practice, we have found 3D pouchography to be an extremely useful adjunct to diagnose various mechanical pouch complications and improve planning for pouch salvage strategies. Given its ease of use and helpfulness in understanding the pouch structure and function, we have started to routinely integrate 3D pouchography into our clinical pouch referral practice. Further study is needed to formally assess to value of this technique to aid in the diagnosis of pouch pathology.
METHODS: We performed a retrospective, descriptive case series of a convenience sample of 10 pouch patients with or without pouch dysfunction who had CT scans appropriate for segmentation were identified from our pouch registry. The steps involved in clinician-driven automated 3D reconstruction are presented.
RESULTS: Three patients who underwent CT imaging and were found to have no primary pouch pathology, and seven patients with known pouch pathology identifiable with 3D reconstruction including pouch strictures, megapouch, pouch volvulus, and twisted pouches underwent 3D virtual modeling; one normal and one twisted pouch were 3D printed. We discovered that 3D pouchography reliably identified staple lines (pouch body, anorectal circular and transverse, and tip of J), the relationship between staple lines, and variations in pouch morphology, and pouch pathology.
CONCLUSIONS: Three-dimensional reconstruction of IPAA morphology is highly feasible using readily available technology. In our practice, we have found 3D pouchography to be an extremely useful adjunct to diagnose various mechanical pouch complications and improve planning for pouch salvage strategies. Given its ease of use and helpfulness in understanding the pouch structure and function, we have started to routinely integrate 3D pouchography into our clinical pouch referral practice. Further study is needed to formally assess to value of this technique to aid in the diagnosis of pouch pathology.
摘要：
背景：这里，我们提出了一项概念验证研究,该研究使用回肠袋-肛门吻合术(IPAA)的虚拟和打印3D模型对正常袋患者和有机械袋并发症的患者进行三维(3D)袋成像.
方法：我们进行了回顾性研究，从我们的囊袋登记中确定了10例有或没有囊袋功能障碍的患者的便利样本的描述性病例系列,这些患者接受了适合于分割的CT扫描.介绍了临床医生驱动的自动3D重建中涉及的步骤。
结果：三例患者接受了CT成像，发现没有原发性囊袋病理，和7例具有已知的囊袋病理的患者，可通过3D重建识别，包括囊袋狭窄，兆包,小袋扭转,扭曲的小袋进行了3D虚拟建模；一个正常的和一个扭曲的小袋进行了3D打印。我们发现3D囊术可靠地识别了钉合线(囊体，肛门直肠圆形和横向，和J的尖端)，装订线之间的关系，和小袋形态的变化，和小袋病理学。
结论：使用现成的技术对IPAA形态进行三维重建是高度可行的。在我们的实践中,我们发现,3D囊袋造影是诊断各种机械性囊袋并发症和改进囊袋抢救策略计划的非常有用的辅助手段.鉴于其易用性和有助于理解袋的结构和功能，我们已经开始将3D囊袋造影术常规整合到我们的临床囊袋转诊实践中.需要进一步的研究来正式评估该技术的价值，以帮助诊断囊袋病理。
方法：我们进行了回顾性研究，从我们的囊袋登记中确定了10例有或没有囊袋功能障碍的患者的便利样本的描述性病例系列,这些患者接受了适合于分割的CT扫描.介绍了临床医生驱动的自动3D重建中涉及的步骤。
结果：三例患者接受了CT成像，发现没有原发性囊袋病理，和7例具有已知的囊袋病理的患者，可通过3D重建识别，包括囊袋狭窄，兆包,小袋扭转,扭曲的小袋进行了3D虚拟建模；一个正常的和一个扭曲的小袋进行了3D打印。我们发现3D囊术可靠地识别了钉合线(囊体，肛门直肠圆形和横向，和J的尖端)，装订线之间的关系，和小袋形态的变化，和小袋病理学。
结论：使用现成的技术对IPAA形态进行三维重建是高度可行的。在我们的实践中,我们发现,3D囊袋造影是诊断各种机械性囊袋并发症和改进囊袋抢救策略计划的非常有用的辅助手段.鉴于其易用性和有助于理解袋的结构和功能，我们已经开始将3D囊袋造影术常规整合到我们的临床囊袋转诊实践中.需要进一步的研究来正式评估该技术的价值，以帮助诊断囊袋病理。
