背景:对肝脏进行图像引导的侵入性手术需要陡峭的学习曲线才能获得必要的技能。实现这些技能的最佳和最安全的方法是通过实践课程,包括模拟和不同并发症的幻影,对患者没有任何风险。市场上有许多由各种材料制成的肝脏幻影;然而,几乎没有多模式肝脏模型,只有两个是在3D打印的模具中铸造的。
方法:我们通过分割CT扫描创建了虚拟肝脏和3D打印模具。InVesalius和AutodeskFusion360软件包用于分割和3D建模。使用这个模块化模具,我们铸造并测试了基于硅酮和明胶的肝脏体模,内部有肿瘤和血管形成。我们测试了明胶肝模型的几个程序,包括超声诊断,弹性成像,纤维扫描,超声引导活检,超声引导引流,超声引导射频消融,CT扫描诊断,CT-超声融合,CT引导活检,MRI诊断。在四个国际大会的动手超声课程中也使用了幻影。
结果:我们评估了33位医生关于他们使用和学习肝脏体模的经验的反馈,以验证我们的超声程序训练模型。
结论:我们验证了我们的肝模型解决方案,证明其对年轻医生的教育的积极影响,他们可以安全地学习新的程序,从而改善不同肝病患者的预后。
BACKGROUND: Image-guided invasive procedures on the liver require a steep learning curve to acquire the necessary skills. The best and safest way to achieve these skills is through hands-on courses that include simulations and phantoms of different complications, without any risks for patients. There are many liver phantoms on the market made of various materials; however, there are few multimodal liver phantoms, and only two are cast in a 3D-printed mold.
METHODS: We created a virtual liver and 3D-printed mold by segmenting a CT scan. The InVesalius and Autodesk Fusion 360 software packages were used for segmentation and 3D modeling. Using this modular mold, we cast and tested silicone- and gelatin-based liver phantoms with tumor and vascular formations inside. We tested the gelatin liver phantoms for several procedures, including ultrasound diagnosis, elastography, fibroscan, ultrasound-guided biopsy, ultrasound-guided drainage, ultrasound-guided radio-frequency ablation, CT scan diagnosis, CT-ultrasound fusion, CT-guided biopsy, and MRI diagnosis. The phantoms were also used in hands-on ultrasound courses at four international congresses.
RESULTS: We evaluated the feedback of 33 doctors regarding their experiences in using and learning on liver phantoms to validate our model for training in ultrasound procedures.
CONCLUSIONS: We validated our liver phantom solution, demonstrating its positive impact on the education of young doctors who can safely learn new procedures thus improving the outcomes of patients with different liver pathologies.