CN108288427A - A kind of production method of 3 D-printing transtracheal mirror lymph node puncture training pattern - Google Patents

Abstract

The invention provides a method for making a three-dimensionally printed lymph node puncture training model through bronchoscopy. Create a number of airway models that conform to the clinical real anatomical structure, then make simulated lymph nodes glued to the corresponding positions on the lateral wall of the bronchus, simulate the jaw model, and the shell used to block and fix the bronchial model, and finally assemble the components according to the anatomical position, The outermost layer is covered with a shell; the method for making a training model of lymph node puncture through bronchoscopy of the present invention makes the airway structure of the training model highly similar to the structure of real cases, and the structure and degree of difficulty of multiple airway models in the training model Each is different, so that the training process is closer to the actual clinical operating environment, and the training process is from easy to difficult, which improves the training effect.

Description

A method for making a three-dimensional printing training model of transtracheal lymph node puncture

technical field

The invention relates to a bronchoscope training model, in particular to a method for making a three-dimensionally printed transbronchoscope lymph node puncture training model.

Background technique

Needle aspiration biopsy through bronchoscope is a special puncture needle with a flexible catheter, which is sent into the airway through the biopsy channel of the fiberoptic bronchoscope, and then penetrates the wall of the airway to treat tracheal and bronchial lesions, such as knots. It is a new technology for acupuncture suction of nodules, masses, enlarged lymph nodes and lung lesions, and to obtain cell or tissue samples for cytological and pathological examination. Needle aspiration biopsy via bronchoscope is widely used in the qualitative diagnosis of lesions close to the trachea and peribronchus, and allows bronchoscopic techniques to participate in the clinical staging of malignant tumors. operate. At present, most of the training is virtual bronchoscopic simulation technology and fiberoptic bronchoscope training box. Although these existing technologies can be used for operational training, there is still a gap between the specific shape of each tissue and organ model of the respiratory system and the real one, relative spatial position and adjacent structure. It is not accurate enough, the choice of materials is not reasonable, and the bronchial structure of the training model is the same, there is no difference in difficulty, so it cannot meet the actual clinical requirements well, and the trainers cannot master the process, skills and techniques of transbronchial needle aspiration biopsy .

Three-dimensional scanning is mainly used to scan the shape, structure and color of the object space to obtain the spatial coordinates of the object surface. The collected data can be used for three-dimensional reconstruction calculations to create digital model files of the actual object, which has high efficiency and high efficiency. characteristics of precision. Based on digital model files, 3D printing technology uses bondable materials such as powdered metal or plastic to construct objects by layer-by-layer printing.

Contents of the invention

In order to solve the problems existing in the prior art, the present invention provides a method for making a three-dimensionally printed lymph node puncture training model through bronchoscopy, so that the bronchial structure of the training model is closer to the anatomical structure of the real case, and there is a degree of difficulty in the training process There are multiple models to choose from, which improves the training effect.

The technical solution of the present invention to solve the above problems is: a method for making a three-dimensionally printed lymph node puncture training model through bronchoscopy, which specifically includes the following steps:

Step 1: Select five low-difficulty, medium-difficulty, and high-difficulty patients, and collect structural information of their larynx, trachea, and bronchus through CT tomography and 3D reconstruction technology to obtain 3D model data;

Step 2: use computer software to read the 3D model data obtained in Step 1, restore and repair, and generate a 3D model of the airway model accordingly;

Step 3: Use a 3D printer to print the 3D models of each airway model, so as to obtain multiple airway models that are highly consistent with the real anatomical structure and individualized. The tracheal ring part of the airway model is made of resin material, and the tracheal wall is soft Partially made of silicone material, the airway model includes simulated larynx, simulated trachea and simulated bronchi from top to bottom;

Step 4: The simulated lymph node is made of silica gel. The simulated lymph node is hollow spherical with a diameter of 5 mm to 10 mm, and the interior is filled with soft tissue. The soft tissue is plasticine or glycerin or paraffin oil, which can be replaced after multiple uses;

Step 5: Use silica gel and metal materials to make a jaw model. This jaw model is used as the insertion port when inserting a bronchoscope. There is a larynx in the middle, and the end of the larynx is connected to the simulated larynx of the airway model, and the airway model can be replaced as a whole according to needs;

Step 6: Choose a transparent plastic material to make the shell, and selectively cover the outer surface of the shell with opaque shielding. The shell is used to accommodate the airway model, and its front side can be opened. The airway model mounting parts are installed in the shell, and the throat of the jaw model is connected to the simulated throat of the airway model. The jaw model is set outside the shell, and the simulated lymph nodes are glued to the real lymph nodes, which can be completed at the end of the puncture training. Finally, open the front of the shell to observe whether the lymph node is punctured;

Further, in step 1, the difficulty of the patient is judged according to the degree of airway patency, airway variation, and the location, size, and shape of the lesion. If the airway is low, the difficulty is high, and if the airway variation is large, the difficulty is high, and the lesion is located in the deep part of the airway. , relatively small, difficult to grasp, and difficult to grasp. At the same time, according to the total time of bronchoscopy standard operation on the patient and the positive rate of biopsy, the airway specimens that take a long time and have a low positive rate of biopsy are difficult;

Further, in step 2, computer software is used to read the three-dimensional model data obtained in step 1. The specific steps are as follows: the first step: read the image, use the image import function to import the CT image into the Mimics software, and automatically define the front, rear, left, and right sides Manually define the upper and lower directions of the image, and the software will automatically generate sagittal and coronal images based on the cross-sectional image; the second step: extract the contour, enter the three-view editable operation interface, and use the threshold setting tool to extract the contour , in the case of ensuring that the reconstructed tissue is selected, try not to make the contour shadow of the structure other than the reconstructed tissue appear, and define the threshold in an appropriate range to form a mask; the third step: select the hot area, and use the region growth tool in the software to perform Hot area selection, if the reconstruction structure needs to be similar to the gray value of the surrounding tissue, manual recognition is required for extraction, and edge segmentation, redundant data removal, selective editing and hole filling must be performed on each layer of image. Step 4: Generate a 3D model. Based on the 3D interpolation method, use the 3D calculation tool of the software - Calculate 3D in the segmentation menu to directly convert the 2D image into a 3D model. The reconstructed model has a realistic appearance and can be translated, zoomed, and any plane Cut, rotate at any angle, directly and clearly reproduce the three-dimensional shape of the larynx, trachea, and bronchi, and save the reconstructed three-dimensional model in SLT format to obtain the reconstructed three-dimensional visualization model.

The present invention has beneficial effects:

The present invention can carry out the training of the puncture technique of puncturing the lymph nodes close to the trachea or bronchi from the inner side of the trachea or bronchi, which cannot be implemented in the existing puncture training models; The anatomical structure is closer, so that the training process is closer to the clinic; the present invention scans the bronchial structure of different patients, and according to the difficulty of bronchoscopic lymph node puncture, it can make training models with different difficulties, so that the training can be done step by step. Helps improve the operator's piercing technique.

Description of drawings

Fig. 1 is the structural representation of puncture model;

In the figure: 1-simulated larynx, 2-simulated trachea, 3-simulated bronchi, 4-jaw model, 5-larynx, 6-shell, 7-airway model mounting parts.

Detailed ways

The present invention will be further described below in conjunction with the accompanying drawings and specific embodiments.

As shown in the figure, a method for making a three-dimensionally printed lymph node puncture training model through bronchoscopy, which specifically includes the following steps:

Step 1: Select five low-difficulty, medium-difficulty, and high-difficulty patients, and collect structural information of their larynx, trachea, and bronchus through CT tomography and 3D reconstruction technology to obtain 3D model data;

Step 2: use computer software to read the 3D model data obtained in Step 1, restore and repair, and generate a 3D model of the airway model accordingly;

Step 3: Use a 3D printer to print the 3D models of each airway model, so as to obtain multiple airway models that are highly consistent with the real anatomical structure and individualized. The tracheal ring part of the airway model is made of resin material, and the tracheal wall is soft Partially made of silicone material, the airway model includes simulated larynx, simulated trachea and simulated bronchi from top to bottom;

Step 4: The simulated lymph node is made of silica gel. The simulated lymph node is hollow spherical with a diameter of 5 mm to 10 mm, and the interior is filled with soft tissue. The soft tissue is plasticine or glycerin or paraffin oil, which can be replaced after multiple uses;

Step 5: Use silica gel and metal materials to make a jaw model. This jaw model is used as the insertion port when inserting a bronchoscope. There is a larynx in the middle, and the end of the larynx is connected to the simulated larynx of the airway model, and the airway model can be replaced as a whole according to needs;

Step 6: Choose a transparent plastic material to make the shell, and selectively cover the outer surface of the shell with opaque shielding. The shell is used to accommodate the airway model, and its front side can be opened. The airway model mounting parts are installed in the shell, and the throat of the jaw model is connected to the simulated throat of the airway model. The jaw model is set outside the shell, and the simulated lymph nodes are glued to the real lymph nodes, which can be completed at the end of the puncture training. Finally, open the front of the shell to observe whether the lymph node is punctured, so it is helpful to improve the evaluation effect of this training model;

Further, in step 1, the difficulty of the patient is judged according to the degree of airway patency, airway variation, and the location, size, and shape of the lesion. If the airway is low, the difficulty is high, and if the airway variation is large, the difficulty is high, and the lesion is located in the deep part of the airway. , relatively small, difficult to grasp, and difficult to grasp. At the same time, according to the total time of bronchoscopy standard operation on the patient and the positive rate of biopsy, the airway specimens that take a long time and have a low positive rate of biopsy are difficult;

Further, in step 2, computer software is used to read the three-dimensional model data obtained in step 1. The specific steps are as follows: the first step: read the image, use the image import function to import the CT image into the Mimics software, and automatically define the front, rear, left, and right sides Manually define the upper and lower directions of the image, and the software will automatically generate sagittal and coronal images based on the cross-sectional image; the second step: extract the contour, enter the three-view editable operation interface, and use the threshold setting tool to extract the contour , in the case of ensuring that the reconstructed tissue is selected, try not to make the contour shadow of the structure other than the reconstructed tissue appear, and define the threshold in an appropriate range to form a mask; the third step: select the hot area, and use the region growth tool in the software to perform Hot area selection, if the reconstruction structure needs to be similar to the gray value of the surrounding tissue, manual recognition is required for extraction, and edge segmentation, redundant data removal, selective editing and hole filling must be performed on each layer of image. Step 4: Generate a 3D model. Based on the 3D interpolation method, use the 3D calculation tool of the software - Calculate 3D in the segmentation menu to directly convert the 2D image into a 3D model. The reconstructed model has a realistic appearance and can be translated, zoomed, and any plane Cut and rotate at any angle, directly and clearly reproduce the three-dimensional shape of the larynx, trachea, and bronchi. Export and save the reconstructed 3D model in SLT format to obtain a reconstructed 3D visualization model.

During the puncture training, the trainer uses the bronchial models of the low-difficulty, medium-difficulty, and high-difficulty groups in turn for training. When in use, the trainer inserts the bronchoscope from the jaw model, through the larynx of the jaw model to the simulated trachea of the airway model Or simulate the bronchi, and use the puncture needle to pass through the soft tissue of the trachea wall in the gap between the trachea or bronchial cartilage ring, and puncture and aspirate the simulated lymph nodes next to the trachea or bronchi. When the soft tissue in the simulated lymph nodes is attracted, it means that the puncture is successful. After the puncture, open the front side of the housing to directly observe whether the puncture is successful. The trainer starts training with a lower difficulty level, and only after the lower difficulty level is passed, can the next level of difficulty training be performed. Therefore, the embodiment of the present invention can significantly improve the training effect of bronchoscopic lymph node puncture.

The above is only a preferred embodiment of the present invention, and is not intended to limit the present invention to other forms. Any skilled person who is familiar with this profession may use the technical content disclosed above to change or modify the equivalent of equivalent changes. The embodiments are applied to other fields, but any simple modifications, equivalent changes and modifications made to the above embodiments according to the technical essence of the present invention still belong to the protection scope of the technical solutions of the present invention without departing from the content of the technical solutions of the present invention.

Claims (3)

1. a kind of production method of 3 D-printing transtracheal mirror lymph node puncture training pattern, which is characterized in that it is specifically included Following steps：

Step 1：Low difficulty, middle difficulty, each five of highly difficult patient are chosen, is acquired by CT tomoscans and three-dimensional reconstruction Their throat, the structural information of trachea-bronchial epithelial cell, obtain three-dimensional modeling data；

Step 2：Using the three-dimensional modeling data obtained in computer software read step 1, is restored and repaired, accordingly generated The threedimensional model of air flue model；

Step 3：Using three-dimensional printer, the three dimensional model printing of each air flue model is molded, is accorded with to obtain multiple both height Real anatomy and the air flue model of individuation are closed, the tracheae loop section of air flue model uses resin material, tracheal wall soft It includes from top to bottom including simulation throat, simulation tracheae portion and simulation bronchus portion that part, which uses silica gel material, air flue model,；

Step 4：Simulation lymph node, inside filling soft tissue are made using silica gel material；

Step 5：Gnathode is made using silica gel, metal material, which is when being inserted into bronchoscope as insert port Position, shape are the simulation model of true jaw, and larynx portion, the mould of the end and air flue model in the larynx portion are equipped in gnathode Quasi- throat is connected, and as needed can integrally replace air flue model；

Step 6：Select transparent plastics material make shell, and hull outside face selectively covering it is opaque block, shell use In receiving air flue model, face side can be opened, and air flue model installation part is equipped in shell, and air flue model passes through air flue model Installation part is mounted in shell, and the larynx portion of gnathode and the simulation throat of air flue model are assembled, and gnathode setting exists Outside shell, simulation lymph node is sticked at true lymph node position.

2. a kind of production method of 3 D-printing transtracheal mirror lymph node puncture training pattern as described in claim 1, special Sign is that soft tissue described in step 4 is plasticine or glycerine or paraffin oil.

3. a kind of production method of 3 D-printing transtracheal mirror lymph node puncture training pattern as described in claim 1, special Sign is, the hollow sphere that lymph junction configuration is diameter 5mm ~ 10mm is simulated described in step 4.