Clinical Application Value Of Three-dimensional (3D) Printing Model Based On Cranial CT Angiography (CTA) In Intracranial Aneurysm

Objective:To explore the effect of three-dimensional reconstruction and printing of aneurysm complex model with CTA(CT angiography)data in patients with intracranial aneurysm clipping,and to provide imaging and solid model basis for patients’ surgical treatment and preoperative conversation.Methods:From January in 2018 to January in 2022,71 patients with intracranial aneurysm of anterior circulation from the First People’s Hospital of Jiujiang and the Third People’s Hospital of Jiujiang were selected as the research objectives.In strict accordance with the exclusion and exclusion criteria,5 cases were excluded from the above cases(2 cases with combined malignancy,and coagulopathy in one case,1 case of moyamoya disease,1 case transferred to superior hospital during treatment),4cases were removed(1 death during hospitalization,1 patient with serious complications during the study,two subjects were treated with other intervention methods during the treatment period).Apart from those cases,the rest of 62 patients met the enrollment criteria,and the enrolled patients were randomly divided into CTA group and model group(31 patients each).According to the preoperative cranial CTA findings,aneurysmal clipping is routinely performed on patients in the CTA group.Surgical head CTA in the model group,and to extract the image data,the aneurysm3 D composite model with the help of the Mimics software,using the 3D printing technology,print out the aneurysm complex model.According to the solid model,preoperative talk,preoperative surgical simulation and intraoperative aneurysm clipping,the effect of treatment in both groups 14 days after the surgery,and a complete 6-month follow-up,comparing two groups of surgical index(preoperative image diagnosis accuracy,operation time and intraoperative bleeding),the effects of surgical treatment 14 days after the surgery[(tumor neck residue,parent artery stenosis,National Institutes of Health Stroke Scale(NIHSS score),Glasgow Coma Scale(GCS score)],perioperative complications(intracranial infection,hydrocephalus,postoperative rebleeding,cerebral vasospasm,neurological dysfunction,deep vein thrombosis)incidence,days of hospitalization and follow-up neurological recovery status(modified Rankin Scale,m RS score)after 6 months were evaluated.All the datas were processed by using the SPSS24.0 software.Results:1.Observe the surgical indexes in two groups:(1)the preoperative image diagnosis accuracy in model group was better than CTA group(P <0.05);(2)in model group,the operation completion time was less than CTA group(P <0.05);(3)and the surgical bleeding loss in model group was less than CTA group(P <0.05).2.Surgery and treatment effect at 14 days after both groups:(1)the incidence of residual tumor neck and parent artery stenosis in model group was lower than that in CTA group(P<0.05);(2)14 days after,NIHSS score of patients in model group was less than CTA group(P <0.05);GCS score of patients in model group was greater than that in CTA group(P <0.05).3.Compared with the two groups of perioperative complications,the incidence of complications in the model group was significantly lower than that in the CTA group(P <0.01);4.The hospital days in the model group were less than the CTA group(P <0.05);5.All enrolled cases completed the 6-month follow-up,and the follow-up results were calculated by m RS score.The results showed that the m RS score shown in the model group at the 6-month follow-up was better than that in the CTA group(P <0.05).Conclusion:(1)We can directly observe and understand aneurysm shape,size and angle by using head CT angiography(CTA)data to reconstruct aneurysm complex model.We can clarify its structure relationship with surrounding tissue,and provide imaging and solid model basis for subsequent preoperative talk and accurate surgical treatment.(2)3D stereomodel for reconstruction and printing can guide the treatment of intracranial aneurysm clipping,improve the surgical accuracy,reduce surgical trauma,reduce the incidence of perioperative complications,improve neurological recovery for 6 months,which is worthy of clinical application.