To Study The Application Of Three-dimensional Reconstruction Based On Mimics In The Diagnosis And Treatment Of Lower Extremity Arteriosclerosis Obliterans

Background:Three-dimensional visualization technology is a research hotspot at present,which plays an important role in the diagnosis and treatment of clinical diseases.It is affecting the development of traditional treatment methods to precision diagnosis and treatment,and promoting the progress and transformation of medical technology.Among them,Mimics software is the most widely used,with powerful functions,and can meet the needs of clinical fields.According to the literature at home and abroad,three-dimensional visualization technology has great application value and space in vascular surgery.The three-dimensional reconstruction model based on Mimics can provide help for the study of lower extremity arteriosclerosis obliterans(LEASO).Through the operations of transparency,rotation,zooming-reduction,and coloring,the spatial course of blood vessels and their spatial relationship with surrounding organs and tissues can be more clearly observed and understood.Through the measurement methods of length,Angle,area,and volume,the quantification of individual anatomical and biological characteristics in three-dimensional space can be realized,so as to provide help and guidance for preoperative planning and intraoperative operation.Objective:Mimics software was used to establish a three-dimensional model of lower extremity arteriosclerosis obliterans,and CTA and DSA data were used as reference to evaluate the safety,effectiveness and accuracy of the diagnosis and treatment of lower extremity arteriosclerosis obliterans based on Mimics three-dimensional reconstruction.Methods:From January 2020 to March 2023,70 LEASO patients in our hospital underwent enhanced thin-slice CT examination of lower extremity arteries,three-dimensional modeling of lower extremity arteries and plaques was performed by Mimics software,and DSA was performed for disease diagnosis and treatment.The results of DSA and CTA were used as reference.The LEASO 3D model was compared with DSA and CTA.The degree of arterial segmental stenosis,the diagnostic agreement rate of diseased artery,the length of surgical intervention artery segment,the diameter of stent,and the PACSS grade of surgical intervention artery segment were compared between Mimics and DSA.The volume of calcified plaque in arterial segments and the proportion of calcification in mixed plaque in stenotic artery segments were compared between Mimics and CTA.Results:1.A total of 840 arterial segments were counted in 70 patients.A total of 792 arterial segments were diagnosed by Mimics and DSA,and the coincidence rate was 94.29%(792/840).The underestimation rate was 1.90%(16/840);2.DSA results showed that there were 320 arterial segments with stenosis≥50%,and 311 of them were diagnosed by Mimics,with a sensitivity of 97.19%(31 1/320).There were 520 arterial segments with stenosis<50%,of which 510 were diagnosed by Mimics,with a specificity of 98.08%(510/520).The false positive rate was 1.92%(10/520),the false negative rate was 2.81%(9/320),the accuracy rate was 97.74%(821/840),and the Kappa value was 0.952;3.There was no significant difference in lesion length measured by Mimics and DSA in 142 interventional segments of popliteal artery and above(P>0.05);4.In 34 arterial segments undergoing stent implantation,there was no significant difference between Mimics stent diameter prediction and DSA stent diameter selection(P>0.05);5.For 105 surgical intervention segments containing calcified plaques in the popliteal artery and above,there was no significant difference in the volume of calcified plaques measured by Mimics and CTA(P>0.05);6.In 155 stenotic artery segments with mixed plaques at popliteal artery and above,there was no significant difference between Mimics and CTA in measuring the proportion of calcification in the stenotic segment(P>0.05);7.Among 142 surgical intervention arterial segments in the popliteal artery and above,Mimics diagnosis results of 135 arterial segments were consistent with DSA,the coincidence rate was 95.07%(135/142).Among the remaining 7 arterial segments,2 arterial segments were overestimated,the overestimation rate was 1.41%(2/142),and 5 arterial segments were underestimated.The underestimation rate was 3.52%(5/142).The Mimics 3D reconstruction model had high accuracy in the PACSS classification of the affected arterial segments.Conclusion:1.The three-dimensional reconstruction model based on Mimics can intuitively display the anatomical course of lower extremity arteries and find the diseased artery segments;2.Mimics could accurately evaluate the degree of stenosis,lesion length,stent diameter,calcified plaque volume,mixed plaque calcification ratio,and PACSS grade;3.The three-dimensional reconstruction based on Mimics has guiding significance for the preoperative accurate diagnosis and treatment of LEASO,and has clinical value for optimizing the diagnosis and treatment of LEASO by CTA.It can reduce the dependence on invasive DSA in clinical practice,and provide a new choice for guiding the diagnosis and treatment of LEASO.