Study On The Clinical Application Of Ultrasound 3D Printing And Mixed Reality Technology For Breast Occupying

Objectives:1)in a fully automated breast volume imaging(automatedbreastvolumescanner ABVS)as the research basis,in combination with 3 d reconstruction technology,realization of breast ultrasound 3 d panoramic stereo reconstruction and 3 d printing,for accurate preoperative design,simplify the doctor-patient communication with technical preparation;2)according to the results of three-dimensional reconstruction of breast ultrasound,three-dimensional reconstruction of breast mri,and postoperative pathology of breast,the coincidence rate of breast ultrasound in calculating the volume of breast lesions was studied.3)on the basis of 3d reconstruction technology of breast ultrasound,and combined with mixed Reality MR,the real-time Shared holographic image was introduced into breast space occupying surgery to "perspective" the location and range of lesions for accurate surgical treatment.Methods:1)obtain the ultrasound image of ABVS breast volume imaging on one side(including the whole breast on one side of the patient and the occupying lesion);Read the ultrasound image format obtained by the breast full-volume imaging system for manual segmentation of tissue structure,placeholder,and three-dimensional image reconstruction.After reading the 3D reconstruction information,the panoramic view of the breast(including the whole breast on one side of the patient and the occupying lesion)was 3d-printed using the fully transparent plastic materials and dyeing materials.2)collect 64 breast surgery breast tumor resection in our placeholder(including 15 cases of benign lesions,49 cases of malignant lesions),preoperative breast mri examination,respectively,and this topic design breast ultrasound:1)reconstruction of ultrasound and mri breast tumor three-dimensional model,generate three-dimensional warp values x,y,z axis,postoperative pathology as the gold standard comparison,operating time is less than 7 days,with all the inspection interval set at 95%significance level.(2)in the examination,the direction of the biggest gravity change of the two kinds of body position is the measurement direction,the difference between the measured value of the tumor in this direction and the other vertical direction is measured,and the influence of the body position on the measured value of the breast tumor is analyzed.(3)calculate the vertical distance between the midpoint of the breast tumor and the nipple,and evaluate the effect of the examination position on the spatial position of the tumor;3)for patients undergoing breast surgery in the general hospital of the people's liberation army who meet the inclusion criteria,the virtual and real space of breast surgery is registered:by adjusting the translation,rotation and scaling of the model,the reconstructed 3d model is superimposed on the real human skin;By changing the transparency of the model(tumor,skin,blood vessels),the model can be adjusted to achieve the safest and most intuitive surgical navigation.Results:1)ABVS+airtight adjustable flume:complete edge development,complete three-dimensional imaging of unilateral breast structure;The probe does not need to touch the breast to reduce breast deformation.The organization boundary is clearly displayed to ensure the accuracy of manual organization segmentation.Breast 3D printed physical pictures achieve 1:1 ratio printing physical objects;Transparent structure is adopted to facilitate patients' understanding and simplify doctor-patient communication.Visual scale,accurate measurement shows tumor location.2)breast tumor size and pathology,X axis:US(r=0.87,p<0.0001),MRI(r=0.86,p<0.0001);Y axis:US(r=0.88,p<0.0001),MRI(r=0.79,p<0.0001).Z-axis:US(r=0.88,p<0.0001),MRI(r=0.86,p<0.0001),US,MRI and pathology were highly correlated(p<0.001).(2)according to the gravity change set to measure the direction of the breast tumor,gravity change the maximum direction compared with the other two vertical direction,gravity change the maximum direction,the difference between the two measured the largest.(3)the vertical distance between the midpoint of the breast tumor and the connecting plane between the nipple and the skin,breast mri/breast ultrasound>2.5,with a significant difference(P>0.05).3)based on the design of the registration method of breast markers and point matching,the mapping relationship between the positioning and image coordinate system is established to realize the fusion of the transparency of breast segmentation image image and breast intraoperative anatomical image.The mixed reality display technology was used to fuse the 3d model of breast tumor into the field of vision during the breast surgery,so as to provide doctors with visual guidance and visual navigation for the fusion of virtual and real.Conculsion:1)based on mammary gland of nuclear magnetic resonance(NMR)to image based 3 d printing technology at home and abroad have been achieved,but as a result of breast mri examination on the position and the operation of the actual position difference,on the basis of this study to realize the ultrasonic image unilateral breast whole 3 d reconstruction and 3 d printing,it will be to simplify the clinicians preoperative doctor-patient communication,to help patients understand exactly specific lesions and rational choice to rationalize the warlock,etc,to provide a new method;2)we use a new method of three-dimensional reconstruction of breast ultrasound to achieve accurate segmentation of breast gland and tumor,and provide clinicians with reliable preoperative 3d image intuitive information such as tumor shape,size and location,as well as a new model for doctors' accurate surgical planning,efficient doctor-patient communication and intraoperative navigation.3)realize the combination of three-dimensional breast ultrasound reconstruction technology and mixed reality technology,and provide doctors with "accurate,intuitive,non-invasive,fast and multi-angle real-time" visual navigation,which will make future breast surgery more accurate,safe and efficient.