Title: Stereolithographic Biomodeling of Congenital Heart Disease by Multislice Computed Tomography Imaging
Abstract: HomeCirculationVol. 113, No. 17Stereolithographic Biomodeling of Congenital Heart Disease by Multislice Computed Tomography Imaging Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBStereolithographic Biomodeling of Congenital Heart Disease by Multislice Computed Tomography Imaging Isao Shiraishi, MD, Yo Kajiyama, MD, Masaaki Yamagishi, MD and Kenji Hamaoka, MD Isao ShiraishiIsao Shiraishi From the Departments of Pediatric Cardiology and Nephrology (I.S., Y.K., K.H.) and Pediatric Cardiovascular Surgery (M.Y.), Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. , Yo KajiyamaYo Kajiyama From the Departments of Pediatric Cardiology and Nephrology (I.S., Y.K., K.H.) and Pediatric Cardiovascular Surgery (M.Y.), Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. , Masaaki YamagishiMasaaki Yamagishi From the Departments of Pediatric Cardiology and Nephrology (I.S., Y.K., K.H.) and Pediatric Cardiovascular Surgery (M.Y.), Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. and Kenji HamaokaKenji Hamaoka From the Departments of Pediatric Cardiology and Nephrology (I.S., Y.K., K.H.) and Pediatric Cardiovascular Surgery (M.Y.), Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. Originally published2 May 2006https://doi.org/10.1161/CIRCULATIONAHA.105.538801Circulation. 2006;113:e733–e734Recently devised 3-dimensional (3D) diagnostic modalities such as magnetic resonance imaging and multislice computed tomography (CT) allow visualization of the heart and great vessels from any angle of view and perspective. In complicated congenital heart disease, however, substantial discrepancies still remain between interpretation of the reconstructed 3D images and the real structures of anatomy. One possible way to overcome these problems is to construct tangible replicas that reproduce the real structures of the disease. Stereolithography is a rapid-prototyping technology whereby an ultraviolet laser beam selectively polymerizes and solidifies a photosensitive, polymeric liquid-plastic solution. By using this technique, 3D volumetric image data can be converted into plastic models that enhance spatial perception of the real anatomy and pathology. After data acquisition by 16-multislice CT (Aquillion 16, Toshiba, Tokyo, Japan), 3D images were generated by image analysis software by defining the volume of interest (X-Tension, Toshiba; ZIO M900, Amin, Tokyo, Japan). The reconstructed 3D data were transferred to a stereolithography biomodeling company (JMC, Yokohama, Japan) and were used to guide the ultraviolet laser beam for polymerizing a selectively photosensitive, polymeric liquid-plastic (for hard biomodels) or a liquid-urethane (for flexible biomodels) solution. The manufactured biomodels clearly reproduced the volume data and demonstrated the anatomy of complicated congenital heart disease, such as asplenia with total anomalous pulmonary venous drainage (Figure, A and B), hypoplastic left heart syndrome (Figure, C and D), and pulmonary atresia and ventricular septal defect associated with major aortopulmonary collateral arteries (Figure, E and F). These 3D models are very informative for surgical repair of the vertical vein, the Norwood procedure, and the unifocalization of major aortopulmonary collateral arteries. Stereolithographic biomodels allow simulation of an individual surgical approach for a specific anatomic disorder or for designing innovative surgical procedures in complicated congenital heart disease. This technique is also suitable for the education of medical students and trainees; furthermore, biomodels are informative for patients and their parents. If stereolithographic devices became widespread, cardiologists and cardiac surgeons could share these tangible 3D replicas of rare cardiovascular anomalies or novel surgical procedures by obtaining digital information via the Internet, resulting in the survival of many children with complicated congenital heart disease. Download figureDownload PowerPointMultislice CT volume-rendering images of complicated congenital heart diseases (A, C, and E) and the corresponding stereolithographic biomodels (B, D, and F, shown in the same colors as the CT images). A and B, A 6-month-old infant with right isomerism, a single atrium, single right ventricle, common atrioventricular canal, pulmonary stenosis, total anomalous pulmonary venous drainage type Ib,1 and a bilateral superior vena cava. The pulmonary veins constitute a tortuous vertical vein (VV) that drains into the right superior vena cava (rSVC), which are clearly reproduced in stereolithography. C and D, A 5-day-old neonate with hypoplastic left heart syndrome. Spatial relationships among the hypoplastic aortic arch, ductus arteriosus (DA), and the right and left pulmonary arteries (rPA and lPA, respectively) are clearly reproduced. E and F, A 1-month-old infant with pulmonary atresia and ventricular septal defect. Two major aortopulmonary collateral arteries (#1 and #2) appear to have originated from the descending aorta (dAo) and supplied pulmonary blood flow to both lungs via the right and left pulmonary arteries. The origin of the major aortopulmonary collateral arteries and the spatial relationships among the pulmonary arteries are clearly recognized by stereolithography. PV indicates pulmonary vein; LA, left atrium; BCA, brachiocephalic artery; INN, innominate vein; and aAo, ascending aorta. Bars in A through F are 1.0 cm.DisclosuresNone.FootnotesCorrespondence to Isao Shiraishi, MD, Department of Pediatric Cardiology and Nephrology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi-Hirokoji, Kamigyo, Kyoto, Japan 602-8566. E-mail [email protected]Reference1 Craig JM, Darling RC, Rothney WB. Total pulmonary venous drainage into the right side of the heart; report of 17 autopsied cases not associated with other major cardiovascular anomalies. 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May 2, 2006Vol 113, Issue 17 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.105.538801PMID: 16651476 Originally publishedMay 2, 2006 PDF download Advertisement SubjectsComputerized Tomography (CT)Congenital Heart DiseaseImaging
Publication Year: 2006
Publication Date: 2006-05-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 18
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