シンポジウム 10 (II-S10)
小児循環器領域のシミュレーション医療：将来の可能性と限界

[II-S10-05] 患者データから作製した心臓立体模型を用いた心臓手術およびカテーテル治療シミュレーション：3年間の臨床応用からみえてきた限界と可能性

^○片岡 功一^1,2, 河田 政明^1,3, 松原 大輔², 岡 健介², 鈴木 峻², 横溝 亜希子², 古井 貞浩², 安済 達也², 南 孝臣², 吉積 功^1,3, 竹内 護¹ (1.自治医科大学 とちぎ子ども医療センター 小児手術・集中治療部, 2.自治医科大学 とちぎ子ども医療センター 小児科, 3.自治医科大学 とちぎ子ども医療センター 小児・先天性心臓血管外科)

キーワード：シミュレーション, 3Dプリント, 立体模型

【Background and Objective】In 2014, we established simple and inexpensive methods using a personal 3D printer to create patient-specific 3D heart models for planning of surgery and simulation of catheter intervention. We report the limitations and potential of simulation using 3D models through our 3-year experience. 【Methods】DICOM data of contrast-enhanced multi-detector CT scan were converted into STL format, and (1) solid ABS resin model was printed using 3D printer. If necessary, (2) transparent silicone hollow model was additionally created using (1) as a mold. All processes were performed at our institution. 【Results】The time/cost needed to create (1) and (2) models were 5-24 h/5,000 JPY and 3-7 days/10,000-20,000 JPY, respectively. (1) was helpful in understanding spatial relationship among great vessels and trachea and so on. (2) had good reproducibility for understanding intracardiac structures and was useful in the surgical planning of complex/rare anomalies, even if their vascular wall thicknesses were not very accurate. Although its hardness rendered it unsuitable for training in detailed surgical techniques, (2) was suitable for simulation of occluder deployment for PDA with calcification in adults. X-ray transparency of (2) was appropriate for catheter manipulation because catheter/device was visible from outside, it was useful for training in catheter interventions. 【Conclusions】From the viewpoint of fidelity for anatomical accuracy, there were some limitations in these models; however, high-quality simulation becomes possible using these features.