Case report: Magnetic resonance imaging-based three-dimensional printing for reconstruction of complex cloacal malformations

被引:3
作者
Gang, Suiin [1 ]
Song, Sang Hoon [2 ]
Kwon, Jaeyoung [3 ]
Kwon, Hyunhee [1 ]
Ha, Suhyeon [1 ]
Park, Jueun [1 ]
Kim, Namkug [4 ]
Yoon, Hee Mang [5 ,6 ]
Namgoong, Jung-Man [1 ]
机构
[1] Asan Med Ctr, Dept Pediat Surg, Seoul, South Korea
[2] Univ Ulsan, Asan Med Ctr, Coll Med, Dept Urol, Seoul, South Korea
[3] Anymedi Inc, Hanam Si, Gyeonggi Do, South Korea
[4] Univ Ulsan, Asan Med Ctr, Coll Med, Dept Radiol Convergence Med, Seoul, South Korea
[5] Univ Ulsan, Asan Med Ctr, Coll Med, Dept Radiol, Seoul, South Korea
[6] Univ Ulsan, Res Inst Radiol, Asan Med Ctr, Coll Med, Seoul, South Korea
来源
FRONTIERS IN PEDIATRICS | 2023年 / 11卷
关键词
cloaca; reconstruction; three-dimensional printing (3D printing); magnetic resonance imaging; contrast;
D O I
10.3389/fped.2023.1103401
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundSurgical reconstruction of the urinary tract, anus, and vagina is the definitive treatment for cloacal malformation. However, this procedure may be technically challenging in patients with a long common channel (>3 cm), because further reconstructive procedures, such as vaginal replacement or vaginal switch maneuver, may be required. Thus, accurate determination of spatial anatomy is essential during surgical planning. Three-dimensional (3D) reconstruction using rotational fluoroscopy, computed tomography (CT), and magnetic resonance imaging (MRI) has recently been reported to help in determining the relationship between the rectum, vagina, and bladder, and provides a more accurate measurement of the channel length compared to conventional cloacography. MRI-based 3D reconstruction provides substantial information regarding soft tissue structures around the cloaca, including the pelvic floor musculature and anus.CaseA 2-year-old girl with cloacal malformation required reconstructive surgery. Colostomy and cystostomy had been performed on the first day of her life. Preoperative loopogram revealed a cloaca with a long common channel (35 mm) and short urethra (9 mm), single vaginal opening in the bladder neck, and the colon anterior to the vagina with a fistula at the vaginal neck. Because the vagina was too short to be pulled through, 3D printing based on MRI was performed to visualize structural relationships prior to surgical correction. Saline was used for cloacal visualization. Furthermore, endoscopy-assisted urogenital mobilization was performed, and vaginal substitution was performed using the rectum. No postoperative complications were observed.ConclusionsWe believe this is the first report of the use of MRI-based 3D imaging and printing, with saline as a contrast agent during surgical planning for correction of cloacal malformation. MRI-based 3D printing is a potentially promising technique for surgical planning of cloacal malformation correction in patients with a long common channel, as it provides detailed information about the surrounding soft tissue structures without exposure to radiation or contrasting agents.
引用
收藏
页数:6
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