Objective: To investigate the construction and significance of in vivo pelvis and abdominal-pelvic arterial vascular network in digital three-dimensional (3D) model for uterine artery embolization (UAE) in the application of surgical approach planning based on computerized tomographic angiography(CTA).
Methods: A series of digital imaging and communications in medicine 3.0 (Dicom 3.0) were obtained from a woman with myoma of uterus by CTA scanning. Then the software Mimics Version 10.01 was used to construct the pelvic and the arterial vascular network 3D model.
Results: The digital model could clearly display the abdominal aorta, bilateral common iliac arteries, left and right external iliac artery, internal iliac artery and its branches around the stage; the right uterine artery emitted in the inferior gluteal artery opening below 15.91 mm, the left uterine artery in inferior gluteal artery below the opening of 15.21 mm, the adjacent artery of internal pudendal artery. At the same time, the artery length and angle of bifurcation were accurately measured. The bifurcation angle of abdominal aorta in fifth lumbar vertebral body edge, was 66.58°, the bifurcation angle of right internal iliac artery was 46.23°, the length of right common iliac artery was 51.43 mm, the bifurcation angle between left and external internal iliac artery was 36.45°, the length of left common iliac artery and 67.50 mm. According to the preoperative approach planning, guided wire across the inferior gluteal artery to the lower 15.00 mm and rotating digital subtraction angiography (DSA) tube, could clearly display the uterine artery opening outward by rotating guide wire, which was relatively easy to enter the uterine artery.
Conclusion: The female pelvic arterial network model in vivo could be successfully constructed by using Mimics Version 10.01 software with database collected through CTA, which may contribute to the materialization of digital models and be used for preoperative surgical simulator.