Noocyada anatomical daabacan ee saddex-geesoodka ah (3DPAMs) waxay u muuqdaan inay yihiin qalab ku habboon qiimaha waxbarasho iyo suurtogalnimada awgeed.Ujeedada dib u eegistani waa in la qeexo oo la falanqeeyo hababka loo isticmaalo in lagu abuuro 3DPAM si loo baro anatomy aadanaha iyo in lagu qiimeeyo waxtarkeeda barbaarineed.
Baadhitaan elektaroonig ah ayaa laga sameeyay PubMed iyadoo la adeegsanayo ereyadan soo socda: waxbarasho, dugsi, waxbarasho, barid, tababar, barid, waxbarasho, saddex-cabbir, 3D, 3-cabbir, daabacaad, daabacaad, daabacaad, anatomi, anatomy, anatomy, iyo anatomi ..Natiijooyinka waxaa ka mid ahaa sifooyinka daraasadda, naqshadeynta moodeelka, qiimeynta morphological, waxqabadka waxbarashada, meelaha ku wanaagsan iyo daciifnimada.
Waxaa ka mid ah maqaallada 68 ee la doortay, tirada ugu badan ee daraasadaha ayaa diiradda saarey gobolka cranial (33 maqaal);51 maqaallo ayaa xusaya daabacaadda lafaha.Maqaallada 47, 3DPAM waxaa lagu sameeyay iyadoo lagu salaynayo sawir qaade la sameeyay.Shan hab oo daabacaad ayaa ku qoran.Caagagga iyo waxyaabaha ka soo baxa ayaa loo adeegsaday 48 daraasadood.Naqshad kastaa waxay u dhaxaysaa qiimaha laga bilaabo $1.25 ilaa $2,800.Soddon iyo toddoba daraasadood ayaa barbardhigay 3DPAM moodooyinka tixraaca.Soddon iyo saddex maqaal ayaa baadhay hawlaha waxbarashada.Faa'iidooyinka ugu muhiimsan waa tayada muuqaalka iyo taabashada, hufnaanta waxbarashada, dib-u-celinta, wax-ka-beddelka iyo karti-u-qabsiga, kaydinta waqtiga, is-dhexgalka anatomy shaqeynaya, awoodaha wareegga maskaxeed ee wanaagsan, haynta aqoonta iyo ku qanacsanaanta macalinka/ardayga.Khasaarooyinka ugu muhiimsan waxay la xiriiraan naqshadeynta: joogteynta, la'aanta faahfaahinta ama hufnaanta, midabada aad u dhalaalaya, waqtiyada daabacaadda dheer iyo qiimaha sare.
Dib-u-eegis nidaamsan ayaa muujinaya in 3DPAM ay tahay mid kharash-ool ah oo wax ku ool u ah baridda anatomy.Moodooyinka dhabta ah ee dheeraadka ah waxay u baahan yihiin isticmaalka tiknoolajiyada daabacaadda 3D ee qaaliga ah iyo waqtiyada naqshadeynta dheer, taas oo si weyn u kordhin doonta qiimaha guud.Furaha ayaa ah in la doorto habka sawirka ku habboon.Marka laga eego dhinaca barbaarinta, 3DPAM waa qalab wax ku ool ah oo lagu baro anatomy, oo saameyn togan ku leh natiijooyinka barashada iyo ku qanacsanaanta.Saamaynta waxbaridda ee 3DPAM ayaa ugu wanaagsan marka ay soo saarto gobollo adag oo anatomical ah oo ardaydu ay u isticmaalaan goor hore tababarkooda caafimaad.
Kala soocida meydadka xoolaha ayaa la sameyn jiray tan iyo Giriigii hore waana mid ka mid ah hababka ugu muhiimsan ee lagu baro anatomy.Qaybaha cadaveric ee la sameeyo inta lagu guda jiro tababbarka wax ku oolka ah waxaa loo adeegsadaa manhajka aragtida ee ardayda caafimaadka jaamacadda waxaana hadda loo tixgeliyaa heerka dahabka ee daraasadda anatomy [1,2,3,4,5].Si kastaba ha ahaatee, waxaa jira caqabado badan oo ka hor imaanaya isticmaalka muunado cadaveric aadanaha, taasoo keentay in la raadiyo qalab cusub oo tababar ah [6, 7].Qaar ka mid ah qalabkan cusub waxaa ka mid ah xaqiiqda la kordhiyay, qalabka dhijitaalka ah, iyo daabacaadda 3D.Sida laga soo xigtay dib u eegista suugaanta dhawaan ee Santos et al.[8] Marka la eego qiimaha tignoolajiyadan cusub ee lagu barayo anatomy, daabacaadda 3D waxay u muuqataa inay tahay mid ka mid ah ilaha ugu muhiimsan, marka la eego qiimaha waxbarasho ee ardayda iyo marka la eego suurtagalnimada fulinta [4,9,10] .
Daabacaadda 3D maaha mid cusub.Ruqsadaha ugu horreeya ee la xidhiidha tignoolajiyadan waxay dib ugu noqdeen 1984: A Le Méhauté, O De Witte iyo JC André ee Faransiiska, iyo saddex toddobaad ka dib C Hull ee USA.Tan iyo markaas, tignoolajiyada ayaa sii waday inay horumariso isticmaalkeeduna wuxuu ku fidday meelo badan.Tusaale ahaan, NASA waxay daabacday shaygii ugu horreeyay ee ka baxsan Earth 2014 [11].Goobaha caafimaadka ayaa sidoo kale qaatay qalabkan cusub, taas oo kordhinaysa rabitaanka horumarinta daawada shakhsi ahaaneed [12].
Qorayaal badan ayaa soo bandhigay faa'iidooyinka isticmaalka qaababka anatomical ee daabacan ee 3D (3DPAM) ee waxbarashada caafimaadka [10, 13, 14, 15, 16, 17, 18, 19].Marka la barayo anatomy aadanaha, moodooyinka aan cudurada ahayn iyo anatomically caadiga ah ayaa loo baahan yahay.Dib u eegisyada qaar ayaa baadhay noocyada tababarka cudurada cudurada ama caafimaadka/qaliinka [8, 20, 21].Si loo horumariyo qaab isku-dhafan oo lagu barayo anatomy aadanaha oo lagu daro qalab cusub sida daabacaadda 3D, waxaan sameynay dib u eegis nidaamsan si aan u sharaxno oo aan u falanqeyno sida walxaha daabacan ee 3D loo abuuray in lagu baro anatomy aadanaha iyo sida ardaydu u qiimeeyaan waxtarka barashada iyagoo isticmaalaya walxahan 3D.
Dib-u-eegis suugaaneedkan habaysan ayaa la qabtay Juun 2022 iyada oo aan waqti xaddidnayn la isticmaalayo PRISMA (Waxyaabaha Warbixinta La Doorbiday ee Dib-u-eegis Habaysan iyo Falanqaynta Meta-Analyses) [22].
Shuruudaha ka mid noqoshada waxay ahaayeen dhammaan waraaqo cilmi-baaris ah oo isticmaalaya 3DPAM ee barida/waxbarashada anatomy.Dib u eegista suugaanta, xarfaha, ama maqaallada diiradda saaraya moodooyinka cudurada, moodooyinka xayawaanka, moodooyinka qadiimiga ah, iyo moodooyinka tababarka caafimaadka/qaliinka waa laga saaray.Maqaallo lagu daabacay Ingiriisi ayaa la doortay.Maqaallada aan lahayn qoraallada online-ka ah waa laga saaray.Maqaallada ay ku jiraan noocyo badan, ugu yaraan mid ka mid ah kuwaas oo caadi ahaan caadi ahaa ama lahaa pathology yar oo aan saamaynayn qiimaha waxbaridda, ayaa lagu daray.
Baadhitaanka suugaanta ayaa lagu sameeyay xogta elektiroonigga ah ee PubMed (Maktabadda Qaranka ee Daawada, NCBI) si loo ogaado daraasadaha khuseeya ee la daabacay ilaa Juun 2022. Isticmaal erayada raadinta soo socda: waxbarashada, dugsiga, waxbaridda, barida, barashada, barida, waxbarashada, saddex- cabbir, 3D, 3D, daabacaad, daabacaad, daabacaad, anatomi, anatomi, anatomi iyo anatomi.Hal su'aal ayaa la fuliyay: ((waxbarasho[Title/Abstract] AMA dugsi [Title/Abstract] AMA Barashada[Title/Abstract] AMA barida[Title/Abstract] Waxbarasho [Title/Abstract]) IYO (Saddex Qaybood [Title] AMA 3D [Title] AMA 3D [Title])) ]]/abstract] ama anatomy [ciwaan/abstract] ama anatomy [ciwaan/abstract] ama anatomy [ciwaan/abstract]).Maqaallo dheeri ah ayaa lagu aqoonsaday iyadoo gacanta lagu baarayo xogta PubMed iyo dib u eegista tixraacyada maqaallada kale ee sayniska.Ma jiro xaddidaad taariikhi ah, laakiin shaandhada "Qofka" ayaa la isticmaalay.
Dhammaan ciwaannada iyo qoraallada la soo saaray ayaa laga eegay ka soo horjeeda ku daridda iyo shuruudaha ka saarista laba qoraa (EBR iyo AL), iyo daraasad kasta oo aan buuxin dhammaan shuruudaha u-qalmitaanka waa laga saaray.Daabacaadaha qoraal-buuxa ee daraasadaha hadhay ayaa la soo saaray oo ay dib u eegeen saddex qoraa (EBR, EBE iyo AL).Markii loo baahdo, khilaafkii xulashada qodobbada waxaa xalliyey qof afraad (LT).Daabacaad buuxiyey dhammaan shuruudaha ka mid noqoshada ayaa lagu daray dib u eegistan.
Soo saarista xogta waxaa si madax banaan u sameeyay laba qoraa (EBR iyo AL) iyadoo ay ilaalinayaan qoraaga saddexaad (LT).
- Xogta naqshadeynta moodeelka: gobollada anatomical, qaybo gaar ah oo anatomical ah, qaabka bilowga ah ee daabacaadda 3D, habka iibsiga, software qaybinta iyo qaabaynta, nooca daabacaha 3D, nooca alaabta iyo tirada, miisaanka daabacaadda, midabka, kharashka daabacaadda.
- Qiimaynta morphological ee moodooyinka: moodooyinka loo isticmaalo isbarbardhigga, qiimeynta caafimaadka ee khubarada/macallimiinta, tirada qiimeeyayaasha, nooca qiimeynta.
- Barista qaabka 3D: qiimaynta aqoonta ardayga, habka qiimaynta, tirada ardayda, tirada kooxaha barbardhiga, kala soocida ardayda, waxbarashada/nooca ardayga.
418 daraasadood ayaa lagu aqoonsaday MEDLINE, iyo 139 maqaallo ayaa laga saaray shaandhada "aadmiga".Ka dib markii dib loo eego ciwaannada iyo qoraallada, 103 daraasadood ayaa loo doortay akhrinta qoraal buuxa.Maqaallada 34 ayaa laga saaray sababtoo ah waxay ahaayeen moodooyinka cudurada (9 articles), moodooyinka tababarka caafimaadka / qalliinka (4 maqaallo), moodooyinka xayawaanka (4 articles), 3D moodooyinka shucaaca (1 maqaal) ama ma ahayn maqaallo saynis ah (16 cutub).).Isku geyn 68 maqaal ayaa lagu soo daray dib u eegista.Jaantuska 1 wuxuu soo bandhigayaa habka xulashada sida jaantus socodka.
Jaantuska socodka oo soo koobaya aqoonsiga, baadhista, iyo ku darida maqaalada dib u eegista habaysan
Dhammaan daraasadaha ayaa la daabacay intii u dhaxaysay 2014 iyo 2022, iyada oo celcelis ahaan daabacaadda sanadka 2019. 68 ka mid ah waxaa ka mid ah maqaallo, 33 (49%) daraasaadka waxay ahaayeen kuwo sharraxaad iyo tijaabo ah, 17 (25%) waxay ahaayeen tijaabo keliya, iyo 18 (26%) waxay ahaayeen tijaabo ah.Si cad u qeexan.50 (73%) ee daraasadaha tijaabada ah, 21 (31%) waxay isticmaaleen kala-sooc.Kaliya 34 daraasadood (50%) ayaa ku jiray falanqaynta tirakoobka.Shaxda 1 ayaa soo koobaysa sifooyinka daraasad kasta.
Qodobbada 33 (48%) ayaa baadhay gobolka madaxa, 19 qodob (28%) ayaa baadhay gobolka xididada, 17 qodob (25%) ayaa baadhay gobolka abdominopelvic, iyo 15 qodob (22%) waxay baadhaan xag-jirnimada.Kow iyo konton maqaal (75%) waxay sheegeen 3D lafaha daabacan inay yihiin moodooyinka anatomical ama noocyo badan oo qaybo anatomical ah.
Marka la eego moodooyinka ilaha ama faylasha loo isticmaalo in lagu horumariyo 3DPAM, 23 maqaal (34%) ayaa sheegay isticmaalka xogta bukaanka, 20 maqaallo (29%) ayaa xusay isticmaalka xogta cadaveric, iyo 17 articles (25%) ayaa xusay isticmaalka xogta.ayaa la isticmaalay, iyo 7 daraasadood (10%) ma aysan shaacin meesha laga keenay dukumeentiyada la isticmaalay.
47 daraasaad (69%) ayaa horumariyay 3DPAM oo ku salaysan sawir sawireed, iyo 3 daraasadood (4%) ayaa sheegay isticmaalka microCT.Maqaallada 7 (10%) waxay saadaaliyeen walxaha 3D iyadoo la adeegsanayo iskaanka indhaha, 4 maqaallo (6%) iyadoo la adeegsanayo MRI, iyo 1 maqaal (1%) iyadoo la adeegsanayo kamaradaha iyo microscopes.Maqaallada 14 (21%) ma sheegin isha 3D galalka naqshadeynta moodeelka.Faylasha 3D waxaa lagu abuuray xal dhexdhexaad ah oo celcelis ahaan ka yar 0.5 mm.Xallinta ugu fiican waa 30 μm [80] iyo xallinta ugu badan waa 1.5 mm [32].
Lixdan codsiyo software oo kala duwan (qaybin, qaabayn, naqshadayn ama daabacaad) ayaa la isticmaalay.Mimics (Materialise, Leuven, Belgium) ayaa la isticmaalay inta badan (14 daraasaad, 21%), waxaa ku xiga MeshMixer (Autodesk, San Rafael, CA) (13 daraasaad, 19%), Geomagic (Nidaamka 3D, MO, NC, Leesville) .(10 daraasaad, 15%), 3D Slicer (Tababarka Horumarinta Slicer, Boston, MA) (9 daraasaad, 13%), Blender (Blender Foundation, Amsterdam, Netherlands) (8 daraasaad, 12%) iyo CURA (Geldemarsen, Netherlands) (7 daraasaad, 10%).
Lixdan iyo toddoba nooc oo daabacadaha kala duwan iyo shan hab oo daabacaad ayaa lagu sheegay.Farsamaynta FDM (Fused Deposition Modeling) waxaa lagu isticmaalay 26 badeecooyin (38%), walxaha qarxa ee 13 badeeco (19%) iyo ugu dambeyntii qarxinta xirmooyinka (11 badeecooyin, 16%).Farsamooyinka ugu yar ee la isticmaalo waa stereolithography (SLA) (5 maqaallo, 7%) iyo xulashada laser sintering (SLS) (4 maqaal, 6%).Daabacaha inta badan la isticmaalo (7 maqaal, 10%) waa Connex 500 (Stratasys, Rehovot, Israel) [27, 30, 32, 36, 45, 62, 65].
Marka la tilmaamayo alaabta loo isticmaalo samaynta 3DPAM (51 maqaalo, 75%), 48 daraasadood (71%) waxay isticmaaleen balaastiig iyo soosaarkooda.Qalabka ugu muhiimsan ee la isticmaalay waxay ahaayeen PLA (polylactic acid) (n = 20, 29%), resin (n = 9, 13%) iyo ABS (acrylonitrile butadiene styrene) (7 nooc, 10%).Maqaallada 23 (34%) ayaa baadhay 3DPAM oo laga sameeyay agabyo kala duwan, 36 maqaallo (53%) ayaa soo bandhigay 3DPAM oo laga sameeyay hal shay oo keliya, iyo 9 maqaallo (13%) ma cayimin wax.
Sagaal iyo labaatan maqaal (43%) ayaa sheegay saamiga daabacaadda oo u dhexeeya 0.25:1 ilaa 2:1, celcelis ahaan 1:1.Shan iyo labaatan maqaal (37%) waxay adeegsadeen saamiga 1:1.28 3DPAMs (41%) waxay ka koobnaayeen midabo badan, iyo 9 (13%) ayaa la rinjiyeeyay daabacaadda kadib [43, 46, 49, 54, 58, 59, 65, 69, 75].
Afar iyo soddon qodob (50%) ayaa la sheegay.9 maqaal (13%) ayaa sheegay qiimaha daabacadaha 3D iyo alaabta ceeriin.Madbacadaha ayaa qiimahoodu u dhexeeyaa $302 ilaa $65,000.Marka la cayimo, qiimaha moodeelku wuxuu u dhexeeyaa $1.25 ilaa $2,800;darafyadani waxay u dhigmaan muunadaha lafaha [47] iyo moodooyinka retroperitoneal-kalsoonida sare [48].Shaxda 2 ayaa soo koobaysa xogta tusaalaha ee daraasad kasta oo lagu daray.
Todoba iyo soddon daraasadood (54%) marka la barbar dhigo 3DAPM tusaalaha tixraaca.Daraasadahaas, isbarbardhigga ugu caansan wuxuu ahaa qaabka tixraaca anatomical, oo loo adeegsaday 14 maqaal (38%), diyaarinta plastinated ee 6 maqaal (16%), diyaarinta plastinated ee 6 maqaal (16%).Isticmaalka xaqiiqada dhabta ah, sawir sawir sawireed mid 3DPAM 5 maqaallo ah (14%), 3DPAM kale 3 maqaallo (8%), ciyaaraha halista ah ee maqaalka 1 (3%), raadiyogaraafka 1 maqaal (3%), moodooyinka ganacsiga 1 maqaal (3%) iyo xaqiiqada la kordhiyay ee 1 maqaal (3%).Afar iyo afartan (50%) ayaa lagu qiimeeyay 3DPAM.Shan iyo toban (48%) daraasado ayaa si faahfaahsan u sharaxay khibradaha qiimeeyaashooda (Shaxda 3).3DPAM waxaa sameeyay dhakhaatiirta qalliinka ama dhakhaatiirta ka qayb galaya daraasadaha 7 (47%), khabiirada anatomical ee daraasadaha 6 (40%), ardayda 3 daraasadood (20%), macalimiin (anshax aan la cayimin) 3 daraasadood (20%) si loo qiimeeyo iyo hal qiimee kale oo ku jira maqaalka (7%).Celceliska tirada qiimeeyayaashu waa 14 (ugu yaraan 2, ugu badnaan 30).Soddon iyo saddex daraasadood (49%) ayaa si tayo leh u qiimeeyay 3DPAM morphology, iyo 10 daraasadood (15%) waxay qiimeeyeen 3DPAM morphology tiro ahaan.33-da daraasadood ee isticmaalay qiimaynta tayada, 16 waxay adeegsadeen qiimayno qeexan oo kali ah (48%), 9 waxay adeegsadeen imtixaano/qiimayn/ sahamin (27%), iyo 8 waxay adeegsadeen cabirka Likert (24%).Shaxda 3 ayaa soo koobaysa qiimaynta morphological ee moodooyinka daraasad kasta oo lagu daray.
Soddon iyo saddex (48%) maqaallo ayaa baadhay oo barbardhigay waxtarka baridda 3DPAM ardayda.Daraasadahan, 23 (70%) maqaallada ayaa qiimeeyay qanacsanaanta ardayda, 17 (51%) waxay isticmaaleen cabirka Likert, iyo 6 (18%) waxay isticmaaleen habab kale.Laba iyo labaatan maqaal (67%) ayaa ku qiimeeyay waxbarashada ardayda imtixaan aqooneed, kuwaas oo 10 (30%) ay isticmaaleen imtixaano horudhac ah iyo/ama imtixaanada danbe.Kow iyo toban daraasaad (33%) waxay adeegsadeen su'aalo iyo imtixaano kala-doorasho badan si ay u qiimeeyaan aqoonta ardayda, iyo shan daraasadood (15%) waxay adeegsadeen calaamadaynta sawirka/aqoonsiga jirka.Celcelis ahaan 76 arday ayaa ka qayb qaatay daraasad kasta (ugu yaraan 8, ugu badnaan 319).Afar iyo labaatan daraasadood (72%) waxay lahaayeen koox kantarool, kuwaas oo 20 (60%) ay adeegsadeen kala sooc.Taas bedelkeeda, hal daraasad (3%) ayaa si aan kala sooc lahayn loogu qoondeeyay moodooyinka anatomical ee 10 arday oo kala duwan.Celcelis ahaan, 2.6 kooxood ayaa la barbardhigay (ugu yaraan 2, ugu badnaan 10).Saddex iyo labaatan daraasadood (70%) ayaa ku lug lahaa ardayda caafimaadka, kuwaas oo 14 (42%) ay ahaayeen arday caafimaadka fasalka koowaad.Lix (18%) daraasado ayaa ku lug lahaa dadka deegaanka, 4 (12%) ardayda ilkaha, iyo 3 (9%) ardayda sayniska.Lix daraasadood (18%) ayaa hirgeliyay oo qiimeeyay barasho madaxbannaan iyadoo la adeegsanayo 3DPAM.Shaxda 4 ayaa soo koobaysa natiijooyinka qiimaynta waxtarka waxbaridda ee 3DPAM ee daraasad kasta oo lagu daray.
Faa'iidooyinka ugu muhiimsan ee ay soo tebiyeen qorayaashu si ay u isticmaalaan 3DPAM sida qalab waxbarasho oo loogu talagalay anatomy caadiga ah ee bini'aadamka waa sifooyinka muuqaalka iyo taabashada, oo ay ku jiraan xaqiiqada [55, 67], saxsanaanta [44, 50, 72, 85], iyo kala duwanaansho joogto ah [34, 45]. ]., 48, 64], midabka iyo hufnaanta [28, 45], cimri dhererka [24, 56, 73], saamaynta waxbarashada [16, 32, 35, 39, 52, 57, 63, 69, 79], kharashka [27, 41, 44, 45, 48, 51, 60, 64, 80, 81, 83], taranka [80], suurtagalnimada hagaajinta ama shakhsiyaynta [28, 30, 36, 45, 48, 51, 53, 59, 61, 67, 80], kartida lagu maareynayo ardayda [30, 49], badbaadinta wakhtiga waxbaridda [61, 80], fududaynta kaydinta [61], awoodda isku-dhafka jirka ama abuurista qaabab gaar ah [51, 53], 67] , Naqshadaynta degdega ah ee moodooyinka qalfoofka [81], awood u lahaanshaha in la abuuro moodooyinka oo loo qaado guriga [49, 60, 71], hagaajinta awoodaha wareega maskaxda [23] iyo xajinta aqoonta [32], iyo sidoo kale macalinka [32] 25, 63] iyo ku qanacsanaanta ardayga [25, 45, 46, 52, 52, 57, 63, 66, 69, 84].
Khasaaraha ugu weyni waxay la xiriiraan naqshadeynta: qallafsanaan [80], joogtayn [28, 62], la'aanta tafatirka ama daahfurnaanta [28, 30, 34, 45, 48, 62, 64, 81], midabyo aad u dhalaalaya [45].iyo jilicsanaanta dhulka[71].Khasaaraha kale waxaa ka mid ah luminta macluumaadka [30, 76], waqti dheer oo loo baahan yahay qaybta sawirka [36, 52, 57, 58, 74], wakhtiga daabacaadda [57, 63, 66, 67], la'aanta kala duwanaansho anatomical [25], iyo kharash .Sare[48].
Dib-u-eegis habaysan ayaa soo koobaya 68 maqaallo oo la daabacay in ka badan 9 sano waxayna iftiimisay xiisaynta bulshada sayniska ee 3DPAM oo ah qalab lagu baro anatomy caadiga ah ee aadanaha.Gobol kasta oo anatomical ah ayaa la darsay oo 3D la daabacay.Maqaalladan, 37 maqaallo waxay barbar dhigeen 3DPAM moodooyinka kale, iyo 33 maqaallo waxay qiimeeyeen ku habboonaanta barbaarineed ee 3DPAM ee ardayda.
Marka la eego kala duwanaanshaha naqshadeynta daraasadaha daabacaadda 3D ee anatomical, uma aanaan qaadanin inay ku habboon tahay in la sameeyo falanqayn-meta.Falanqaynta-meta ee la daabacay 2020 inta badan waxay diiradda saartay imtixaannada aqoonta anatomical ka dib tababarka iyada oo aan la falanqeyn dhinacyada farsamada iyo tignoolajiyada ee naqshadeynta iyo soosaarka 3DPAM [10].
Gobolka madaxa ayaa ah kan ugu badan ee la derso, malaha sababtoo ah kakanaanta jidhkiisa ayaa ku adkeynaysa ardayda inay ku sawiraan gobolkan anatomical meel bannaan oo saddex-cabbir ah marka la barbar dhigo addimada ama lafaha.CT ilaa hadda waa habka ugu badan ee la isticmaalo sawirka.Farsamadan ayaa si weyn loo isticmaalaa, gaar ahaan goobaha caafimaadka, laakiin waxay leedahay xallin xaddidan oo xaddidan iyo kala duwanaansho jilicsan oo hooseeya.Xaddidaadahan ayaa CT-ga ka dhigaya kuwo aan ku habboonayn kala qaybinta iyo qaabaynta habdhiska neerfaha.Dhanka kale, sawir-gacmeedka la xisaabiyay ayaa ku habboon kala-qaybinta/qaabaynta unugyada lafaha;Kala duwanaanshaha unugyada lafaha/jilicda ayaa caawiya in la dhamaystiro tillaabooyinkan ka hor inta aan 3D daabacin moodooyinka anatomical.Dhanka kale, microCT waxaa loo tixgeliyaa tignoolajiyada tixraaca marka loo eego xallinta booska sawirka lafaha [70].Sawir-qaadayaasha indhaha ama MRI ayaa sidoo kale loo isticmaali karaa si loo helo sawirro.Xallinta sare waxay ka hortagtaa simay sagxadaha lafaha waxayna ilaalisaa khiyaanada qaababka anatomical [59].Doorashada moodeelku waxay sidoo kale saameynaysaa xallinta booska: tusaale ahaan, moodooyinka balaastikada waxay leeyihiin xallin hoose [45].Nashqadeeyayaasha garaafku waa inay abuuraan moodooyin 3D caado ah, kaas oo kordhiya kharashaadka ($25 ilaa $150 saacadii) [43].Helitaanka galalka .STL oo tayo sare leh kuma filna in la abuuro moodooyinka anatomical ee tayada sare leh.Waa lagama maarmaan in la go'aamiyo xuduudaha daabacaadda, sida jihaynta qaabka anatomical ee saxanka daabacaadda [29].Qorayaasha qaarkood waxay soo jeedinayaan in tignoolajiyada daabacaadda horumarsan sida SLS loo isticmaalo meel kasta oo suurtagal ah si loo hagaajiyo saxnaanta 3DPAM [38].Soo saarista 3DPAM waxay u baahan tahay kaalmo xirfadeed;Khabiirada ugu badan ee la raadiyo waa injineerada [72], raajooloji, [75], naqshadeeyayaasha garaafka [43] iyo anatomists [25, 28, 51, 57, 76, 77].
Qaybinta iyo qaabaynta softiweerka ayaa ah arrimo muhiim u ah helida moodooyinka saxda ah ee anatomical, laakiin qiimaha xirmooyinkooda softiweerka iyo kakanaantahooda ayaa caqabad ku ah isticmaalkooda.Daraasado dhowr ah ayaa isbarbardhigay isticmaalka xirmooyin software kala duwan iyo teknoolojiyadda daabacaadda, iyagoo muujinaya faa'iidooyinka iyo khasaarooyinka tignoolajiyada kasta [68].Marka lagu daro software-samaynta, daabacaadda software ku habboon daabacaha la doortay ayaa sidoo kale loo baahan yahay;Qorayaasha qaarkood waxay door bidaan inay isticmaalaan daabacaadda 3D ee internetka [75].Haddii walxo 3D ku filan la daabaco, maalgashigu wuxuu u horseedi karaa soo celin maaliyadeed [72].
Cagtu waa ilaa hadda waxa ugu badan ee la isticmaalo.Kala duwanaanshaheeda kala duwan ee textures iyo midabada ayaa ka dhigaya alaabta doorashada ee 3DPAM.Qorayaasha qaar ayaa ammaanay xooggeeda sare marka loo eego moodooyinka cadaveric ama balaastiga ah [24, 56, 73].Qaar ka mid ah balaastikada ayaa xitaa leh sifooyin foorarsi ama foorarsi.Tusaale ahaan, Filaflex oo leh tignoolajiyada FDM waxay fidsan kartaa ilaa 700%.Qorayaasha qaarkood waxay u arkaan inay tahay maaddada doorashada ee murqaha, seedaha iyo taranka [63].Dhanka kale, laba cilmi-baaris ayaa soo bandhigay su'aalo ku saabsan hanuuninta fiber-ka xilliga daabacaadda.Dhab ahaantii, jihaynta fiber muruqa, gelinta, gudaha, iyo shaqada ayaa muhiim u ah qaabaynta muruqa [33].
Waxa la yaab leh, daraasado yar ayaa sheegaya miisaanka daabacaadda.Maadaama ay dad badani u haystaan in saamiga 1:1 uu yahay halbeeg, waxa laga yaabaa in qoraagu uu doortay in aanu xusin.Inkasta oo kor u qaadista ay faa'iido u leedahay barashada tooska ah ee kooxaha waaweyn, suurtogalnimada miisaan-qaadista weli lama sahamin, gaar ahaan tirada fasallada sii kordheysa iyo cabbirka jireed ee moodeelku waa arrin muhiim ah.Dabcan, miisaanka buuxa ayaa fududeynaya in la helo oo lala xiriiro xubno kala duwan oo anatomical ah bukaanka, kuwaas oo sharxi kara sababta inta badan loo isticmaalo.
Madbacadaha badan ee laga heli karo suuqa, kuwa isticmaala tignoolajiyada PolyJet (qalabka ama binder inkjet) si ay u bixiyaan midab iyo lakabyo badan (iyo qoraallo badan) qiimaha daabacaadda qeexitaan sare oo u dhexeeya US$20,000 iyo US$250,000 (https: //www .aniwaa.com/).Qiimahan sare waxa laga yaabaa inuu xaddido kor u qaadida 3DPAM ee dugsiyada caafimaadka.Marka lagu daro kharashka daabacaha, qiimaha alaabta looga baahan yahay daabacaadda inkjetka ayaa ka sarreeya madbacadaha SLA ama FDM [68].Qiimaha daabacadaha SLA ama FDM sidoo kale waa la awoodi karaa, oo u dhexeeya € 576 ilaa € 4,999 ee maqaallada ku taxan faallooyinkan.Sida laga soo xigtay Tripodi iyo asxaabtiisa, qayb kasta oo lafaha ah waxaa lagu daabici karaa US$1.25 [47].Kow iyo toban daraasadood ayaa lagu soo gabagabeeyay in daabacaadda 3D ay ka jaban tahay balaastiigga ama moodooyinka ganacsiga [24, 27, 41, 44, 45, 48, 51, 60, 63, 80, 81, 83].Waxaa intaa dheer, moodooyinkan ganacsi waxaa loogu talagalay inay bixiyaan macluumaadka bukaanka iyada oo aan tafatiran ku filan waxbaridda anatomy [80].Moodooyinkan ganacsi waxaa loo arkaa inay ka hooseeyaan 3DPAM [44].Waxaa xusid mudan in, marka lagu daro tignoolajiyada daabacaadda ee la isticmaalo, qiimaha ugu dambeeya wuxuu u dhigmaa miisaanka iyo sidaas darteed cabbirka ugu dambeeya ee 3DPAM [48].Sababahan dartood, miisaanka buuxa ayaa la door bidaa [37].
Hal daraasad oo keliya ayaa la barbardhigay 3DPAM moodooyinka anatomical ee ganacsi ahaan la heli karo [72].Muunada cadaveric waa isbarbardhigga inta badan loo isticmaalo 3DPAM.Inkasta oo ay xaddidan yihiin, moodooyinka cadaveric ayaa ah qalab qiimo leh oo lagu baro anatomy.Waa in la kala saaraa inta u dhaxaysa baaritaanka meydka, kala goynta iyo lafta qallalan.Iyada oo ku saleysan imtixaannada tababarka, laba daraasadood ayaa muujiyay in 3DPAM ay si aad ah uga waxtar badan tahay kala-soocidda plastined [16,27].Hal daraasad ayaa barbardhigtay hal saac oo tababar ah iyadoo la adeegsanayo 3DPAM (xagjirnimada hoose) oo leh hal saac oo kala-soocidda isla gobolka anatomical [78].Ma jirin farqi weyn oo u dhexeeya labada hab waxbarid.Waxay u badan tahay in ay jirto cilmi-baaris yar oo mawduucan ah sababtoo ah isbarbardhigga noocaas ah way adagtahay in la sameeyo.Kala qaybintu waa diyaargarow wakhti badan qaadata ardayda.Mararka qaarkood daraasiin saacadood oo diyaargarow ayaa loo baahan yahay, iyadoo ku xiran waxa la diyaarinayo.Isbarbardhigga saddexaad waxaa lagu samayn karaa lafo qalalan.Daraasad ay sameeyeen Tsai iyo Smith ayaa lagu ogaaday in buundooyinka imtixaanku ay si aad ah ugu fiicnaayeen kooxda iyagoo isticmaalaya 3DPAM [51, 63].Chen iyo asxaabtiisuba waxay xuseen in ardayda isticmaalaysa moodooyinka 3D ay si fiican uga shaqeeyeen aqoonsiga qaab-dhismeedka (dhafoofyada), laakiin ma jirin farqi u dhexeeya buundooyinka MCQ [69].Ugu dambeyntii, Tanner iyo asxaabtiisu waxay soo bandhigeen natiijooyin wanaagsan oo ka dambeeya baaritaanka kooxdan iyagoo isticmaalaya 3DPAM ee fossa pterygopalatine [46].Qalab kale oo cusub oo waxbarid ayaa lagu aqoonsaday dib u eegista suugaanta.Kuwa ugu caansan waxaa ka mid ah xaqiiqooyinka la kordhiyay, xaqiiqada dhabta ah iyo ciyaaraha culus [43].Marka loo eego Mahrous iyo asxaabtiisa, doorbidida moodooyinka anatomical waxay kuxirantahay tirada saacadaha ardaydu ciyaaraan ciyaaraha fiidiyowga [31].Dhanka kale, dib u dhac weyn oo ku yimid aaladaha waxbaridda anatomy ee cusub ayaa ah jawaab celin haptic ah, gaar ahaan aaladaha tooska ah [48].
Inta badan daraasaadka lagu qiimeeyay 3DPAM-ka cusub waxay adeegsadeen tijaabo aqooneed.Tijaabooyinku waxay caawiyaan in laga fogaado eexda xagga qiimaynta.Qorayaasha qaarkood, ka hor intaanay samayn daraasado tijaabo ah, waxay ka saarayaan dhammaan ardayda ka keenay celceliska imtixaankii hordhaca ahaa [40].Eexda Garas iyo asxaabtii la sheegay waxaa ka mid ahaa midabka moodeelka iyo xulashada tabaruceyaasha fasalka ardayda [61].Midabaynta waxay sahlaysa aqoonsiga qaababka anatomical.Chen iyo asxaabtiisuba waxay dejiyeen shuruudo tijaabo ah oo adag iyada oo aan wax farqi ah u dhexeynin kooxaha daraasaddana waa la indho tiray ilaa xadka ugu badan ee suurtogalka ah [69].Lim iyo asxaabtiisuba waxay ku talinayaan in qiimaynta imtixaanka ka dib ay dhamaystiraan cid saddexaad si looga fogaado eexda qiimaynta [16].Daraasadaha qaarkood waxay adeegsadeen cabbirada Likert si ay u qiimeeyaan suurtagalnimada 3DPAM.Qalabkani wuxuu ku habboon yahay in lagu qiimeeyo qanacsanaanta, laakiin weli waxaa jira eexyo muhiim ah oo lagu ogaanayo [86].
Muhiimadda waxbarasho ee 3DPAM ayaa ugu horrayn lagu qiimeeyay ardayda caafimaadka, oo ay ku jiraan ardayda caafimaadka sannadka koowaad, 14 ka mid ah 33 daraasadood.Daraasaddooda tijaabada ah, Wilk iyo asxaabtiisuba waxay soo sheegeen in ardayda caafimaadku ay rumaysnaayeen in daabacaadda 3D lagu daro waxbarashadooda anatomy [87].87% ardayda la sahamiyey ee daraasadda Cercenelli waxay rumaysnaayeen in sannadka labaad ee daraasaddu ay tahay wakhtiga ugu wanaagsan ee la isticmaalo 3DPAM [84].Natiijooyinka Tanner iyo asxaabtooda ayaa sidoo kale muujiyay in ardaydu ay si fiican u qabteen haddii aysan waligood baran goobta [46].Xogtaasi waxay soo jeedinaysaa in sannadka ugu horreeya ee dugsiga caafimaadka uu yahay wakhtiga ugu habboon ee lagu darayo 3DPAM waxbaridda anatomy.Falanqaynta Meta-Yes waxay taageertay fikradan [18].Maqaallada 27 ee lagu soo daray daraasadda, waxaa jiray farqi weyn oo u dhexeeya buundooyinka imtixaanka ee u dhexeeya 3DPAM iyo moodooyinka dhaqameed ee ardayda caafimaadka, laakiin maaha dadka deegaanka.
3DPAM sida qalab waxbarasho waxa ay wanaajisaa guusha tacliinta [16, 35, 39, 52, 57, 63, 69, 79], haysashada aqoonta muddada dheer [32], iyo qanacsanaanta ardayga , 66]., 69 , 84].Guddiyada khubarada ayaa sidoo kale helay moodooyinkan mid waxtar leh [37, 42, 49, 81, 82], iyo laba daraasadood oo helay qanacsanaanta macalinka ee 3DPAM [25, 63].Dhammaan ilaha, Backhouse iyo asxaabtiisuba waxay tixgeliyaan daabacaadda 3D inay tahay beddelka ugu fiican ee moodooyinka dhaqanka caadiga ah [49].Falanqaynta Meta-koowaad ee ugu horeysay, Ye iyo asxaabtu waxay xaqiijiyeen in ardayda heshay tilmaamaha 3DPAM ay ka heleen buundooyin imtixaan ka dib ka wanaagsan kuwii ardayda helay 2D ama tilmaamaha cadaver [10].Si kastaba ha ahaatee, waxay ku kala sooceen 3DPAM ma aha kakanaanta, laakiin si fudud wadnaha, habdhiska dareenka, iyo godka caloosha.Toddobada daraasadood, 3DPAM kama aysan fiicneyn moodooyinka kale ee ku saleysan imtixaannada aqoonta ee la qaado ardayda [32, 66, 69, 77, 78, 84].Falanqaynta-meta, Salazar iyo asxaabtiisu waxay soo gabagabeeyeen in isticmaalka 3DPAM uu si gaar ah u wanaajiyo fahamka anatomy adag [17].Fikradani waxay la socotaa warqadda Hitas ee tifaftiraha [88].Meelaha anatomical qaarkood ee loo arko inay ka adag yihiin uma baahna isticmaalka 3DPAM, halka meelo badan oo anatomical ah (sida qoorta ama habdhiska dareenka) ay u noqon doonaan doorasho macquul ah 3DPAM.Fikradan ayaa laga yaabaa inay sharaxdo sababta 3DPAM-yada qaarkood aan loogu tixgalin inay ka sarreeyaan moodooyinka dhaqameed, gaar ahaan marka ardaydu ay aqoon la'aan u leeyihiin qaybta halka waxqabadka moodeelka la ogaado inuu ka sarreeyo.Markaa, u soo bandhigida tusaalaha fudud ee ardayda horeba u lahaa aqoonta maadada (ardayda caafimaadka ama dadka deegaanka) ma caawinayso horumarinta waxqabadka ardayga.
Dhammaan faa'iidooyinka waxbarasho ee liiska ku jira, 11 daraasadood ayaa xoogga saaray tayada muuqaalka ama taabashada moodooyinka [27,34,44,45,48,50,55,63,67,72,85], iyo 3 daraasadood ayaa hagaajiyay xoogga iyo cimri dhererka (33) , 50 -52, 63, 79, 85, 86).Faa'iidooyinka kale waxaa ka mid ah in ardaydu ay ku dhaqmi karaan qaab-dhismeedka, macalimiintu waxay badbaadin karaan wakhti, way ka sahlan yihiin in la ilaaliyo cadavers, mashruuca waxaa lagu dhamayn karaa 24 saacadood gudahood, waxaa loo isticmaali karaa qalab guri, waxaana loo isticmaali karaa in lagu baro qadar badan. ee xogta.kooxaha [30, 49, 60, 61, 80, 81].Daabacaadda 3D ee soo noqnoqda ee waxbaridda anatomy ee mugga sare waxay ka dhigaysaa moodooyinka daabacaadda 3D kharash-ool badan [26].Isticmaalka 3DPAM wuxuu wanaajin karaa awoodaha wareegga maskaxda [23] iyo hagaajinta tarjumaadda sawirada qaybaha [23, 32].Laba cilmi-baaris ayaa lagu ogaaday in ardayda la kulmay 3DPAM ay aad ugu dhowdahay in lagu sameeyo qalliin [40, 74].Xidhiidhiyayaasha birta ah ayaa lagu dhejin karaa si loo abuuro dhaqdhaqaaqa loo baahan yahay si loo barto anatomy functional [51, 53], ama moodooyinka waxaa lagu daabici karaa iyadoo la adeegsanayo naqshadaha kiciya [67].
Daabacaadda 3D waxay u oggolaanaysaa abuurista moodooyin la hagaajin karo oo anatomical ah iyadoo hagaajinaysa dhinacyo gaar ah inta lagu jiro marxaladda qaabaynta, [48, 80] abuurista saldhig ku habboon, [59] isku darka noocyo badan, [36] iyadoo la adeegsanayo daahfurnaan, (49) midab, [45] ama samaynta dhismayaal gudaha ah oo muuqda [30].Tripodi iyo asxaabtiisuba waxay isticmaaleen dhoobo farshaxan si ay u dhamaystiraan moodooyinka lafaha daabacan ee 3D, iyaga oo xoogga saaraya qiimaha moodooyinka la sameeyay sida qalab waxbarasho [47].Daraasadaha 9, midabka ayaa la dabaqay ka dib daabacaadda [43, 46, 49, 54, 58, 59, 65, 69, 75], laakiin ardaydu waxay codsadeen hal mar kaliya [49].Nasiib darro, daraasaddu ma qiimeyn tayada tababbarka moodeelka ama habka tababarka.Tani waa in lagu tixgaliyaa macnaha guud ee waxbarashada anatomy, maadaama faa'iidooyinka barashada isku dhafan iyo wax-abuurka ay si wanaagsan u dhisan yihiin [89].Si loola tacaalo dhaqdhaqaaqa xayaysiisyada ee sii kordhaya, is-barashada ayaa marar badan loo adeegsaday si loo qiimeeyo moodooyinka [24, 26, 27, 32, 46, 69, 82].
Hal daraasad ayaa lagu soo gabagabeeyey in midabka maadada caaga ah uu aad u iftiimay[45], daraasad kale ayaa lagu soo gabagabeeyey in qaabku aad u jilicsanaa [71], iyo laba daraasadood oo kale ayaa muujiyay la'aanta isbeddelka anatomical ee naqshadeynta moodooyinka shakhsi ahaaneed [25, 45]. ]..Toddoba daraasadood ayaa soo gabagabeeyey in faahfaahinta anatomical ee 3DPAM aysan ku filneyn [28, 34, 45, 48, 62, 63, 81].
Wixii faahfaahin dheeraad ah oo ku saabsan qaababka anatomical ee gobollada waaweyn iyo kuwa adag, sida retroperitoneum ama laf-dhabarka ilmo-galeenka, qaybta iyo wakhtiga qaabaynta ayaa loo tixgeliyaa mid aad u dheer oo kharashkuna aad buu u sarreeyaa (qiyaastii US $ 2000) [27, 48].Hojo iyo asxaabtooda waxay ku sheegeen daraasaddooda inay qaadatay 40 saacadood si ay u abuuraan qaabka anatomical ee miskaha [42].Waqtiga ugu dheer ee kala qaybinta wuxuu ahaa saacadaha 380 ee daraasad ay sameeyeen Weatherall iyo asxaabtiisa, kaas oo noocyo badan oo la isku daray si loo abuuro qaabka hawo-mareenka carruurta oo dhamaystiran [36].Sagaal daraasadood, qaybinta iyo wakhtiga daabacaadda ayaa loo tixgeliyey khasaare [36, 42, 57, 58, 74].Si kastaba ha ahaatee, daraasadaha 12 ayaa dhaleeceeyay sifooyinka jireed ee moodooyinkooda, gaar ahaan joogtaynta, [28, 62] la'aanta daahfurnaanta, [30] jilicsanaanta iyo monochromaticity, [71] la'aanta unugyada jilicsan, [66] ama faahfaahin la'aanta [28, 34]., 45, 48, 62, 63, 81].Khasaarooyinkan waxaa lagaga gudbi karaa iyadoo la kordhiyo qaybta ama wakhtiga jilitaanka.Luminta iyo soo celinta macluumaadka khuseeya waxay ahayd dhibaato ay wajaheen saddex kooxood [30, 74, 77].Marka loo eego warbixinnada bukaan-socodka, wakiilada isbar-bardhigga iodinated ma aysan bixinin muuqaalka ugu wanaagsan ee xididdada dhiigga sababtoo ah xaddidnaanta qiyaasta [74].Duritaan ee qaabka cadaveric wuxuu u muuqdaa inuu yahay hab ku habboon oo ka fog mabda'a "sida ugu yar ee suurtogalka ah" iyo xaddidnaanta qiyaasta wakiilka isbarbardhigga ee la duray.
Nasiib darro, maqaallo badan ma sheegaan qaar ka mid ah sifooyinka muhiimka ah ee 3DPAM.In ka yar kala badh qodobbada ayaa si cad u sheegay in 3DPAM-kooda la midabeeyay iyo in kale.Daboolista baaxadda daabacaaddu waxay ahayd mid aan is waafaqsanayn (43% ee maqaallada), kaliya 34% ayaa sheegay adeegsiga warbaahinno badan.Qiyaasaha daabacan waa muhiim sababtoo ah waxay saameeyaan sifooyinka barashada 3DPAM.Maqaalada intooda badani ma bixiyaan macluumaad ku filan oo ku saabsan kakanaanta helitaanka 3DPAM (waqtiga naqshadeynta, shahaadooyinka shaqaalaha, kharashyada software, kharashyada daabacaadda, iwm.).Macluumaadkani waa muhiim waana in la tixgeliyo ka hor inta aan la bilaabin mashruuca lagu horumarinayo 3DPAM cusub.
Dib-u-eegid habaysan ayaa muujinaysa in naqshadaynta iyo daabacaadda 3D ee moodooyinka caadiga ah ee anatomical ay tahay mid macquul ah oo qiimo jaban ah, gaar ahaan marka la isticmaalayo FDM ama SLA madbacadaha iyo walxo caag ah oo hal midab ah oo jaban.Si kastaba ha noqotee, naqshadahan aasaasiga ah waxaa lagu wanaajin karaa iyadoo lagu darayo midab ama lagu daro naqshado qalab kala duwan.Noocyo waaqici ah oo badan (oo lagu daabacay iyadoo la adeegsanayo agabyo badan oo midabo kala duwan leh iyo textures si ay si dhow ugu soo celiyaan tayada la taaban karo ee qaabka tixraaca cadarka) waxay u baahan yihiin teknoolojiyad daabacaadda 3D oo qaali ah iyo waqtiyo naqshadeynta oo dheer.Tani waxay si weyn u kordhin doontaa kharashka guud.Si kastaba ha ahaatee habka daabacaadda ee la doortay, doorashada habka sawirka ku habboon ayaa fure u ah guusha 3DPAM.Markasta oo ay sare u kacdo xalinta goobtu, waxa sii badanaya qaabka dhabta ah waxaana loo isticmaali karaa cilmi baadhis heersare ah.Marka laga eego dhinaca barbaarinta, 3DPAM waa qalab wax ku ool ah oo lagu baro anatomy, sida ay caddaynayaan imtixaannada aqoonta ee ardayda la qaado iyo ku qanacsanaanta.Saamaynta waxbaridda ee 3DPAM ayaa ugu wanaagsan marka ay soo saarto gobollo adag oo anatomical ah oo ardaydu ay u isticmaalaan goor hore tababarkooda caafimaad.
Xogta la sameeyay iyo/ama lagu falanqeeyay daraasaddan hadda si guud looma heli karo caqabadaha luqadda awgeed laakiin waxa laga heli karaa qoraaga u dhiganta codsi macquul ah.
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Ghosh SK Cadaveric qaybinta sida qalab waxbarasho oo loogu talagalay sayniska anatomical qarniga 21aad: Qaybinta sidii qalab waxbarasho.Falanqaynta waxbarashada sayniska.2017;10 (3):286–99.
Waqtiga boostada: Abriil-09-2024