Heron Werner1

Jorge Lopes Dos Santos2 Physical models of the foetus created using
Edward Araujo Júnior3
magnetic resonance imaging, computed
tomography, and ultrasound data: history,
description, and potential uses
Modelos físicos de fetos criados por meio de dados da ressonância
magnética, tomografia computadorizada e ultrassonografia:
histórico, descrição e potenciais aplicações
Editorial
Improvements in the technology for non-invasive acquisition and visualization of
images have brought about great advances in medicine, particularly in the diagnostic and
prognostic assessments of foetal anomalies1. In general, ultrasound (US) and magnetic
resonance imaging (MRI) are two techniques that are used to acquire images of the foetus
and uterus during pregnancy. The computed tomography (CT) also provides detailed
foetal images, especially those of the foetal skeleton from the 30th week; however, its
application is limited to the diagnosis of complex skeletal disorders because of the effects
of ionizing radiation2.
The earliest attempts to graphically represent the foetus date back to the 15th cen-
tury A.D. Artistic renderings from that period onwards can be found in museums and
private collections worldwide. Leonardo da Vinci is among the artists who refined the
quality of the foetus visual representation. By means of several anatomical studies, da
Vinci illustrated the entire process of foetal development.
The usage of physical models in medical teaching began in Italy during the Renaissance.
At that time, highly realistic wax models began to be employed to accurately represent
different parts of the human body, including changes in the bodies of pregnant women.
The Florentine school also used models to teach anatomy, with the aim of dissemination
of morphological and anatomical information without the need of the direct observa-
tion of a cadaver. Various models can still be observed in the permanent exhibition at
La Specola, in the Museum of Zoology and Natural History in Florence, Italy, which
was founded in 1775. Until the early 19th century, it was the only scientific museum
specifically created for the general public3. Another significant initiative occurred in
France around 1778, when Madame Du Coudray designed and produced a set of teaching
models made of different types of fabric and materials known as “La Machine”. These
realistic examples of the mother-foetus couple were used in many villages for teaching
and spreading information about the birth process3,4.

Correspondence Department of Radiology, Clínica de Diagnóstico por Imagem – CPDI – Rio de Janeiro (RJ), Brazil.
Edward Araujo Júnior
1
Department of Radiology, Clínica de Diagnóstico por Imagem – CPDI – Rio de Janeiro (RJ), Brazil.
Departamento de Obstetrícia, Escola Paulista de Medicina,
2
Departament of Arts and Design, Pontifícia Universidade Católica – PUC-Rio – Rio de Janeiro (RJ), Brazil.
Universidade Federal de São Paulo
3
Fetal Medicine Subject, Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP –
Rua Napoleão de Barros, 875 – Vila Clementino São Paulo (SP), Brazil.
Zip Code: 04024-002 Conflict of interests: none.
São Paulo (SP), Brazil

Received
12/18/2014

Accepted with modifications

01/20/2015

DOI: 10.1590/SO100-720320150005250
 Werner H, Santos JL, Araujo Júnior E

US has given us a means to study the foetus, and

it has been used in obstetrics for more than 30 years.
At present, it is the predominant method for the
routine screening of foetal malformations due to its
relative simplicity and safety for the mother-foetus
couple. MRI is a non-invasive diagnostic technique
that provides sharp images of the human body and is
complementary to US4.
Today, many companies are dedicated to producing
physical teaching models that represent all stages of
pregnancy. These models, with some of them being
of pathological cases, are used in medical schools and
related fields of study for inspection and palpation ses-
sions3,5,6. Virtual three-dimensional (3D) modelling has
gained great momentum in recent years because of the
Figure 1. Virtual and physical model of a 32-week-old foetus obtained
development of high-performance software used in using ultrasound and magnetic resonance imaging scan data and
the areas of engineering, architecture, and design. It has printed using a ZCorp 3D printer and plaster-based powder
also become increasingly easier to use, facilitating the
visualization of 3D images, which can be generated from
data obtained from conventional imaging techniques
(e.g. US, CT and MRI) or from other techniques like of the study was the difficulty to obtain high-quality
laser scanning. The post-processing of medical imaging images that could be manipulated using 3D modelling
data may provide new applications for 3D representa- software without a loss of accuracy. Foetal movements
tion, facilitated by technological advances in virtual 3D through image acquisition were a major difficulty, espe-
modelling software. cially in MRI studies. This problem is less significant in
Only two studies using US data to construct 3D US because images are acquired at real time and may be
models have been conducted. Blaas et al.7 calculated the frozen during movement. However, limitations of grey
volume of embryos and foetuses in the first trimester of scale images decrease the lower contrast resolution of
pregnancy, transforming such area into a virtual model. The US in some cases. The quality of the process is directly
second study, conducted by Nelson and Bailey2, converted associated with the accuracy of the mathematical data
3D data from US into a body surface/shape represented that will be used to generate physical models. The
in the form of polygons, which is then transposed onto pictures are achieved in layers, which are overlapped
physical models using various types of rapid prototyping to create models9.
devices, allowing the creation of solid 3D objects. This This study sought to demonstrate the advantages of
was considered the first attempt to change US data into 3D visualization in comparison with traditional visual-
3D physical models. ization techniques. Using such modality, the region of
The segmentation and reconstruction techniques interest can be evaluated and manipulated by the observer
created for foetal modelling can be applied to the to clearly appreciate the physical characteristics of ana-
construction of both virtual and physical models con- tomical structures and their spatial relationships. In this
structed using US, MRI, and CT data1,8-11. 3D print- respect, rapid prototyping served as a 3D visualization
ing technologies allow the conversion of 3D virtual method, forming a powerful tool for the visualization of
models into physical ones rapidly, easily, and precisely. various anatomical structures. The resulting models
In the construction process, a 3D data file is moved represent an important palpable model for teaching and
to a rapid prototyping machine that builds physical helped conveying more comprehensible information to
models by overlaying thin layers of raw materials6,12,13 pregnant women9.
(Figure 1). It is believed that physical models will assist in
Werner et al.9 described the use of physical models the palpatory and interactive study of complex ab-
in foetal research, an area in which there are few studies normalities in various disciplines in the near future.
of 3D digital modelling. Their preliminary research sug- In  addition, these techniques allow the creation of
gests possible uses in representing interactions between 3D models with the physical characteristics of the
parents and foetus during the prenatal period, physically foetus, which may be useful for providing a more
recreating uterine cavity at pregnancy and recreating direct emotional connection of prospective parents to
scale anatomical models of the foetus. A major concern their unborn children.

150 Rev Bras Ginecol Obstet. 2015; 37(4):149-51

 Physical models of the foetus created using magnetic resonance imaging, computed tomography, and ultrasound data: history, description, and potential uses

References

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2. Nelson TR, Bailey MJ. Solid object visualization of 3D ultrasound 9. Werner H, dos Santos JR, Fontes R, Daltro P, Gasparetto E,
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