中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2010年
22期
4172-4175
,共4页
龚振宇%李国华%刘彦普%何黎升%周树夏
龔振宇%李國華%劉彥普%何黎升%週樹夏
공진우%리국화%류언보%하려승%주수하
体层摄影术%计算机辅助%图像处理%半侧颜面萎缩%快速成型%数字化医学
體層攝影術%計算機輔助%圖像處理%半側顏麵萎縮%快速成型%數字化醫學
체층섭영술%계산궤보조%도상처리%반측안면위축%쾌속성형%수자화의학
背景:半侧颜面萎缩畸形的整复方法较多,以往常通过制备患者的石膏面模,在上面堆蜡来恢复患者的面形,蜡型用作手术中衬垫的参考.但由于畸形的变化多,矫治设计的难度大,矫治效果不甚理想.目的:探讨应用计算机辅助设计和快速成型技术制造用于矫正半侧颜面萎缩等凹陷畸形衬垫物的可能性.方法:对半侧颜面萎缩患者行螺旋CT扫描,利用工作站进行扫描图像的容积三维重建后,重新间隔分层,利用CuteFTP 4.0软件以BMP格式下载.应用课题组自主开发的CT图像处理软件对已下载的二维图像进行过滤、筛减、降噪、校正失真等处理,对图像的边缘轮廓进行提取,得到面颅骨皮质骨边缘轮廓的矢量化线图,将该线图数据输入Surfacer 9.0重建软件,对轮廓曲线进行矢量叠加,从而得到面颅骨的三维三角形面片线框模型及实体模型.将健侧面颅骨的点云数据按镜像对称变换到患侧,这样在患侧骨和健侧镜像之间就形成了充填物的三维模型,为补偿软组织的萎缩,将其外表面点云数据外移1.5 mm.对CAD后的三维Surfacer数据重新分层,在RpDataRepare中完成充填物的轮廓编辑和成型的支撑设置,形成RP项目文件,输出快速原型所需的加工文件.par,制造出衬垫物模板,作为实施手术过程中的参照.结果与结论:获得了患者颅面骨表面轮廓的三维实体模型,并由计算机辅助设计,快速成型制造出衬垫物模板,并以此为参照完成手术,效果满意.说明应用快速成型技术可以完成半侧颜面萎缩等凹陷畸形的衬垫物的制造,精度高,快捷,在颅颌面外科假体的个体化制造方面有良好的应用前景.
揹景:半側顏麵萎縮畸形的整複方法較多,以往常通過製備患者的石膏麵模,在上麵堆蠟來恢複患者的麵形,蠟型用作手術中襯墊的參攷.但由于畸形的變化多,矯治設計的難度大,矯治效果不甚理想.目的:探討應用計算機輔助設計和快速成型技術製造用于矯正半側顏麵萎縮等凹陷畸形襯墊物的可能性.方法:對半側顏麵萎縮患者行螺鏇CT掃描,利用工作站進行掃描圖像的容積三維重建後,重新間隔分層,利用CuteFTP 4.0軟件以BMP格式下載.應用課題組自主開髮的CT圖像處理軟件對已下載的二維圖像進行過濾、篩減、降譟、校正失真等處理,對圖像的邊緣輪廓進行提取,得到麵顱骨皮質骨邊緣輪廓的矢量化線圖,將該線圖數據輸入Surfacer 9.0重建軟件,對輪廓麯線進行矢量疊加,從而得到麵顱骨的三維三角形麵片線框模型及實體模型.將健側麵顱骨的點雲數據按鏡像對稱變換到患側,這樣在患側骨和健側鏡像之間就形成瞭充填物的三維模型,為補償軟組織的萎縮,將其外錶麵點雲數據外移1.5 mm.對CAD後的三維Surfacer數據重新分層,在RpDataRepare中完成充填物的輪廓編輯和成型的支撐設置,形成RP項目文件,輸齣快速原型所需的加工文件.par,製造齣襯墊物模闆,作為實施手術過程中的參照.結果與結論:穫得瞭患者顱麵骨錶麵輪廓的三維實體模型,併由計算機輔助設計,快速成型製造齣襯墊物模闆,併以此為參照完成手術,效果滿意.說明應用快速成型技術可以完成半側顏麵萎縮等凹陷畸形的襯墊物的製造,精度高,快捷,在顱頜麵外科假體的箇體化製造方麵有良好的應用前景.
배경:반측안면위축기형적정복방법교다,이왕상통과제비환자적석고면모,재상면퇴사래회복환자적면형,사형용작수술중츤점적삼고.단유우기형적변화다,교치설계적난도대,교치효과불심이상.목적:탐토응용계산궤보조설계화쾌속성형기술제조용우교정반측안면위축등요함기형츤점물적가능성.방법:대반측안면위축환자행라선CT소묘,이용공작참진행소묘도상적용적삼유중건후,중신간격분층,이용CuteFTP 4.0연건이BMP격식하재.응용과제조자주개발적CT도상처리연건대이하재적이유도상진행과려、사감、강조、교정실진등처리,대도상적변연륜곽진행제취,득도면로골피질골변연륜곽적시양화선도,장해선도수거수입Surfacer 9.0중건연건,대륜곽곡선진행시량첩가,종이득도면로골적삼유삼각형면편선광모형급실체모형.장건측면로골적점운수거안경상대칭변환도환측,저양재환측골화건측경상지간취형성료충전물적삼유모형,위보상연조직적위축,장기외표면점운수거외이1.5 mm.대CAD후적삼유Surfacer수거중신분층,재RpDataRepare중완성충전물적륜곽편집화성형적지탱설치,형성RP항목문건,수출쾌속원형소수적가공문건.par,제조출츤점물모판,작위실시수술과정중적삼조.결과여결론:획득료환자로면골표면륜곽적삼유실체모형,병유계산궤보조설계,쾌속성형제조출츤점물모판,병이차위삼조완성수술,효과만의.설명응용쾌속성형기술가이완성반측안면위축등요함기형적츤점물적제조,정도고,쾌첩,재로합면외과가체적개체화제조방면유량호적응용전경.
BACKGROUND: There are many methods for repairing the hemifacial atrophy, the most common is preparing plaster facial mold of the patient, with wax piled on the surface to restore the patient's facial shape, and wax pattern serves as a reference of surgical pad. However, the therapeutic effect for the correction and treatment is not satisfactory due to varied abnormality and difficult plans.OBJECTIVE: To discuss the feasibility of manufacturing underlay for the treatment of hemifacial atrophy using computer-assisted design and rapid prototyping technology. METHODS: Skull of the hemifacial atrophy patient was scanned with Picker 6000 SCT, and the data obtained were processed in Voxel Q image workstation for 3-D reconstruction with volume rendering technique. After the interval lamination, the images were downloaded at 0.4-mm interval in a BMP format using CuteFTP 4.0 software. Then the transaxial 2-D image data were converted into digitized 2-D contour data by using image processing software developed by experimental team through a series of processes, including filtering, screening, noise reduction, and distortion correction. The edges and contour of the images was extracted to obtain a vector diagram of facial cranial cortical bone contour line. The digitized data were inputted into image processing software of Surfacer 9.0 for vector superposing, thus the 3-D wire frame and solid images of skull could be reconstructed. According to mirror-image symmetry relation, the point-cloud data of facial bone on the normal side was duplicated to the atrophied side. Thus a 3-D model of the underlay was produced between the atrophied bone and the mirror image of normal side. In order to compensate the atrophy of soft tissues, the model was designed 1.5 mm thicker. After the three-dimensional Surfacer data on the CAD were re-stratified, the contour editing of the underlay and the supporting set of prototype were completed in RpDataRepare, forming RP files and creating underlay template through rapidly output of the processing file for rapid prototyping required, as a reference of surgical procedures.RESULTS AND CONCLUSION: The 3-D solid model of the patient skull bone surface contour was obtained and simulacrum of the underlay was prepared with computer assistance and rapid prototyping. According to the simulacrum, the operation was carried out and got a satisfactory result. The manufacture of underlay for the treatment of hemifacial atrophy could be accomplished by computer assisted design and rapid prototyping in a highly precise and rapid manner. It is a promising technique in the field of individualized underlay making in craniofacial surgery.
