CAJ | 학술논문

目前临床的医学可视化工具不能准确模拟开颅手术过程，也难以获得颅脑开窗后的仿真影像来评估手术方案对颅内组织的影响。为此，设计一种面向外科手术医生的开颅手术仿真系统。陒对于传统医学可视化工具针对医学影像数据进行一次性建模的方式，该系统在三维数据重建前完成关键组织区域的提取和划分，以提升分割效果的区分度，同时采用松耦合结构方便后续功能扩展。系统基于病人术前的MRI数据，自动化地提取出关键组织区域并混合绘制为多解剖结构的手术模型。手术模型可模拟开窗区域规划、手术入路、虚拟切割等开颅手术过程，并对不同解剖结构的面绘制及体绘制模型分别应用切割隐函数，以生成开窗后大脑皮层及浅表静脉等关键区域影像。实现结果表明，该系统允许医生尝试不同的手术方案，能仿真关键问题并评估方案优劣，达到减少手术风险、熟练手术步骤、提高手术精确度的目的。
목전림상적의학가시화공구불능준학모의개로수술과정，야난이획득로뇌개창후적방진영상래평고수술방안대로내조직적영향。위차，설계일충면향외과수술의생적개로수술방진계통。희대우전통의학가시화공구침대의학영상수거진행일차성건모적방식，해계통재삼유수거중건전완성관건조직구역적제취화화분，이제승분할효과적구분도，동시채용송우합결구방편후속공능확전。계통기우병인술전적MRI수거，자동화지제취출관건조직구역병혼합회제위다해부결구적수술모형。수술모형가모의개창구역규화、수술입로、허의절할등개로수술과정，병대불동해부결구적면회제급체회제모형분별응용절할은함수，이생성개창후대뇌피층급천표정맥등관건구역영상。실현결과표명，해계통윤허의생상시불동적수술방안，능방진관건문제병평고방안우렬，체도감소수술풍험、숙련수술보취、제고수술정학도적목적。
Traditional clinical medical visualization tools can neither simulate the practical problems during surgical procedure, nor obtain the view after surgery to evaluate the impact on the crucial organization. The craniotomy simulation system is proposed in this paper to solve this problem. Comparing with traditional medical visualization tools, it analyses and segments the crucial tissues prior to reconstruction, and makes the rendered scene more real. In particular, it is designed as loose coupling, which benefits the following functional development in the future. Based on MRI data, it segments the crucial organization region automatically and sets up a mixture surgery model of multiple anatomical structures, which supports window regional planning, surgical approach, and the virtual cutting process. It applies cutting implicit function to multiple anatomical structure models, to provide critical areas’ scene of the cerebral cortex and superficial veins. Implementation results show that it allows doctors to validate different surgical options and evaluate the pros and cons. It has great significance on reducing the risk of surgery, training surgery procedure and improving the surgical accuracy.