CAJ | 학술논문

目的：以头颅X线正侧定位片和激光扫描获取的软组织图象为数据源，研发归一化的颅颌硬软组织三维模型。方法：①人脸贴定铅点：铅点共5个，分布在呈“十”字交叉状的两个方向上，即面中线方向和眶耳平面方向。②拍摄头颅X线正侧位片须保证头颅在水平姿势位下拍摄，嘱患者牙齿咬合接触。③三维硬组织结构模型的建立：以结构完整，表面清晰且符合亚洲人特点的头颅作为标准模型并确立三维坐标系，调整X线片使其与模版的坐标系相一致，在标准头颅模型上标定特征点54个，作为初始特征点，再在X线正侧位片上调整这些点的位置，作为目标特征点，要求二者所定义的位置相一致。依据一定形变算法，以X线片所确立的特征点对缩放后的标准头颅模型进行变形，得到患者颅颌硬组织模型。④激光扫描面部软组织：拍摄面部正中，左右45°，共3幅图象。⑤面部软组织重建：将扫描获得的三幅图象进行前期处理，合成患者完整的软组织三维模型。⑥软硬组织拟合：通过铅点坐标的配准，将面部软组织与骨组织拟合起来。结果：①构建了能够反映颅颌硬组织表面结构的三维模型；②实现了硬软组织的拟合。构建的三维图象生动、直观的显示了颅面部的结构，并且可以从任意角度观察其三维形态，为进一步进行正颌手术的模拟和形貌预测奠定了基础。结论：①与CT重建相比，该系统信息源获取简易，放射危害小，虽不及CT精确，但手术关键区域与患者较为吻合，具有一定的应用前景；②激光三维扫描是目前最先进的软组织获取方法，本研究实现了软硬组织的拟合，真实可靠。
목적：이두로X선정측정위편화격광소묘획취적연조직도상위수거원，연발귀일화적로합경연조직삼유모형。방법：①인검첩정연점：연점공5개，분포재정“십”자교차상적량개방향상，즉면중선방향화광이평면방향。②박섭두로X선정측위편수보증두로재수평자세위하박섭，촉환자아치교합접촉。③삼유경조직결구모형적건립：이결구완정，표면청석차부합아주인특점적두로작위표준모형병학립삼유좌표계，조정X선편사기여모판적좌표계상일치，재표준두로모형상표정특정점54개，작위초시특정점，재재X선정측위편상조정저사점적위치，작위목표특정점，요구이자소정의적위치상일치。의거일정형변산법，이X선편소학립적특정점대축방후적표준두로모형진행변형，득도환자로합경조직모형。④격광소묘면부연조직：박섭면부정중，좌우45°，공3폭도상。⑤면부연조직중건：장소묘획득적삼폭도상진행전기처리，합성환자완정적연조직삼유모형。⑥연경조직의합：통과연점좌표적배준，장면부연조직여골조직의합기래。결과：①구건료능구반영로합경조직표면결구적삼유모형；②실현료경연조직적의합。구건적삼유도상생동、직관적현시료로면부적결구，병차가이종임의각도관찰기삼유형태，위진일보진행정합수술적모의화형모예측전정료기출。결론：①여CT중건상비，해계통신식원획취간역，방사위해소，수불급CT정학，단수술관건구역여환자교위문합，구유일정적응용전경；②격광삼유소묘시목전최선진적연조직획취방법，본연구실현료연경조직적의합，진실가고。
Objective In this study, we used frontal and lateral cephalograms combining laser scanning of the the facial soft tissue as the sources of the information to develope the integrated 3D model of the craniofacial hard and soft tissues. Methods ①Setting lead points on the face.Lead a total of five points, distributed in a"+"-like character in both directions,that is,the direction of the center line and Frankfort plane direction.②Shooting frontal and lateral cephalograms.It is necessary to ensure that the posture of the head is level and the teeth are in contact.③To establish the 3D model of the Cranialfacial hard tissue.Take the skull from Asians with integrity structures and clear surface as a standard model,then establish the 3D coordinate system.Adjust to the X- ray films and the coordinates of the line. In the standard model of the skull,set 54 feature points as the initial feature points.Then take a adjustment of the location of these points in the frontal and lateral cephalograms, as the target feature points,ensuring that both the positions defined are in correspondence.Based on a certain deformation algorithm,deform the standard skull model according to the feature points established in the X-ray films,then the model of craniofacial hard tissue in patient is achieved.④Laser scanning of facial soft tissue.A total of three screens are shot including the median facial image and the ones from about 45 degrees in the left and right.⑤Facial soft tissue reconstruction.The three screens by scanning are pretreated,then synthesize the complete 3D model of soft tissue.⑥Fitting of the soft and hard tissues. Fit the facial soft tissue and bone tissue models together according to the lead coordinates. Results ①The 3D model that reflects the surface construction of the craniofacial hard tissue was constructed.②The fitting of the hard and soft tissues came ture.The 3D image of the model constructed showed a lively and visual screen of the craniofacial structures, and can be observed from any directions. It laid the foundation of the further orthognathic surgery simulation and morphology prediction. Conclusion ①Compared with the CT reconstruction, the system easily access to the information sources,radiation hazards small,although was not as accurate as CT,but the key regions of the model were anastomosis to the surgery patients.It will achieve some kind of application in the future.②3D laser scanning is the most advanced method of accessing to soft tissue, this study had a fitting of the soft and hard tissues,real and reliable.