臺灣博碩士論文加值系統

　　隨著醫療技術的進步與人們對整形手術接受程度的提昇，人們為了使自己變得更漂亮、活得更有自信而進行整形手術的情形已經越來越普遍。整形醫師就像一個可提供客製化外表的廠商，將消費者想像中的模樣製作出來。然而一個成功的顏面整形手術必須在手術前與病人經過詳盡的溝通及縝密規劃，執刀的醫師除了要有豐富的臨床經驗外，還要具備良好的審美觀及術後外觀結果的預測能力。但是經常因為整形醫師與整形者溝通不良、對整形目標認知的落差等因素而使手術不盡理想，甚至引起醫療糾紛。
　　
　　隨著電腦圖學的相關技術日益成熟，已有相當多利用電腦來輔助手術進行的研究與應用而本研究將針對顏面整形手術術前計劃的部份進行研究，在研發的初期以雙眼皮整形手術為例進行術前計劃系統的開發。本研究結果開發出一套將提供整形醫師在診所諮詢時以低成本高效率的情況下重建整型者的臉部手術區的三維模型、手術切割線的模擬繪製，以及手術完成後外觀動態模擬與預測。最後並且以一位單眼皮的受測者運用本研究所開發的系統軟體進行案例實作與系統程式測試，實作效果良好。

　　It is very popular and popular for people doing facial surgery for expecting to become more beauty and increase their confidence, due to the improvement in medical treatment technology and the increase in the acceptance of facial surgery for people. A plastic surgeon can be considered as a factory owner who can provide a customized appearance, which is imaged or specified by a customer. But a successful facial surgery should be completed under a detailed communication between patient and plastic surgeon and careful planning. The operation executor not only should have plentiful clinical experience but also should have good sense of appreciation of the beauty and the power of anticipating the patient’s appearance after operation. But a lot of failure cases were usually found due to ill communicated and/or bad medical skill. Along with the gradually matured computer graphic technology, a lot of investigations and applications of computer-assisted surgical operation have been proposed.
　　
　　The purpose of this study is to construct a computer-assisted facial surgery system, which can be used by the physician to communicate with the patient using a computer in the cosmetic clinic before the cosmetic surgery. This system will contain the functions of 3D facial data reconstruction, virtual surgical operation, and appearance simulation after operation based on biomechanics. With the aid of this system, the medical dispute due to ill-communicated will be reduced.

摘要.......................................................................................................I
Abstract.................................................................................................II
誌謝.....................................................................................................III
目錄.....................................................................................................IV
圖目錄.................................................................................................VI
　
第一章　緒論.......................................................................................1　
　1.1 研究動機.....................................................................................1
　1.2 研究目的.....................................................................................2
　1.3 研究限制.....................................................................................4
　1.4 論文架構.....................................................................................4
　
第二章　文獻探討...............................................................................6
　2.1 電腦輔助手術（Computer-Assisted Surgery; CAS）.................6
　　　2.1.1 電腦輔助實體模型製作..................................................6
　　　2.1.2 電腦輔助術前模擬與結果預測......................................7
　2.2 顱顏三維影像重建技術...........................................................10
　　　2.2.1 以電腦斷層掃描技術為基礎........................................10
　　　2.2.2 以直接量測技術為基礎................................................12
　　　2.2.3 以電腦圖學技術為基礎................................................12
　2.3 雙眼皮整形手術.......................................................................14
　　　2.3.1 雙眼皮與單眼皮在組織結構上的差異........................15
　　　2.3.2 雙眼皮整形手術的方式與原理....................................16
　　
第三章　理論基礎.............................................................................20　
　3.1 以立體成像為基礎的三維重建...............................................20
　　　3.1.1 立體成像原理................................................................20
　　　3.1.2 特徵對應點比對............................................................21
　　　3.1.3 深度資料計算................................................................22
　3.2 以電腦繪圖數學理論為基礎的虛擬手術...............................26
　　　3.2.1 繪製手術切割線............................................................26
　　　3.2.2 建立術後縫合網格........................................................29
　3.3 以物理為基礎的術後模擬.......................................................33
　
第四章　研究流程與步驟.................................................................42
　4.1 研究架構...................................................................................42
　4.2 三維重建階段...........................................................................43
　　　4.2.1 取像環境........................................................................43
　　　4.2.2 二值化影像....................................................................46
　　　4.2.3 標定二值影像................................................................46
　　　4.2.4 刪除不需要的黑色像素................................................48
　　　4.2.5 取得手術邊界特徵點....................................................49
　　　4.2.6 初始網格........................................................................50
　　　4.2.7 四分樹細分網格............................................................51
　　　4.2.8 計算深度座標與手術區三維重建................................53
　4.3 虛擬手術階段...........................................................................53
　　　4.3.1 繪製虛擬手術切割線....................................................54
　　　4.3.2 計算手術切割線與網格線交點的三維座標................55
　　　4.3.3 重建術後縫合網格........................................................57
　4.4 動態模擬階段...........................................................................60
　　　4.4.1 分類術後網格並計算模擬時所需的特徵點及參數值...60
　　　4.4.2 將網格點的螢幕座標系統座標值轉成動態模擬座標系統座標值...61
　　　4.4.3 依照位移方程式計算位移後的網格點座標................62
　　　4.4.4 在立體模型的網格上貼上皮膚的顏色........................63
　　　4.4.5 將位移後的網格依螢幕座標顯示在螢幕上................64
　
第五章　系統程式開發與案例實作.................................................66　
　5.1 系統程式開發架構與流程.......................................................66
　　　5.1.1 系統程式開發環境........................................................66
　　　5.1.2 系統程式執行流程........................................................66
　　　5.1.3系統程式使用介面介紹.................................................68
　5.2 案例實作...................................................................................71
　
第六章　結論與未來展望.................................................................80
　6.1 成果與貢獻...............................................................................80
　6.2 結果討論...................................................................................82
　6.3 未來展望...................................................................................83
　
參考文獻.............................................................................................85
自述.....................................................................................................93

[1]　Truitt H.P., James R.A., Lindley P.E., and Boyne P.,“Morphologic replication of the mandible using computerized tomography for the fabrication of a subperiosteal implant.”, Oral Surgery, Oral Medicine and Oral Pathology, Vol. 65, pp.499-504, 1988.
　　
[2]　Guyuron B., and Ross R.J., “Computer-Generated Model Surgery,” IEEE Visualization and Computer Graphics, Vol. 1, Issue 4, pp.328-342, Dec. 1995.
　　　
[3]　Komori T., Takato T., and Akagawa T., “Use of a Laser-hardened Three-dimensional Replica for Simulated Surgery,” Journal of Oral and Maxillofacial Surgery, Vol.52, pp.516, 1994.
　　　
[4]　James W.J.,. Slabbekroom M.A,. Edgin W.A, and et al, “Correction of Congenital Malar Hypoplasia Using Stereolithography for Presurgical Planning,” Journal of Oral an Maxillofacial Surgery, Vol.56, pp.512, 1998.
　
[5]　Perry M., Banks P., Richards R., Friedman E.P., and Shaw P., “The Use of Computer-generated Three-dimensional Models in Orbital Reconstruction,” Journal of Oral and Maxillofacial surgery, Vol.36, pp.275-284, 1998.
　
[6]　Demey S., and Vrielink L., “Drilling Templates for Oral Implants Based on Preoperative Planning on CT Images,” Proceedings of the 13th International Congress and Exhibition on Computer Assisted Radiology and Surgery, pp.883-887, 1999, Paris, France.
　
[7]　Cuttung C., Bookstein F.L., Grayson B., Fellingham L., and McCarthy J.G., “Three-Dimensional Computer-Assisted Design of Craniofacial Surgical Procedures: Optiminization and Interaction with Cephalometric and CT-Based Models,” Plastic and Reconstructive Surgery Vol.77, pp.877-885, 1986.
　
[8]　Jans G., Sloten J.V., Gobin R., and Perre G.V., et al, “A Preoperative CAD-based Planning Environment for Cranial Surgery: A First Clinical Case,” Computer Assisted Radiology and Surgery, CARS ’99, Elsevier Amsterdem, pp. 779-783, 1999.
　
[9]　Keeve E., Girod S., Pfeifle P., et al., “Anatomy-based Facial Tissue Modeling Using the Finite Element Method,” Processing of IEEE Visualization San Francisco,CA, pp. 21-28,27 Oct.- 1 Nov. 1996.
　
[10]　Koch R. M., Gross M.H., Carlsy F. R., et al.,” Simulating Facial Surgery Using Finite Element Models,” Proc.of SIGGRAPH,New Orleans,LA,ACM Computer Graphics, Vol. 30, pp. 4-9., 1996.
　
[11]　Koch R. M., Roth S. H. M., Gross M. H., et al.,” A Framework for Facial Surgery Simulation,” ACM, 2002.
　
[12]　Waters K. and Terzopoulos D., ”Modeling and animating faces using scanned data,” J. of Visualization and Computer Animation, Vol.2, Issue 4, pp.123-128, 1991.
　
[13]　Yuencheng Lee, Demetri Terzopoulos, Keith Waters,” Realistic Modeling for Facial Animation,” Proceedings of the SIGGRAPH'95. ACM Press, pp. 55-62, 1995.
　
[14]　Ricci A.A.., ”A constructive geometry for computer graphics”, The computerJournal , Vol.16, Issue 2, pp.157-160, 1973.
　
[15]　Waite Langwidere C.L., ”Hierarchical spline based facial animation system with simulated muscles”, Master's thesis,University of Calgary,Calgary,1993.
　
[16]　Kuo Chung J., Huang Ruey-Song, Lin Tsang-Gang.” 3-D Facial Model Estimation From Single Front-View Facial Image,” IEEE Transactions on Circuits and Systems for Video Technology, Vol.12, No.3, pp.183-192, 2002.
　
[17]　Kuo Chung J., Lin Tsang-Gang, Huang Ruey-Song, et al,” Facial Model Estimation From Stereo/Mono Image Sequence,” IEEE Transactions on Multimedia, Vol.5, No.1, pp.8-23, 2003.
　
[18]　Yang Sung Yurl,” Oriental Double Eyelid: A Limited-Incision Technique,” Annals of Plastic Surgery, Vol.46, No. 4, pp.364-368, 2001.
　
[19]　Chung Woo Chang, Kim Yong Oock, Kim Young Soo, et al,” Refinement of Double Eyelidplasty in Asian Patients: Attachment of the Septoaponeurotic Union to the Pretarsal Dermis,” Aesthetic Surgery Journal, Vol.22, No.2, pp.154-161, 2002.
　
[20]　Yoo Won-Min, Park Sang-Hyeon, and Kwag Dong-Rhyul, “ Root Z-Epicanthoplasty in Asian Eyelids, ” Plastic and Reconstructive Surgery, Vol.109, No.6, pp.2072-2073, 2002.
　
[21]　Yoo Won-Min, Park Sang-Hyeon, and Kwag Dong-Rhyul, “ Root Z-Epicanthoplasty in Asian Eyelids, ” Plastic and Reconstructive Surgery, Vol.109, No.6, pp.2067-2071, 2002.
　
[22]　Haiming Zhang, Hongxing Zhuang, Hao Yu,” A New Z-Epicanthoplasty and a Concomitant Double Eyelidplasty in Chinese Eyelids,” Plastic and Reconstructive Surgery, Vol.118, No.4, pp.900-907 2006.
　
[23]　Cho Byung Chae, Lee Kyung Young,” Medial Epicanthoplasty Combined with Plication of the Medial Canthal Tendon in Asian Eyelids,” Plastic and Reconstructive Surgery, Vol.110, No.1, pp.293-300, 2002.
　
[24]　Moravec H.P.,” Towards automatic visual obstacle avoidance,” in Proceedings of the 5th International Joint Conference on Artificial Intelligence, Cambridge, Ma, USA, pp. 584, 1977.
　
[25]　Gennery D. B.,” Object detection and measurement using stereo vision,” in Proc . ARPA Image Understanding Workshop, College Park, pp.217-253, 1980.
　
[26]　Hannah M. J.,” Bootstrap stereo,” in Proc. ARPA Image Understanding Workshop, College Park , pp. 201-208, 1980.
　
[27]　Hannah, M. J.,” A System for Digital Stereo Matching,” Phototgrammetric Engineering & Remote Sensing, Vol. 55, No.12, pp. 1765-1770, 1989.
　
[28]　Witkin, Terzopoulos A. D., Kass M.,” Signal Matching through Scale Space,” International Journal on Computer Vision, Vol.1,pp.231-258,1987.
　
[29]　Barnard S. T.,” Stereo Matching by Hierarchical Microcanonical Annealing,” Proceedings of the Image Understanding Workshop, Los Angels,pp.792-797,1987.
　
[30]　Ohta Y., Kanade T.,” Stereo by Intra- and Inter- Scanline Search Using Dynamic Programmimg,” IEEE Transactions on Pattern Analysis and Machine Intelligence, Vol. PAMI-7, pp. 139-154, 1985.
　
[31]　Marr D. and Poggio T.,”A theory of human stereo vision”, in Proc. R. Soc. London vol B204, pp. 301-328,1979.
　
[32]　Gonzalez Rafael C., Woods Richard E.,Digital Image Processing, 2nd Edition, Prentice Hall, 2002.
　
[33]　Delingette H., Subsol G, Cotin S, et al,” A craniofacial surgery simulation tested,” Int. Proc. Conference on Visualization in Biomedical Computing, Rochester, Minnesota, pp. 607-618, 1994.
　
[34]　Motrten B. N., Cotin S.,” Real-time volumetric deformable models for surgery simulation using finite elements and condensation,” int. Proc. Eurographics’96－Computer Graphics Forum, France, pp.57-66,1996.
　
[35]　Cotin S., Delingette H., Nicholas A.,” Real-time elastic deformations of soft tissues for surgery simulation,” IEEE Trans Visualization and Computer Graphics, Vol. 5, No.1, pp. 62-73, 1999.
　
[36]　Wu Wen, Sun Jian, Heng Pheng Ann,” A hybrid condensed finite element model for interactive 3D soft tissue cutting,” Stud Health Technol Inform, Vol. 94, pp. 401-403, 2003.
　
[37]　McCartney J., Hinds B.K., Chong K.W., “ Pattern flattening for orthotropic materials. ”, Computer-Aided Design, Vol.37, No.6, 2005.
　
[38]　李武松，” 顱顏整行型手術用植入物之設計與製作 ”，國立中央大學機械工程研究所碩士論文，1999。
　
[39]　劉立，” 電腦模擬顏面整形手術術後臉型之準確性及在不修改模擬軟體情況下增加模擬準確度 ”，台北醫學大學醫學資訊研究所碩士論文，2003。
　
[40]　李俊毅，” 顎面手術輔助空間導引系統之設計與實作 ”，國立成功大學機械工程研究所碩士論文，2001。
　
[41]　葉士豪，” 以實際影像序列為依據之人臉動作模擬 ”，國立中山大學資訊工程研究所碩士論文，2001。
　
[42]　郭泰宏，” 醫療影像軟體開發－基礎介面與三維實體模型重建 ”，國立成功大學機械工程研究所碩士論文，2001。
　
[43]　鄭北驥，彭永進，伍立柴，彭群生，” 基於物理模型的人臉表情動畫技術研究 ”，計算機學報，Vol.25，No.3，2002。
　
[44]　祝華健，” 電腦繪圖的數學基礎 ”，儒林圖書公司，台北，1990。
　
[45]　Alies Computer Team M2，” Java2 500個高段應用範例技巧大全 ”，碩博文化股份有限公司，台北，2004。
　
[46]　Dolphin Imaging　www.DolphinImaging.com
　
[47]　蔡豐洲整型整所　http://www.medi-life.com.tw/
　
[48]　MUTABOR 美式整形外科　http://www.doctornet.com.tw/
　
[49]　Syncromax 軟體介紹　http://www.jp558.com/syncromax.asp