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研究生:胡育昇
研究生(外文):Yu-sheng Hu
論文名稱:電腦輔助骨盆骨折術前規劃系統發展
論文名稱(外文):On the development of a computer aided preoperative planning system for pelvis surgery
指導教授:賴景義賴景義引用關係
指導教授(外文):Jiing-Yih Lai
學位類別:碩士
校院名稱:國立中央大學
系所名稱:機械工程研究所
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2011
畢業學年度:99
語文別:中文
論文頁數:90
中文關鍵詞:骨盆骨折、術前規劃、復位模擬、植入物置入模擬、骨板彎折
外文關鍵詞:registrationbone reductionpelvic surgery planningpelvis fracturebone plate templates
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骨盆手術中,通常使用CT影像資訊來幫助診斷及進行術前規劃,但由於骨盆的幾何構造複雜,一般的影像檢視,無法提供醫師術前足夠的輔助資訊,更遑論進行其他操作。在術中,為了固定破裂骨組織,必須將骨板彎折至合適的外形後再進行固定,但其作業上是相當耗時費力的。為了讓醫師有良好的術前規劃模擬及輔助手術骨板彎折,本研究發展電腦輔助骨盆手術規劃系統,而此系統架構可分為:(1)電腦斷層影像三維顯示,(2)破裂骨骼分離與三維網格模型重建,(3)破裂骨組織虛擬復位,(4)植入物置入模擬,(5)骨板術前輔助彎折,提供破裂骨組織進行復位。並於復位後之骨組織進行植入物擺放模擬,再將模擬結果輸出,利用RP技術製造輔助彎折模板,提供醫師輔助彎折。本研究藉由骨盆人工骨進行驗證其模擬結果之貼覆性,並實際以數個骨盆資料進行重建與復位,說明本系統之可行性,最後透過本系統流程進行臨床實例,驗證本研究提出之方法的可行性。
骨盆手術中,通常使用CT影像資訊來幫助診斷及進行術前規劃,但由於骨盆的幾何構造複雜,一般的影像檢視,無法提供醫師術前足夠的輔助資訊,更遑論進行其他操作。在術中,為了固定破裂骨組織,必須將骨板彎折至合適的外形後再進行固定,但其作業上是相當耗時費力的。為了讓醫師有良好的術前規劃模擬及輔助手術骨板彎折,本研究發展電腦輔助骨盆手術規劃系統,而此系統架構可分為:(1)電腦斷層影像三維顯示,(2)破裂骨骼分離與三維網格模型重建,(3)破裂骨組織虛擬復位,(4)植入物置入模擬,(5)骨板術前輔助彎折,提供破裂骨組織進行復位。並於復位後之骨組織進行植入物擺放模擬,再將模擬結果輸出,利用RP技術製造輔助彎折模板,提供醫師輔助彎折。本研究藉由骨盆人工骨進行驗證其模擬結果之貼覆性,並實際以數個骨盆資料進行重建與復位,說明本系統之可行性,最後透過本系統流程進行臨床實例,驗證本研究提出之方法的可行性。
摘要 ...................................................................................................II
Abstract ..................................................................................................III
誌謝 ................................................................................................. IV
目錄 ...................................................................................................V
圖目錄................................................................................................VII
表目錄...................................................................................................X
第一章緒論...............................................................................................1
1.1 前言...............................................................................................1
1.2 文獻回顧.......................................................................................4
1.3 研究背景說明..............................................................................6
1.4 研究目的與方法..........................................................................9
1.4.1 研究目的.............................................................................9
1.4.2 研究方法.............................................................................9
1.5 論文架構.....................................................................................12
第二章骨盆骨折手術輔助系統架構....................................................13
2.1前言..............................................................................................13
2.2骨盆及骨盆骨折介紹..................................................................13
2.3現行骨盆骨折手術醫療方式.....................................................18
2.4骨盆骨折手術輔助系統架構.....................................................20
2.4.1三維影像模型顯示............................................................22
2.4.2骨骼組織自動分離............................................................24
2.4.3破裂骨組織虛擬復位........................................................25
2.4.4植入物置入模擬................................................................25
2.4.5骨板術前輔助彎折............................................................27
第三章骨組織復位方法及植入物設計................................................30
3.1前言..............................................................................................30
3.2骨組織復位..................................................................................31
3.2.1座標轉置矩陣關係............................................................31
3.2.2 於VDCS進行平移..........................................................33
3.2.3 於垂直VDCS平面之軸進行旋轉..................................33
3.2.4 於WCS進行旋轉............................................................35
3.3骨板置入模擬方法......................................................................39
3.3.1骨板模型資料庫................................................................39
3.3.2骨板貼覆與骨板網格變形................................................41
3.4骨釘鎖入模擬及剖面瀏覽.........................................................49
3.4.1骨釘模型資料庫................................................................49
3.4.2骨釘角度調整....................................................................53
3.4.3骨釘鎖入剖面瀏覽............................................................53
第四章範例驗證及臨床實例................................................................56
4.1前言..............................................................................................56
4.2骨板貼覆驗證與輔助彎折模板.................................................56
4.3實際骨折案例模擬......................................................................59
4.4臨床實例......................................................................................73
第五章結論與未來展望........................................................................84
5.1結論..............................................................................................84
5.2未來展望......................................................................................85
參考文獻..................................................................................................87
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