臺灣博碩士論文加值系統

勃起功能障礙已被證實為心血管疾病併發的表徵之一，勃起功能障礙的治療與追蹤是心血管疾病患者相當重要的治療指標之一，目前臺大醫院醫療團隊已提出一創新有效的勃起功能障礙療法，且實驗證明利用MSCT影像可建立三維骨盆腔血管模型，應用於臨床診斷、追蹤。在骨盆腔血管樹部分，目前醫院所購買的套裝軟體，無法準確對醫師主要判別病灶的骨盆腔血管部位進行三維血管模型重建，且血管模型建立途中需醫師執行繁複的手動參數調整，十分耗時費力。
MSCT骨盆腔血管具有HU值組成複雜、目標分割血管亮度低、血管細小、多曲折，且與周遭組織相似，在狹窄區段缺乏連通性......等特性，上述原因使得此部分的血管分割與量化十分困難，目前現行的研究方法皆無法適用於骨盆腔血管重建，為協助醫師於臨床中進行診斷與手術後評估，本論文發展一自動化骨盆腔血管重建與狹窄分析系統。
本論文利用Sato管狀偵測器為理論基礎，發展多尺度權重修正Sato濾波器計算血管結構響應值，協助增加血管權重，並使用自適應參數的區域成長法進行血管重建，將所得的骨盆腔血管樹基於圖論概念計算後續的路徑提取、血管截面積量化分析與評估血管狹窄區域。
與傳統分割方法相比，本論文在骨盆腔血管樹分割中已證實可取得較好的結果，並於血管路徑計算中可準確提取出正確的單一指定路徑，綜觀而言已完成一電腦輔助診斷系統的完整架構。本論文在血管截面積分析與狹窄評估中尚須多加考慮演算法細節與進行細部修正，將針對更多臨床案例進行實測與討論，以期未來可實際運用於輔助臨床之骨盆腔血管治療。

Erectile dysfunction(ED) has been confirmed as one of the precursor of cardiovascular disease. The treatment and tracking of ED is one of the quite worth noting therapeutic indicators for patients with cardiovascular disease. At present, the medical team of National Taiwan University Hospital has proposed an innovative and effective therapy for ED. Simultaneously, experiments show that the three-dimensional pelvic vascular model can be established by using MSCT pelvic angiography images, which can be applied to the clinical diagnosis and tracking of ED patients. The software package which purchased by the hospital cannot accurately reconstruct the three-dimensional vascular model of the pelvic vascular, moreover the establishment of the vascular model requires the physician to perform complicated manual parameter adjustments, which is very time consuming and laborious.
The MSCT pelvic vascular has the characteristics of complex HU value, low target segmentation vascular intensity, tiny blood vessels, multiple tortuosity, similar to surrounding soft tissues, lack of connectivity in the narrow segment. The above reasons make it difficult to segment accurately and quantify the vessels in pelvic vascular. So far, the current research can not be applied to pelvic vascular reconstruction effectly. To assist physicians in clinical diagnosis and postoperative evaluation, this paper develops an automated pelvic vascular reconstruction and stenosis anlysis algorithm.
In purposed method, this paper develops a multi-scale modifited Sato filter to calculate the vascular structural response value based on the Sato filter, assists in increasing the vascular weight, and uses the adaptive parameter region growing method for vascular reconstruction. Utilize the resulting of pelvic vascular tree calculates simple path extraction, tube cross-sectional area quantification analysis and assessment of vascular stenosis based on the concept of graph theory.
Compared with the widespread segmentation method, the result which confirmed to be better can be obtained in the pelvic vascular tree segmentation in this paper, and the correct single specified path can be accurately extracted in the vascular path calculation. In this paper, the details of the algorithm and the detailed correction must be considered in the analysis of the vessel cross-sectional area and the stenosis. The actual measurement and discussion will be carried out for more clinical cases in this research, so that the future can be practically applied to the clinical pelvic vascular treatment.

考試委員審定書 I
致謝 II
摘要 III
Abstract IV
目錄 VI
圖目錄 VIII
表目錄 X
第一章 緒論 1
1.1 研究背景與目的 1
1.2文獻探討 2
1.2.1 血管樹重建 2
1.2.2 血管指定路徑計算與量化分析 6
1.3 論文架構 6
第二章 基礎理論 7
2.1 電腦斷層攝影(Computed tomography, CT)成像原理 7
2.2 區域成長(Region Growing) 8
2.3 空間濾波器 9
2.3.1 Hessian-Based filter 9
2.3.2 高斯濾波器(Gaussian filter) 11
2.3.3 Sato filter 12
2.4 大津演算法(Otsu Algorithm) 12
2.5 馬可夫鍊(Markov chain) 13
2.6 最大期望演算法(Expectation-maximization algorithm) 13
2.7 型態學細線化 14
第三章 研究方法 16
3.1 研究材料 16
3.2 研究流程 17
3.2.1 多尺度修正Sato濾波器 17
3.2.2 自適應參數區域成長法 24
3.2.3 中心線提取與路徑分析 27
3.2.4 血管橫截面積計算與狹窄評估 28
第四章 結果與討論 30
4.1 血管樹重建 30
4.2 中心線提取與路徑分析 36
4.3 血管橫截面積計算與狹窄評估 41
4.4 準確性評估 43
4.5 演算法限制 44
第五章 結論 45
參考文獻 46

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