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研究生： 楊遠祥
Yuan-Hsiang Yung
論文名稱： 應用於股骨轉子間骨折回復手術之C-arm based 手術導引系統
C-arm based surgical navigation system applied for reduction of intertrochanteric fracture
指導教授： 曾清秀
Ching-Shiow Tseng
口試委員:
學位類別： 碩士
Master
系所名稱： 工學院 - 機械工程學系
Department of Mechanical Engineering
畢業學年度： 93
語文別： 中文
論文頁數： 70
中文關鍵詞： C-arm 、手術導引系統 、影像扭正
外文關鍵詞： C-arm, Surgical navigation system, image dewarp
相關次數： 點閱：11  下載：0 
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    • 近年來C-arm已成為骨科手術中最常被使用的工具之一。但是由於C-arm有限的視野以及二維影像的限制，使得醫生在為了得知器械與骨骼之空間關係的同時，必須拍攝大量的C-arm影像，造成承受高輻射劑量的風險。在股骨轉子間骨折回復手術中，最關鍵的步驟即為將Guide Pin從股骨外側以正確的方位鑽入股骨頭，此過程往往需要大量的C-arm影像進行確認。為改善C-arm使用上之缺點及立體定位的限制，本研究發展一套以C-arm影像為主的骨科手術導引系統，通過光學式定位裝置所提供之空間資訊以及模擬C-arm的投影成像過程，本系統能在手術中提供器械與骨骼的空間關係，並即時顯示在電腦螢幕上，以協助醫生能更準確進行鑽孔及後續置放植入物的動作。
    本研究利用光學式定位裝置追蹤骨骼、器械與C-arm的空間關係，並將校正器裝設於C-arm接收端，通過其上的附加標記計算X光之有效發射源，以修正諸如重力等因素所造成的投影誤差，並建構X光投影模式。通過全域性法(Global Method)校正C-arm影像之針墊變形與S-shape扭曲變形，並利用投影幾何原理，以球體模擬股骨頭，在術中提供醫生器械鑽入深度之導引資訊。
    本研究所發展之系統已進行過系統整體精度驗證之實驗，其定位精度為1.07±0.33mm、方向精度為1.92±1.28°，鑽入深度導引之平均誤差為0.61±0.27mm。

    摘 要 I 目 錄 II 圖目錄 IV 表目錄 VII 表目錄 VII 第一章 序論 1 1-1 研究動機 1 1-2 文獻回顧 2 1-3 研究方法簡介 3 1-4 論文架構 6 第二章 系統架構 7 2-1 硬體架構 7 2-1-1 光學式定位裝置 8 2-1-2 校正器 11 2-1-3 手術器械 11 2-2 軟體介紹 15 2-3 系統操作流程 15 第三章 C-arm影像校正與立體定位 22 3-1 座標系統定義 22 3-2 建立座標系統轉換關係 24 3-3 手術鑽頭座標系統及校正器座標系統對正 27 3-3-1 手術鑽頭座標系統對正 27 3-3-2 校正器座標系統對正 29 3-4 附加標記自動辨識 30 3-4-1 偵測影像圓形邊界 31 3-4-2 影像對比強化 32 3-4-3 辨識鋼珠位置 33 3-4-4 去除雜訊 35 3-5 影像扭曲與校正 36 3-6 建構投影模式 41 3-7 計算股骨頭近似球之球心與半徑 44 3-7-1 反投影計算股骨頭近似球之球心 45 3-7-2 計算股骨頭近似球半徑 48 第四章 實驗結果與討論 51 4-1 影像扭正實驗 51 4-2 器械鑽入深度導引實驗 54 4-3 系統整體精度實驗 56 4-4 誤差分析 60 4-4-1 光學式定位裝置誤差 60 4-4-2 校正器座標系統誤差 60 4-4-3 附加標記偵測誤差 62 4-4-4 影像扭正誤差 62 4-4-5 有效發射源計算誤差 62 4-4-6 人為操作誤差 63 第五章 結論 65 參考文獻 67

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