電腦輔助骨盆骨折術前規劃系統發展｜國立中央大學博碩士論文系統

簡易檢索 / 詳目顯示

回結果列表

研究生：	胡育昇 Yu-sheng Hu
論文名稱：	電腦輔助骨盆骨折術前規劃系統發展 On the development of a computer aided preoperative planning system for pelvis surgery
指導教授：	賴景義 Jiing-Yih Lai
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：	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：	registration, bone reduction, pelvic surgery planning, pelvis fracture, bone plate templates
相關次數：	點閱：8 下載：0
分享至:	分享至facebook 分享至twitter

查詢本校圖書館目錄查詢臺灣博碩士論文知識加值系統勘誤回報

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 前言...............................................................................................1
2 文獻回顧.......................................................................................4
3 研究背景說明..............................................................................6
4 研究目的與方法..........................................................................9
4.1 研究目的.............................................................................9
4.2 研究方法.............................................................................9
5 論文架構.....................................................................................12
第二章骨盆骨折手術輔助系統架構....................................................13
1前言..............................................................................................13
2骨盆及骨盆骨折介紹..................................................................13
3現行骨盆骨折手術醫療方式.....................................................18
4骨盆骨折手術輔助系統架構.....................................................20
4.1三維影像模型顯示............................................................22
4.2骨骼組織自動分離............................................................24
4.3破裂骨組織虛擬復位........................................................25
4.4植入物置入模擬................................................................25
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
1前言..............................................................................................30
2骨組織復位..................................................................................31
2.1座標轉置矩陣關係............................................................31
2.2 於VDCS進行平移..........................................................33
2.3 於垂直VDCS平面之軸進行旋轉..................................33
2.4 於WCS進行旋轉............................................................35
3骨板置入模擬方法......................................................................39
3.1骨板模型資料庫................................................................39
3.2骨板貼覆與骨板網格變形................................................41
4骨釘鎖入模擬及剖面瀏覽.........................................................49
4.1骨釘模型資料庫................................................................49
4.2骨釘角度調整....................................................................53
4.3骨釘鎖入剖面瀏覽............................................................53
第四章範例驗證及臨床實例................................................................56
1前言..............................................................................................56
2骨板貼覆驗證與輔助彎折模板.................................................56
3實際骨折案例模擬......................................................................59
4臨床實例......................................................................................73
第五章結論與未來展望........................................................................84
1結論..............................................................................................84
2未來展望......................................................................................85
參考文獻..................................................................................................87

                                

[1]K. Bühler, A. Neubauer, M. Hadwiger, S. Wolsfberger and R. Wegenkittl, “Interactive 3D techniques for computer aided diagnosis and surgery simulation tools”, Hruby, W. (ed.) Digital Revolution in Radiology—Bridging the Future of Health Care, 2nd edn, 2005.
[2]L. Soler and J. Marescaux, “Patient-specific surgical simulation”, World Journal of Surgery, Vol. 32, No. 2, pp. 208-212, 2008.
[3] J. Bruns , C. R. Habermann, W. Rüther and D. Delling, “The use of CT derived solid modelling of the pelvis in planning cancer resections”, European Journal of Surgical Oncology (EJSO), Vol. 36, No. 6, pp. 594-598, 2010.
[4]M. Cimerman and A. Kristan, “Preoperative planning in pelvic and acetabular surgery:The value of advanced computerized planning modules”, Injury, Vol. 38, pp. 442-449, 2007.
[5]M. Tomazevic, D. Kreuh, A. Kristan, V. Puketa and M. Cimerman, “Preoperative planning program tool in treatment of articular fractures: process of segmentation procedure”, XII Mediterranean Conference on Medical and Biological Engineering and Computing, Vol. 29, pp. 430-433, 2010.
[6] F. Jürgen, K. Marius, H. Matthias, M. Borut, S. Gábor and F. Thomas, “An interactive surgical planning tool for acetabular fractures: initial results”, J Orthop Surg Res, Vol. 29, pp.50, 2010.
[7] S. Winkelbach, R. Westphal, and T. Goesling, “Pose estimation of cylindrical fragments for semi-automatic bone fracture reduction”, Michaelis, B., Krell, G. (Eds.): Pattern Recognition (DAGM 2003), Lecture Notes in Computer Science 2781, pp. 566–537, 2003.
[8]L. Tockus, L. Joskowicz, A. Simkin and C. Milgrom, “Computer-aided image-guided bone fracture surgery: modeling, visualization, and preoperative planning”, Medical Image Computing and Computer-Assisted Interventation — MICCAI’98 Lecture Notes in Computer Science, Vol. 1496, pp. 29-38, 1998.
[9]Y. Nakajima, T. Tashiro, T. Okada, Y. Sato, N. Sugano, M. Saito, K. Yonenobu, H. Yoshikawa, T. Ochi and S. Tamura, “Computer-assisted fracture reduction of proximal femur using preoperative CT data and intraoperative fluoroscopic images”, Proc. Comput. Assist. Radiol. Surg. (CARS 2004), pp. 620, 2004.
[10]T. Okada, Y. Iwasaki, T. Koyama, N. Sugano, Y. W. Chen, K. Yonenobu and Y. Sato, “Computer-assisted preoperative planning for reduction of proximal femoral fracture using 3-D-CT data”, IEEE Transactions on Biomedical Engineering, Vol. 56, Issue 3, pp. 749-759, 2009.
[11]M. Harders, A. Barlit, C. Gerber, J. Hodler and G. Székely, “An optimized surgical planning environment for complex proximal humerus fractures”, MICCAI Workshop on Interaction in Medical Image Analysis and Visualization, 2007.
[12]A. Schweizer, P. Fürnstahl, M. Harders, G. Székely and L. Nagy, “Complex radius shaft malunion: osteotomy with computer-assisted planning”, Hand, Vol. 5, No. 2, pp. 171-178, 2010.
[13]S. Munjal, S. S. Leopold, D. Kornreich, S. Shott and H. A. Finn, “CT-generated 3-dimensional models for complex acetabular reconstruction”, J Arthroplasty, Vol. 15, pp. 644, 2000.
[14]M. Citak, M. J. Gardner and D. Kendoff, “Virtual 3D planning of acetabular fracture reduction”, J Orthop Res, Vol. 26, pp. 547-552, 2008.
[15]G. A. Brown, K. Firoozbakhsh and R. J. Gehlert, “Three-dimensional CT modeling versus traditional radiology techniques in treatment of acetabular fractures”, Iowa Orthop J, Vol. 21, pp. 20-24, 2001.
[16]M. Tile, Fractures of the pelvis and acetabulum, Williams& Wilkins, 1984.
[17]G. F. Pennal, M. Tile and J. P. Waddell, “Pelvic disruption: assessment and classification”, Clinical Orthopaedics and Related Research, Vol. 151, pp. 12-21, 1980.
[18]J. W. Young, A. R. Burgess, R. J. Brumback and A. Poka, “Pelvic fractures: value of plain radiography in early assessment and management”, Radiology, Vol. 160, pp. 445-451, 1986.
[19]W. T. Corrêa, R. J. Jensen and C. E. Thayer, “Texture mapping for cel animation”, International Conference on Computer Graphics and Interactive Techniques. Proceedings of the 25th annual conference on Computer graphicsand interactive techniques, pp. 435-446, 1998.
[20]Orthopaedic Trauma Association, http://www.ota.org/index.html.
[21]張發元和段廣斌，「不穩定骨盆骨折手術內固定19例分析」, 長治醫學院學報，2007。
[22]羅賴鈞，「醫學影像之三維顯示與骨組織三角網格重建技術探討」，國立中央大學機械工程學系碩士班論文， 2009。
[23]俞首安，「電腦輔助骨盆骨折術前評估系統發展」，國立中央大學機械工程學系碩士論文，2010。
[24]莊曜瑋，「電腦輔助下顎骨切割與重建手術規劃」，國立中央大學機械工程學系碩士論文，2010。
[25]蔡松霖，「RP輔助醫學手術」，國立中央大學機械工程學系碩士論文，2011。

簡易檢索 / 詳目顯示

相關論文