本文選題：雙源CT + 前交叉韌帶�。� 參考：《第四軍醫(yī)大學(xué)》2015年碩士論文

【摘要】：實(shí)驗(yàn)一雙源CT測(cè)量前交叉韌帶單束重建術(shù)后隧道位置的臨床研究目的:應(yīng)用雙源CT(Dual-source computer tomography,DSCT)測(cè)量前交叉韌帶(Anterior cruciate ligament,ACL)單束重建術(shù)后脛骨、股骨隧道位置,并對(duì)隧道位置進(jìn)行評(píng)價(jià)。方法:對(duì)2013年1月至2014年6月我科收治的92例(男64例,女28例,平均年齡31.2歲)ACL單束重建患者術(shù)后膝關(guān)節(jié)進(jìn)行雙源CT掃描并行三維重建,應(yīng)用Adobe Photoshop CS6軟件圈畫隧道中心并采用Lorenz法測(cè)量脛骨隧道中心點(diǎn)相對(duì)位置百分比(Tx,Ty),采用Bernard四格表法測(cè)量股骨隧道中心點(diǎn)相對(duì)位置百分比(Fx,Fy)。結(jié)果:Tx平均為(54.54±3.42)%,Ty平均為(39.58±6.72)%,Fx平均為(28.98±6.51)%,Fy平均為(28.04±8.70)%。男、女性及左、右膝之間Tx、Ty、Fx、Fy的差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:雙源CT能夠清晰,三維顯示ACL術(shù)后隧道,可以用來評(píng)估隧道位置,為改進(jìn)ACL損傷后的手術(shù)方式及個(gè)體化解剖重建提供幫助。實(shí)驗(yàn)二半腱肌腱應(yīng)力松弛實(shí)驗(yàn)及彈性模量的測(cè)量計(jì)算目的:研究新鮮尸體膝關(guān)節(jié)半腱肌腱的粘彈性力學(xué)特性,計(jì)算單股半腱肌腱彈性模量,為有限元分析提供生物力學(xué)參數(shù)。方法:尸體標(biāo)本上取出半腱肌腱,修整成尺寸統(tǒng)一的試樣,應(yīng)用力學(xué)試驗(yàn)機(jī)對(duì)肌腱施加拉伸載荷,當(dāng)位移達(dá)到預(yù)定行程時(shí)保持位移不變,觀察力的變化。結(jié)果:得到了半腱肌腱應(yīng)力松弛實(shí)驗(yàn)數(shù)據(jù),繪制了載荷-位移曲線及載荷-時(shí)間曲線,經(jīng)計(jì)算得到了單股半腱肌腱的彈性模量E=143.46±8.35 MPa。結(jié)論:半腱肌腱具有粘彈性材料典型的應(yīng)力松弛生物特性,其粘彈性力學(xué)特性使其可以作為ACL移植物應(yīng)用。實(shí)驗(yàn)三基于雙源CT的前交叉韌帶重建術(shù)后脛股關(guān)節(jié)有限元模型的建立及移植物應(yīng)力的有限元分析目的:基于雙源CT斷層圖像構(gòu)建ACL單束重建術(shù)后脛股關(guān)節(jié)有限元模型,分析移植物應(yīng)力大小及分布。方法:應(yīng)用雙源CT對(duì)1例ACL單束重建術(shù)后患者右膝關(guān)節(jié)進(jìn)行伸直位掃描,獲得斷層數(shù)據(jù),將此數(shù)據(jù)導(dǎo)入MIMICS及GEOMAGIC STUDIO軟件建立三維幾何模型,將幾何模型導(dǎo)入ANSYS軟件并劃分網(wǎng)格,進(jìn)行材料賦值后建立ACL單束重建術(shù)后脛股關(guān)節(jié)有限元模型,利用模型模擬前抽屜試驗(yàn)時(shí)移植物應(yīng)力的分布及大小。結(jié)果:1.成功利用雙源CT斷層數(shù)據(jù)、MIMICS及GEOMAGIC STUDIO軟件構(gòu)建了ACL單束重建術(shù)后脛股關(guān)節(jié)三維實(shí)體模型。2.利用ANSYS軟件建立了ACL單束重建術(shù)后脛股關(guān)節(jié)三維有限元模型,對(duì)該模型進(jìn)行了網(wǎng)格劃分,邊界約束及材料賦值。3.應(yīng)用有限元模型分析了前抽屜試驗(yàn)下移植物的應(yīng)力分布及大小。結(jié)論:1.應(yīng)用雙源CT及MIMICS、GEOMAGIC STUDIO等逆向工程軟件可以準(zhǔn)確地建立三維實(shí)體模型,可用來觀察ACL重建術(shù)后移植物空間位置。2.將三維實(shí)體模型導(dǎo)入有限元分析軟件ANSYS并進(jìn)行網(wǎng)格劃分,邊界約束及材料賦值后可以進(jìn)行移植物應(yīng)力的分析。3.移植物股骨隧道內(nèi)口附著處應(yīng)力分布較大,理論上為其最容易發(fā)生斷裂的部位。
[Abstract]:Objective: to measure the location of tibia and femur tunnel after single bundle reconstruction of anterior cruciate ligament (ACL) by double source CT. Objective: to evaluate the location of tibia and femur tunnel after single bundle reconstruction of anterior cruciate ligament (ACL) by double source CT(Dual-source computer tomographygraphy (DSCT). Methods: from January 2013 to June 2014, 92 patients (64 males and 28 females) with an average age of 31.2 years old with single bundle reconstruction of ACL, underwent dual source CT scan and 3D reconstruction. Adobe Photoshop CS6 software was used to circle the center of the tunnel and the relative position percentage of the center point of tibial tunnel was measured by Lorenz method. The relative position of the center point of femur tunnel was measured by Bernard four-grid table method. Results the average Tx of TX was 54.54 鹵3.42 and Ty was 39.58 鹵6.72 and Fx was 28.98 鹵6.51 and the average Fy was 28.04 鹵8.70. There was no significant difference between male, female, left knee and right knee in TxTX type FX Fy (P 0.05). Conclusion: Dual-source CT can clearly display the tunnel after ACL, and can be used to evaluate the location of the tunnel. It can be used to improve the operation mode and individual anatomical reconstruction after ACL injury. Experimental stress relaxation experiment and calculation of Elastic Modulus of the second half tendon objective: to study the viscoelastic properties of the semitendinosus tendon of the knee joint of fresh cadavers and to calculate the elastic modulus of the semitendinosus tendon of the single strand so as to provide biomechanical parameters for finite element analysis. Methods: the semitendinosus tendon was taken out from the cadaveric specimen, and the specimen was trimmed into a uniform size sample. The tensile load was applied to the tendon by mechanical testing machine, and the displacement remained the same when the displacement reached the predetermined stroke, and the change of the observation force was observed. Results: the experimental data of stress relaxation of semitendinosus tendon were obtained, the load-displacement curve and load-time curve were plotted, and the elastic modulus of single-stranded semitendinosus tendon (E) 143.46 鹵8.35 MPa was calculated. Conclusion: the semitendinosus tendon has the typical stress relaxation biological properties of viscoelastic material, and its viscoelastic mechanical properties make it can be used as ACL graft. Experiment 3: establishment of tibiofemoral joint finite element model and finite element analysis of graft stress after anterior cruciate ligament reconstruction based on dual-source CT objective: to construct tibiofemoral joint finite element model after ACL single-bundle reconstruction based on dual-source CT tomography. The size and distribution of graft stress were analyzed. Methods: double source CT scan was performed on the right knee joint of one ACL patient after single bundle reconstruction. The data were imported into MIMICS and GEOMAGIC STUDIO software to establish 3D geometric model, and the geometric model was imported into ANSYS software and divided into meshes. The finite element model of tibiofemoral joint after ACL single bundle reconstruction was established after material assignment. The distribution and size of graft stress during anterior drawer test were simulated by the model. The result is 1: 1. The three-dimensional solid model of tibiofemoral joint after ACL single-bundle reconstruction was successfully constructed by using dual-source CT tomography data mics and GEOMAGIC STUDIO software. The three-dimensional finite element model of tibiofemoral joint after ACL single bundle reconstruction was established by using ANSYS software. The model was meshed with boundary constraints and material assignment. 3. Finite element model was used to analyze the stress distribution and size of the moving plants in front drawer test. Conclusion 1. Using reverse engineering software such as dual-source CT and Mimics Gomagic STUDIO, 3D solid model can be built accurately, and it can be used to observe the space position of grafts after ACL reconstruction. The three-dimensional solid model is introduced into the finite element analysis software ANSYS and meshed. After the boundary constraints and the material value are assigned, the graft-stress can be analyzed. 3. The stress distribution at the inner end of the femoral tunnel is large, which is the most prone to fracture in theory.
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 張強(qiáng);張春禮;徐虎;王迎春;孫芳菲;李曉建;;雙源CT三維重建前交叉韌帶脛骨止點(diǎn)印跡的臨床研究[J];中國微創(chuàng)外科雜志;2012年02期

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本文編號(hào)：1887511