本文選題：脛骨平臺(tái) + 骨折��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的探討Mimics軟件三維重建技術(shù)在脛骨平臺(tái)骨折診斷分型中的應(yīng)用價(jià)值,以及術(shù)前指導(dǎo)臨床治療的意義。方法收集新鄉(xiāng)醫(yī)學(xué)院第三附屬醫(yī)院2010年1月至2014年12月期間,60例脛骨平臺(tái)骨折患者的X線(xiàn)和CT片以及CT三維重建圖像,并應(yīng)用Mimics軟件進(jìn)行三維重建。然后分別邀請(qǐng)資深骨科醫(yī)師(主任醫(yī)師)和年輕骨科醫(yī)師(主治醫(yī)師)4人,在2個(gè)月期間單獨(dú)根據(jù)上述4種影像學(xué)資料分別進(jìn)行診斷。分別對(duì)8人的前后兩次診斷正確率進(jìn)行對(duì)比分析,得出結(jié)論。然后再次選擇3例脛骨平臺(tái)骨折患者,用Mimics軟件建立模型,讓醫(yī)師直接在個(gè)人電腦上依靠三維動(dòng)態(tài)模型進(jìn)行術(shù)前評(píng)估,并模擬手術(shù)操作過(guò)程。結(jié)果1. Mimics三維重建圖像,使醫(yī)師在個(gè)人電腦可以得到對(duì)骨折更全面,更完整的了解。在本研究中還發(fā)現(xiàn)了3例X線(xiàn)平片未能發(fā)現(xiàn)的骨折塊。2.依據(jù)Schatzker分型法,間隔2個(gè)月使用X線(xiàn)、2DCT、CT三維重建與Mimics三維建模,對(duì)脛骨平臺(tái)骨折分類(lèi)統(tǒng)計(jì)學(xué)評(píng)價(jià)差異均不明顯,無(wú)統(tǒng)計(jì)學(xué)意義(X線(xiàn)、2DCT、CT三維重建與Mimics三維建模的資深組及年輕組P0.05),從對(duì)比兩次診斷方法的百分比差異性來(lái)看,X線(xiàn)、2DCT、CT三維重建與Mimics三維建模四種診斷方法的百分比差異性依次減小,Mimics三維重建比普通CT重建更能清晰地反映骨折情況,能精確測(cè)量脛骨平臺(tái)骨折累及關(guān)節(jié)面程度,指導(dǎo)手術(shù)治療方案。3.3例實(shí)際應(yīng)用的三維重建虛擬模型,使手術(shù)醫(yī)師在個(gè)人電腦上完成了360。全方位骨折情況的了解,并依其結(jié)果進(jìn)行了手術(shù)方案選擇。最終完成了虛擬手術(shù)全部過(guò)程,提前了解了手術(shù)設(shè)計(jì)的不足,并在實(shí)際手術(shù)前對(duì)手術(shù)過(guò)程進(jìn)行了完善。結(jié)論1.X線(xiàn)存在疊影效應(yīng),二維CT和CT三維重建在一定程度上解決了其缺陷,Mimics三維重建虛擬圖像能更好地使臨床醫(yī)師從立體圖形上得到更全面的信息。2. Mimics三維技術(shù)重建的脛骨平臺(tái)骨折三維模型,可以讓臨床醫(yī)師多角度、全方位、直接觀(guān)察骨折的空間位置關(guān)系,對(duì)骨折部位的形態(tài)了解更清晰。3.臨床醫(yī)師可以通過(guò)Mimics軟件模擬整個(gè)手術(shù),反復(fù)演練并優(yōu)化手術(shù)設(shè)計(jì),從而減少患者痛苦,提高手術(shù)成功率,減少并發(fā)癥的發(fā)生。
[Abstract]:Objective to evaluate the value of Mimics software 3D reconstruction in the diagnosis and classification of tibial plateau fractures and the significance of guiding clinical treatment before operation. Methods from January 2010 to December 2014, 60 patients with tibial plateau fractures were collected from the third affiliated Hospital of Xinxiang Medical College. X-ray and CT images were collected and 3D reconstruction was performed with Mimics software. Four senior orthopedic physicians (chief doctors) and four young orthopedic physicians (attending physicians) were invited to diagnose the four imaging data separately during the 2-month period. The correct rate of diagnosis before and after 8 cases were compared and analyzed, and the conclusion was drawn. Then 3 cases of tibial plateau fracture were selected again and the model was established by Mimics software. The doctors were directly evaluated by 3D dynamic model on personal computer and the procedure of operation was simulated. Result 1. Mimics 3D reconstruction images allow physicians to gain a more comprehensive and complete understanding of fractures on personal computers. In this study, 3 cases of fracture mass. 2. 2 were also found in X-ray plain film. According to Schatzker classification method, using X-ray 2DCT CT 3D reconstruction and Mimics 3D modeling, there was no significant difference in the classification and statistical evaluation of tibial plateau fractures. There was no statistical significance between CT 3D reconstruction and Mimics 3D modeling in the senior group and young group (P0.05). From the percentage difference of the two diagnostic methods, we can see the difference of the four diagnostic methods of CT 3D reconstruction and Mimics 3D modeling. Mimics 3D reconstruction can reflect fracture more clearly than conventional CT reconstruction. It can accurately measure the degree of articular surface involvement of tibial plateau fracture, guide the surgical treatment plan. 3.3 cases of practical application of three-dimensional reconstruction of virtual model, so that the surgeon on the personal computer completed 360. To understand the situation of all-directional fractures and to select the operative plan according to the results. Finally, the whole process of virtual surgery is completed, the deficiency of operation design is understood in advance, and the operation process is perfected before the actual operation. Conclusion 1. X ray has overlapping effect, 2D CT and CT 3D reconstruction can solve its defect to some extent and imics 3D reconstruction virtual image can make clinicians get more comprehensive information from stereoscopic image. 2. The three-dimensional model of tibial plateau fracture reconstructed by Mimics technique can help clinicians to observe the spatial position of fracture directly from multiple angles and all directions, and to understand the shape of fracture site more clearly. 3. Clinicians can simulate the whole operation through Mimics software, repeat the exercise and optimize the operation design, so as to reduce the pain of patients, improve the success rate of surgery, and reduce the occurrence of complications.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

【參考文獻(xiàn)】

中國(guó)期刊全文數(shù)據(jù)庫(kù) 前8條

1 方馳華;劉宇斌;唐云強(qiáng);潘家輝;彭豐平;魯朝敏;鮑蘇蘇;;胰體尾腫瘤的可視化仿真手術(shù)研究[J];南方醫(yī)科大學(xué)學(xué)報(bào);2008年06期

2 曾智敏;羅從風(fēng);;脛骨平臺(tái)骨折手術(shù)治療的并發(fā)癥[J];國(guó)際骨科學(xué)雜志;2009年04期

3 劉登均;賀小兵;王明貴;殷浩;冉廣文;李爭(zhēng)艷;;Mimics軟件在齒狀突骨折診斷中的價(jià)值[J];局解手術(shù)學(xué)雜志;2012年01期

4 劉彥普,龔振宇,何黎升,趙晉龍,于擘;基于快速成型技術(shù)的下頜骨缺損重建術(shù)[J];實(shí)用口腔醫(yī)學(xué)雜志;2003年05期

5 陳健;羅從風(fēng);;不同影像學(xué)技術(shù)對(duì)脛骨平臺(tái)骨折的評(píng)估[J];中國(guó)組織工程研究與臨床康復(fù);2007年22期

6 吳艷剛;呂鵬;趙民;張永林;焦順成;;脛骨平臺(tái)骨折合并內(nèi)側(cè)副韌帶損傷的診治體會(huì)[J];中國(guó)矯形外科雜志;2007年12期

7 付淼;李莉;何葉松;;Mimics與醫(yī)學(xué)圖像三維重建[J];中國(guó)現(xiàn)代醫(yī)學(xué)雜志;2010年19期

8 阿依古麗·喀斯木;艾尼瓦爾江·艾沙;烏日開(kāi)西·艾依提;滕勇;;逆向工程與快速成形技術(shù)在脊柱外科手術(shù)中的應(yīng)用研究[J];現(xiàn)代制造工程;2014年01期

，

本文編號(hào)：1948714