發(fā)布時(shí)間：2018-04-03 08:05

  本文選題：增強(qiáng)CT　切入點(diǎn)：腹膜后腔　出處：《山西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：基于增強(qiáng)CT原始數(shù)據(jù)，探討腹膜后腔個(gè)體化三維數(shù)字模型的構(gòu)建方法及其意義，為腎區(qū)個(gè)體化手術(shù)方案的制定及生物力學(xué)研究提供形態(tài)學(xué)參考和模型基礎(chǔ)。 方法：分別于術(shù)前獲取我院2011年3月-11月間，46例泌尿外科腎上腺、腎臟及上尿路疾病住院患者腹部增強(qiáng)CT斷層掃描圖像的原始數(shù)據(jù)（圖像格式符合DICOM協(xié)議標(biāo)準(zhǔn)，掃描層厚0.625mm，矩陣512 512，像素大小0.9766mm，含動(dòng)脈期、靜脈期及延遲期圖像），其中腎上腺相關(guān)疾病12例（左6例，右6例），腎臟相關(guān)疾病22例（左10例，右12例），腎盂、輸尿管相關(guān)疾病12例（左6例，右6例），逐層閱片后，應(yīng)用mimics 10.01醫(yī)學(xué)圖像處理軟件，在三期內(nèi)綜合、反復(fù)應(yīng)用剖面線、閾值分割、區(qū)域生長、動(dòng)態(tài)區(qū)域生長、布爾運(yùn)算、銷蝕膨脹、蒙罩編輯及3D計(jì)算等工具，分別對(duì)病灶及其周圍重要組織器官進(jìn)行圖像分割及三維重建，將重建出的各組織器官子模型以STL格式導(dǎo)入同一場景，，圖像配準(zhǔn)成完整模型，并與術(shù)中所見作比較。 結(jié)果： 1. 46例腹膜后腔個(gè)體化三維數(shù)字模型均于術(shù)前成功構(gòu)建（包括以腎上腺為主的、以腎臟為主的、以上尿路為主的三類個(gè)體化模型），模型準(zhǔn)確、直觀，兼具疾病分類特點(diǎn)與個(gè)體特征； 2.通過自由地旋轉(zhuǎn)、縮放、透視及單獨(dú)或聯(lián)合顯示，各模型均清晰地展示了病灶與其周圍重要組織器官的空間解剖位置及相互毗鄰關(guān)系，并與術(shù)中所見完全相符。 結(jié)論： 1.基于增強(qiáng)CT數(shù)據(jù)所逆向重建出的以非骨性結(jié)構(gòu)為主、兼具疾病分類特點(diǎn)及個(gè)體特征的腹膜后腔三維數(shù)字模型，不僅能夠準(zhǔn)確、直觀及形象地反映病灶及周圍組織器官的實(shí)體情況，為腎區(qū)個(gè)體化手術(shù)方案的制定提供形態(tài)學(xué)依據(jù)，而且為其生物力學(xué)研究及后續(xù)的個(gè)體化虛擬手術(shù)奠定了模型基礎(chǔ)； 2.該構(gòu)建方法能夠在術(shù)前順利完成模型重建工作，在泌尿外科術(shù)前方案規(guī)劃、術(shù)中輔助性定位、導(dǎo)航及預(yù)警方面有一定的應(yīng)用價(jià)值； 3.該構(gòu)建方法通過應(yīng)用基于圖形處理技術(shù)的醫(yī)學(xué)圖像處理軟件，能夠借助普及的個(gè)人PC機(jī)及windows操作平臺(tái)，開展三維重建及觀察工作，其準(zhǔn)入門檻低，易于推廣使用。
[Abstract]:Objective: based on the original data of enhanced CT, to explore the method and significance of constructing individualized three-dimensional digital model of retroperitoneal cavity, and to provide morphological reference and model basis for individual operation plan and biomechanical study in renal area.Methods: the original CT images of 46 patients with urological adrenal, renal and upper urinary tract diseases were obtained from March to November 2011 in our hospital before operation. (the image format was in accordance with the standard of DICOM protocol.The scanning slice thickness was 0.625mm, matrix was 512,512, pixel size was 0.9766mm, including arterial phase, venous phase and delayed phase, including 12 cases of adrenal diseases (6 cases left, 6 cases right), 22 cases of renal diseases (10 cases left, 12 cases right, pyelopeles).12 cases of ureter-related diseases (left 6 cases, right 6 cases) were analyzed by mimics 10.01 medical image processing software in three phases, and repeated application of profile line, threshold segmentation, region growth, dynamic region growth, Boolean operation.The image segmentation and 3D reconstruction of the lesions and their surrounding important tissues and organs were carried out with the tools of erosion expansion, mask editing and 3D calculation. The reconstructed submodels of tissues and organs were imported into the same scene in STL format.The image registration was made into a complete model and compared with the intraoperative findings.Results:1.Three dimensional digital models of retroperitoneal cavity were successfully constructed before operation (including three types of individualized models of adrenal gland, kidney, and above urinary tract). The models were accurate and intuitionistic.Both disease classification and individual characteristics;2.By free rotation, scaling, fluoroscopy and single or combined display, each model clearly shows the spatial anatomical position and the relationship between the lesion and its surrounding important tissues and organs, and it is consistent with the intraoperative findings.Conclusion:1.The three-dimensional digital model of retroperitoneal cavity based on enhanced CT data, which is mainly non-bone structure and has the characteristics of disease classification and individual features, can not only be accurately reconstructed.It can directly and vividly reflect the solid situation of the lesion and surrounding tissues and organs, and provide morphological basis for the formulation of individual operation plan in renal area, and also lay a model foundation for its biomechanical research and subsequent individualized virtual surgery.2.The method can successfully complete the reconstruction of the model before operation, and has certain application value in the planning of urology before operation, auxiliary positioning during operation, navigation and early warning.3.Through the application of medical image processing software based on graphics processing technology, this method can carry out 3D reconstruction and observation with the help of popular personal computer and windows operating platform, and its entry threshold is low, and it is easy to be popularized and used.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R816.5

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