交互式医学图像控制系统（MIMICS）在下颌骨肿瘤切除及缺损重建中的应用

发布时间：2018-07-25 13:10

【摘要】：目的:探讨交互式医学图像控制系统(MIMICS)在下颌骨肿瘤切除,腓骨瓣修复重建下颌骨缺损中的应用价值,为术前进行精确设计手术方案及达到术后良好的重建效果提供可靠依据。方法:选取2014年11月至2015年12月收治的下颌骨肿瘤需重建的10例患者。术前行上下颌骨及供区小腿螺旋CT扫描,将DICOM数据导入交互式医学图像控制系统(MIMICS),观察肿瘤确定安全范围、模拟肿瘤切除、镜像恢复患侧、腓骨瓣模拟重建、预测重建效果。术中按术前设计方案切除肿瘤、腓骨瓣制备塑形、钛板固定、腓骨瓣固定就位。结果:全部手术按术前模拟顺利完成,移植腓骨瓣术后全部成活。术后1、3、6、9、12个月随访复查,行曲断或CT复查,结果示10例患者腓骨瓣位置良好,开口度2~3指,供区小腿腓骨创面愈合良好未见明显并发症。患者对术后面部外形及小腿功能的恢复均为满意。结论:在下颌骨肿瘤切除及缺损重建中利用CT影像资料,采用交互式医学图像控制系统(MIMICS)实现在计算机屏幕前制定手术方案,进行术前手术评估和术后重建效果预测,提高下颌骨肿瘤切除的准确性及腓骨重建颌骨的连续性和对称性。
[Abstract]:Objective: to explore the application value of interactive medical image control system (MIMICS) in mandibular tumor resection and reconstruction of mandibular defect with fibula flap. Methods: from November 2014 to December 2015, 10 patients with mandibular tumor needed reconstruction. Spiral CT scanning of upper mandible and leg was performed before operation. DICOM data were introduced into interactive medical image control system (MIMICS),) to observe the safe range of tumor, to simulate tumor resection, to restore the affected side by mirror image, and to predict the effect of reconstruction with fibular flap. According to the preoperative design, the tumor was resected, the fibula flap was molded, the titanium plate was fixed, and the fibular flap was fixed in place. Results: all the operations were successfully completed according to the simulation before operation and all survived after fibula flap transplantation. The results showed that the fibula flap was well located in 10 cases, and the opening degree was 2 ~ 3 fingers. There was no obvious complication in the wound healing of the donor leg fibula. The patients were satisfied with the recovery of facial appearance and leg function. Conclusion: in mandibular tumor resection and reconstruction, CT images and interactive medical image control system (MIMICS) were used to make the operation plan in front of the computer screen, to evaluate the operation before operation and to predict the effect of reconstruction after operation. To improve the accuracy of mandibular tumor resection and the continuity and symmetry of mandibular reconstruction.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.8;TP391.41

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