胫骨平台骨折Mimics三维重建及临床应用

发布时间：2018-05-29 00:03

  本文选题：胫骨平台 + 骨折　； 参考：《新乡医学院》2015年硕士论文

【摘要】：目的探讨Mimics软件三维重建技术在胫骨平台骨折诊断分型中的应用价值,以及术前指导临床治疗的意义。方法收集新乡医学院第三附属医院2010年1月至2014年12月期间,60例胫骨平台骨折患者的X线和CT片以及CT三维重建图像,并应用Mimics软件进行三维重建。然后分别邀请资深骨科医师(主任医师)和年轻骨科医师(主治医师)4人,在2个月期间单独根据上述4种影像学资料分别进行诊断。分别对8人的前后两次诊断正确率进行对比分析,得出结论。然后再次选择3例胫骨平台骨折患者,用Mimics软件建立模型,让医师直接在个人电脑上依靠三维动态模型进行术前评估,并模拟手术操作过程。结果1. Mimics三维重建图像,使医师在个人电脑可以得到对骨折更全面,更完整的了解。在本研究中还发现了3例X线平片未能发现的骨折块。2.依据Schatzker分型法,间隔2个月使用X线、2DCT、CT三维重建与Mimics三维建模,对胫骨平台骨折分类统计学评价差异均不明显,无统计学意义(X线、2DCT、CT三维重建与Mimics三维建模的资深组及年轻组P0.05),从对比两次诊断方法的百分比差异性来看,X线、2DCT、CT三维重建与Mimics三维建模四种诊断方法的百分比差异性依次减小,Mimics三维重建比普通CT重建更能清晰地反映骨折情况,能精确测量胫骨平台骨折累及关节面程度,指导手术治疗方案。3.3例实际应用的三维重建虚拟模型,使手术医师在个人电脑上完成了360。全方位骨折情况的了解,并依其结果进行了手术方案选择。最终完成了虚拟手术全部过程,提前了解了手术设计的不足,并在实际手术前对手术过程进行了完善。结论1.X线存在叠影效应,二维CT和CT三维重建在一定程度上解决了其缺陷,Mimics三维重建虚拟图像能更好地使临床医师从立体图形上得到更全面的信息。2. Mimics三维技术重建的胫骨平台骨折三维模型,可以让临床医师多角度、全方位、直接观察骨折的空间位置关系,对骨折部位的形态了解更清晰。3.临床医师可以通过Mimics软件模拟整个手术,反复演练并优化手术设计,从而减少患者痛苦,提高手术成功率,减少并发症的发生。
[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.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【参考文献】

中国期刊全文数据库 前8条

1 方驰华;刘宇斌;唐云强;潘家辉;彭丰平;鲁朝敏;鲍苏苏;;胰体尾肿瘤的可视化仿真手术研究[J];南方医科大学学报;2008年06期

2 曾智敏;罗从风;;胫骨平台骨折手术治疗的并发症[J];国际骨科学杂志;2009年04期

3 刘登均;贺小兵;王明贵;殷浩;冉广文;李争艳;;Mimics软件在齿状突骨折诊断中的价值[J];局解手术学杂志;2012年01期

4 刘彦普,龚振宇,何黎升,赵晋龙,于擘;基于快速成型技术的下颌骨缺损重建术[J];实用口腔医学杂志;2003年05期

5 陈健;罗从风;;不同影像学技术对胫骨平台骨折的评估[J];中国组织工程研究与临床康复;2007年22期

6 吴艳刚;吕鹏;赵民;张永林;焦顺成;;胫骨平台骨折合并内侧副韧带损伤的诊治体会[J];中国矫形外科杂志;2007年12期

7 付淼;李莉;何叶松;;Mimics与医学图像三维重建[J];中国现代医学杂志;2010年19期

8 阿依古丽·喀斯木;艾尼瓦尔江·艾沙;乌日开西·艾依提;滕勇;;逆向工程与快速成形技术在脊柱外科手术中的应用研究[J];现代制造工程;2014年01期

，

本文编号：1948714