基于CT的腹膜后腔个体化三维数字模型构建初探

发布时间：2018-04-03 08:05

本文选题：增强CT　切入点：腹膜后腔　出处：《山西医科大学》2012年硕士论文

【摘要】：目的：基于增强CT原始数据，探讨腹膜后腔个体化三维数字模型的构建方法及其意义，为肾区个体化手术方案的制定及生物力学研究提供形态学参考和模型基础。方法：分别于术前获取我院2011年3月-11月间，46例泌尿外科肾上腺、肾脏及上尿路疾病住院患者腹部增强CT断层扫描图像的原始数据（图像格式符合DICOM协议标准，扫描层厚0.625mm，矩阵512 512，像素大小0.9766mm，含动脉期、静脉期及延迟期图像），其中肾上腺相关疾病12例（左6例，右6例），肾脏相关疾病22例（左10例，右12例），肾盂、输尿管相关疾病12例（左6例，右6例），逐层阅片后，应用mimics 10.01医学图像处理软件，在三期内综合、反复应用剖面线、阈值分割、区域生长、动态区域生长、布尔运算、销蚀膨胀、蒙罩编辑及3D计算等工具，分别对病灶及其周围重要组织器官进行图像分割及三维重建，将重建出的各组织器官子模型以STL格式导入同一场景，，图像配准成完整模型，并与术中所见作比较。结果： 1. 46例腹膜后腔个体化三维数字模型均于术前成功构建（包括以肾上腺为主的、以肾脏为主的、以上尿路为主的三类个体化模型），模型准确、直观，兼具疾病分类特点与个体特征； 2.通过自由地旋转、缩放、透视及单独或联合显示，各模型均清晰地展示了病灶与其周围重要组织器官的空间解剖位置及相互毗邻关系，并与术中所见完全相符。结论： 1.基于增强CT数据所逆向重建出的以非骨性结构为主、兼具疾病分类特点及个体特征的腹膜后腔三维数字模型，不仅能够准确、直观及形象地反映病灶及周围组织器官的实体情况，为肾区个体化手术方案的制定提供形态学依据，而且为其生物力学研究及后续的个体化虚拟手术奠定了模型基础； 2.该构建方法能够在术前顺利完成模型重建工作，在泌尿外科术前方案规划、术中辅助性定位、导航及预警方面有一定的应用价值； 3.该构建方法通过应用基于图形处理技术的医学图像处理软件，能够借助普及的个人PC机及windows操作平台，开展三维重建及观察工作，其准入门槛低，易于推广使用。
[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.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.5

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