下颌骨爆炸伤有限元模型的建立、仿真模拟及生物力学机制的初步研究
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摘要
颌面部位置暴露，无论战时还是平时均易发生损伤，随着爆炸性武器的应用日趋广泛和恐怖活动的日益猖獗，颌面部特别是下颌骨爆炸伤发生率呈明显上升趋势。因此，颌面部颌面部爆炸伤的研究是颌面部乃至全身创伤研究中的重点问题。目前对于颌面部爆炸伤的研究主要集中在创伤的救治及修复重建上，对于爆炸伤模型的建立及生物力学分析等基础研究相对较少。传统的爆炸伤模型虽然可以较真实地模拟人体组织遭受爆炸冲击时的损伤情况，但是随着科技和社会的发展，特别是医学伦理的限制，使得传统爆炸伤模型逐渐表现出自身的缺陷。
有限元法(Finite Element Method FEM)是一个具有60年发展历史且成熟的计算机模拟方法，在工程机械领域运用非常广泛，现已成为计算机模拟技术中使用最为广泛的方法。有限元在医学领域的应用也有40年的历史，在这40年中，有限元技术在医学特别是口腔医学中得到了广泛的应用，已成为进行生物力学分析的常规方法之一。由于有限元法可以弥补传统的爆炸伤实验在致伤机制研究中的不足，因此，将有限元法运用于颌面部爆炸伤中将有助于深入研究颌面部爆炸伤损伤机制，并能为颌面部爆炸伤致伤部位伤情的快速判断、迅速救治、战时防护以及评估冲击波致伤效应等等提供新的思路和方法。
本研究首先通过建立猪下颌骨爆炸伤三维有限元模型，动态模拟爆炸冲击波致伤下颌骨损伤过程，仿真结果与动物实验对比，验证模型及仿真方法的有效性，然后利用中国可视化数字人(CVH)的头颈部CT数据建立人下颌骨爆炸伤三维有限元模型，动态模拟不同爆炸条件下冲击波致伤人下颌骨组织的致伤过程及生物力学分布情况，初步探讨爆炸冲击波与机体组织之间的相互力学作用及效应。
研究方法和结果：
1.改良猪下颌骨爆炸伤动物实验模型，用600mg纸质RDX电雷管于15cm和5cm距离致伤猪下颌骨标本的下颌角部位，测量各种致伤参数及致伤过程中猪下颌骨的生物
力学变化参数，为分析下颌骨爆炸伤生物力学机制和验证有限元模型和仿真结果提供动物实验数据。结果表明：实验方法重复性好，有效获取计算机动态模拟需要的爆炸致伤、生物力学变化数据。
2.将猪下颌骨计算机X射线断层扫描(Computed tomography，CT)数据导入影像处理软件MIMICS中，通过三维重建获得猪下颌骨面网格模型，然后将该模型导入有限元前处理软件ANSA中，采用六面体为主，结合四面体、五面体的方式建立猪下颌骨爆炸伤三维有限元模型。建立的猪下颌骨三维有限元模型的单元数为36254，节点数为38875，所有单元均为实体单元。结果表明：该模型单元质量好，与真实标本的几何外形相似程度高，满足仿真模拟要求。
3.选择适合的材料模型、生物力学参数及算法，加载与动物实验相似的力学载荷和边界条件，用所建立的猪下颌骨爆炸伤三维有限元模型在LS-DYNA软件中进行仿真计算；通过比较有限元仿真结果与动物实验中的实测数据，验证所采用的有限元方法的合理性。结果表明，本研究所采用的有限元方法对下颌骨爆炸伤生物力学作用机制及其效应有较好的预测能力，能满足下颌骨火器伤生物力学机制研究的要求。
4.将中国可视化数字人(Chinese Visible Human, CVH)头面部CT数据导入影像处理软件MIMICS中，通过三维重建获得猪下颌骨面网格模型，然后将该模型导入有限元前处理软件ANSA中，采用六面体为主结合四面体、五面体的方式建立猪下颌骨爆炸伤三维有限元模型。其中单元数为26644，节点数为27522，所有单元均为实体单元。结果表明，该模型单元质量好，与真实标本的几何外形相似程度高，满足下步仿真模拟要求。
5.在前期猪下颌骨爆炸伤三维有限元模拟的基础上，选择适合的材料模型、材料参数、边界条件及算法，对所建立的人下颌骨火器伤三维有限元模型加载不同的致伤条件(两个致伤部位、三个爆炸当量及三个致伤距离)，在LS-DYNA软件中进行仿真计算，动态模拟人下颌骨火器伤的致伤过程、应力、应变传导及分布的情况。结果表明，该方法成功实现CVH下颌骨不同致伤条件下爆炸伤有限元仿真，模拟了下颌骨动态损伤过程和损伤后形态，并且能够动态观察、提取、分析不同部位应力、应变变化及分布情况，从而进行相关的致伤机制的分析和研究。
结论：
1.成功进行了猪下颌骨爆炸伤三维有限元仿真模拟，通过动物实验验证了所建模型及所采用的有限元分析方法的合理性和可靠性，明确了在研究爆炸伤生物力学机制方面，有限元方法可以弥补目前爆炸伤研究动物模型的不足。
2.成功建立了人下颌骨爆炸伤三维有限元模型并成功模拟了人下颌骨在不同致伤条件下的损伤过程，明确了有限元法在颌面部爆炸伤应用中的可行性和可靠性，可以为颌面部爆炸伤致伤机制研究提供参考。
3.成功进行了人下颌骨爆炸伤生物力学分析，Von Mises应力及有效应变可作为判断和评价骨组织损伤严重程度的标准之一，也可以作为有限元仿真过程中预测骨组织损伤的指标。
4.在下颌骨爆炸冲击波致伤过程中，除直接致伤部位外，双侧髁状突及乙状切迹是高应力、高应变集中区域，也是骨折好发部位。
5.本次建立的三维有限元模型和仿真方法需要不断完善和改进。
The maxillofacial region is often damaged by explosives as an exposed part of thebody sustained in wartime and peacentime. At a time when explosive weapons areincreasingly used and terrorist activities are on the rise, blast injuries to the maxillofacialarea, especially the mandible, are increasing. Hence, researches for mandibular blastinjuries have become an important subject in the researches of maxillofacial and evenfull-body trauma. Currently, researches on mandibular blast injuries are focused on traumatreatment and reconstruction; however, the basic science that includes the creation of a blastinjury model and subsequent biomechanical analyses have been overlooked. The traditionalmodels of blast injury can reliably mimic the damage to the human body from an explosion;however, scientific, technological and social developments are making this approachobsolete, especially because it increasingly faces challenges associated with medical ethics.
The finite element method (FEM) is a mature computer simulation methods of60-yearhistory in the engineering and mechanical fields and has became the most widely usedmethod of computer simulation technology now. FEM has been applied to the medical fieldfor fifty years, in the past fifty years, the FEM has been widely used in the in medicineparticular in oral medicine and has become one of the conventional methods ofbiomechanical analysis. Because the FEM can compensate for the deficiencies of thetraditional experimental studies of blast injury mechanisms, so it can be used inmaxillofacial blast injury and contribute to the in-depth study of maxillofacial blast injurymechanisms and can provide new ideas and methods of fast injury judgment, rapidtreatment, wartime protection, assessment of wounding effect of maxillofacial blast injury.
In this study,3D FE models of the pig mandible were developed to simulate blastinjuries and experimental studies were carried out to validate the FE model and simulatedmethod. Then,3D FE models of mandible of Chinese Visible Human (CVH) for blast injuries were developed and dynamical simulations were carried out by using these models.Based on the simulation results of FEM, the biomechanical mechanism of blast injuries ofthe human mandible were investigated and discussed. The main methods and conclusionswere as follows:
Methods and Results:
1. Based on the improved animal model of blast injuries of the pig mandible, anexperimental study was carried out to measure impact load parameters from the pigmandibles that were damaged at the mandibular angle by standard600mg RDX paperelectric detonators at5cm and15cm distances. The experimental results showed that thedata were reliable and representative. The improved animal model of blast injuries of thepig mandible was reasonable and repeatable. The results of the experimental study can beused to validate the FE model and simulated results.
2. Computed tomography (CT) data of the pig mandible was imported into MIMICSsoftware. A three-dimension computer-aided design (CAD) model of the pig mandible wasreconstructed by using certain functions of MIMICS. Then, the original triangular surfacemesh model of the pig mandible was generated by the “remesh” module of MIMICS. Basedon the surface model of the pig mandible, a combined hexahedral-tetrahedral FE model ofthe pig mandible was developed by ANSA software. The results showed that the number ofthe elements and node were36254and38875respectively, and all the elements were solidelements. The FE model of the pig mandible was similar to its anatomical structure. Withlower cost of modeling, the combined hexahedral-tetrahedral FE model of the pig mandiblecan meet the demand of biomechanical research of blast injury of the pig mandible.
3. By choosing appropriate constitutive model, biomechanical parameters and contactalgorithm for the FE models of the pig mandible, finite element analysis (FEA) wasperformed through the LS-DYNA code under impact loads similar to those obtained fromthe experimental study. The FEM of simulation of blast injuries of the pig mandible wasvalidated based on the results of comparison between the results of FE simulation andexperimental study. The results showed that the constitutive models, algorithm and theparameters, which were chosen for the FE model of blast injuries to pig mandible in ourstudy, were reasonable and reliable. The FEM utilized in our study had a fairly capability ofpredicting on blast injuries of the pig mandible.
4. Firstly, the head and facial CT image of Visible Chinese Human were imported intosoftware MIMICS to reconstituted3D computer-aided designing surface mesh models.Then, the model was imported to the finite element pre-processing software ANSA toreconstituted combined hexahedral-tetrahedral FE model of the pig mandible for blastinjuries. The number of the elements and node were26644and27522. The results showedthat the model had good quality and good similarity and met the requires of next stepsimulation absolutely.
5. Based on the previous FE simulation of blast injuries to the pig mandible,compatible material model, internal parameters, boundary condition and algorithm ofcontact in LS-DYNA software were selected. After computation of simulation, the dynamicdamage process, stresses and strains distributions in its various regions under differentinjury conditions(two injured parts,three explosions equivalents,three injured distance)were simulated by using3D FE model of blast injuries of the human mandible. The resultsshowed that the FE model and methods could dynamically simulate dynamic damageprocess of blast injuries to the human mandible, and could dynamically simulate the processof the spreading and the stress distribution patterns of stresses and strains in each region ofthe mandible affected by blast.
Conclusions:
1. The3D FE model of blast injuries of pig mandible were successfullyestablished.The animal experiment results demonstrate the rationality and reliability of theFE model and simulated results.When concerned with the investigation of biomechanicalmechanism of blast injuries, FEM can make up for the insufficiency of traditionalexperimental models.
2. The3D FE model of blast injuries of human mandible were established and thedamage process of the mandible in different injury conditions were simulated successfully.The simulation results show the feasibility and reliability of the applications of FE methodin maxillofacial blast injuries and can provide a reference for maxillofacial blast injurymechanism.
3. The biomechanical analyses of the human mandible blast injuries were carried outsuccessfully, Von Mises stress and effective strain could be used as criteria of judgment andevaluation of bone damage severity and could be used as indicators of finite element simulation predicted of bone damage.
4. In the injury process of blast, the regions of condyle and simoid notch presentedhigh stress and high strain, and produced fracture easily.
5. The3D finite element models and simulation results of our experiments had somedeficiencies and needed to be refined and improved continually.
有限元法(Finite Element Method FEM)是一个具有60年发展历史且成熟的计算机模拟方法，在工程机械领域运用非常广泛，现已成为计算机模拟技术中使用最为广泛的方法。有限元在医学领域的应用也有40年的历史，在这40年中，有限元技术在医学特别是口腔医学中得到了广泛的应用，已成为进行生物力学分析的常规方法之一。由于有限元法可以弥补传统的爆炸伤实验在致伤机制研究中的不足，因此，将有限元法运用于颌面部爆炸伤中将有助于深入研究颌面部爆炸伤损伤机制，并能为颌面部爆炸伤致伤部位伤情的快速判断、迅速救治、战时防护以及评估冲击波致伤效应等等提供新的思路和方法。
本研究首先通过建立猪下颌骨爆炸伤三维有限元模型，动态模拟爆炸冲击波致伤下颌骨损伤过程，仿真结果与动物实验对比，验证模型及仿真方法的有效性，然后利用中国可视化数字人(CVH)的头颈部CT数据建立人下颌骨爆炸伤三维有限元模型，动态模拟不同爆炸条件下冲击波致伤人下颌骨组织的致伤过程及生物力学分布情况，初步探讨爆炸冲击波与机体组织之间的相互力学作用及效应。
研究方法和结果：
1.改良猪下颌骨爆炸伤动物实验模型，用600mg纸质RDX电雷管于15cm和5cm距离致伤猪下颌骨标本的下颌角部位，测量各种致伤参数及致伤过程中猪下颌骨的生物
力学变化参数，为分析下颌骨爆炸伤生物力学机制和验证有限元模型和仿真结果提供动物实验数据。结果表明：实验方法重复性好，有效获取计算机动态模拟需要的爆炸致伤、生物力学变化数据。
2.将猪下颌骨计算机X射线断层扫描(Computed tomography，CT)数据导入影像处理软件MIMICS中，通过三维重建获得猪下颌骨面网格模型，然后将该模型导入有限元前处理软件ANSA中，采用六面体为主，结合四面体、五面体的方式建立猪下颌骨爆炸伤三维有限元模型。建立的猪下颌骨三维有限元模型的单元数为36254，节点数为38875，所有单元均为实体单元。结果表明：该模型单元质量好，与真实标本的几何外形相似程度高，满足仿真模拟要求。
3.选择适合的材料模型、生物力学参数及算法，加载与动物实验相似的力学载荷和边界条件，用所建立的猪下颌骨爆炸伤三维有限元模型在LS-DYNA软件中进行仿真计算；通过比较有限元仿真结果与动物实验中的实测数据，验证所采用的有限元方法的合理性。结果表明，本研究所采用的有限元方法对下颌骨爆炸伤生物力学作用机制及其效应有较好的预测能力，能满足下颌骨火器伤生物力学机制研究的要求。
4.将中国可视化数字人(Chinese Visible Human, CVH)头面部CT数据导入影像处理软件MIMICS中，通过三维重建获得猪下颌骨面网格模型，然后将该模型导入有限元前处理软件ANSA中，采用六面体为主结合四面体、五面体的方式建立猪下颌骨爆炸伤三维有限元模型。其中单元数为26644，节点数为27522，所有单元均为实体单元。结果表明，该模型单元质量好，与真实标本的几何外形相似程度高，满足下步仿真模拟要求。
5.在前期猪下颌骨爆炸伤三维有限元模拟的基础上，选择适合的材料模型、材料参数、边界条件及算法，对所建立的人下颌骨火器伤三维有限元模型加载不同的致伤条件(两个致伤部位、三个爆炸当量及三个致伤距离)，在LS-DYNA软件中进行仿真计算，动态模拟人下颌骨火器伤的致伤过程、应力、应变传导及分布的情况。结果表明，该方法成功实现CVH下颌骨不同致伤条件下爆炸伤有限元仿真，模拟了下颌骨动态损伤过程和损伤后形态，并且能够动态观察、提取、分析不同部位应力、应变变化及分布情况，从而进行相关的致伤机制的分析和研究。
结论：
1.成功进行了猪下颌骨爆炸伤三维有限元仿真模拟，通过动物实验验证了所建模型及所采用的有限元分析方法的合理性和可靠性，明确了在研究爆炸伤生物力学机制方面，有限元方法可以弥补目前爆炸伤研究动物模型的不足。
2.成功建立了人下颌骨爆炸伤三维有限元模型并成功模拟了人下颌骨在不同致伤条件下的损伤过程，明确了有限元法在颌面部爆炸伤应用中的可行性和可靠性，可以为颌面部爆炸伤致伤机制研究提供参考。
3.成功进行了人下颌骨爆炸伤生物力学分析，Von Mises应力及有效应变可作为判断和评价骨组织损伤严重程度的标准之一，也可以作为有限元仿真过程中预测骨组织损伤的指标。
4.在下颌骨爆炸冲击波致伤过程中，除直接致伤部位外，双侧髁状突及乙状切迹是高应力、高应变集中区域，也是骨折好发部位。
5.本次建立的三维有限元模型和仿真方法需要不断完善和改进。
The maxillofacial region is often damaged by explosives as an exposed part of thebody sustained in wartime and peacentime. At a time when explosive weapons areincreasingly used and terrorist activities are on the rise, blast injuries to the maxillofacialarea, especially the mandible, are increasing. Hence, researches for mandibular blastinjuries have become an important subject in the researches of maxillofacial and evenfull-body trauma. Currently, researches on mandibular blast injuries are focused on traumatreatment and reconstruction; however, the basic science that includes the creation of a blastinjury model and subsequent biomechanical analyses have been overlooked. The traditionalmodels of blast injury can reliably mimic the damage to the human body from an explosion;however, scientific, technological and social developments are making this approachobsolete, especially because it increasingly faces challenges associated with medical ethics.
The finite element method (FEM) is a mature computer simulation methods of60-yearhistory in the engineering and mechanical fields and has became the most widely usedmethod of computer simulation technology now. FEM has been applied to the medical fieldfor fifty years, in the past fifty years, the FEM has been widely used in the in medicineparticular in oral medicine and has become one of the conventional methods ofbiomechanical analysis. Because the FEM can compensate for the deficiencies of thetraditional experimental studies of blast injury mechanisms, so it can be used inmaxillofacial blast injury and contribute to the in-depth study of maxillofacial blast injurymechanisms and can provide new ideas and methods of fast injury judgment, rapidtreatment, wartime protection, assessment of wounding effect of maxillofacial blast injury.
In this study,3D FE models of the pig mandible were developed to simulate blastinjuries and experimental studies were carried out to validate the FE model and simulatedmethod. Then,3D FE models of mandible of Chinese Visible Human (CVH) for blast injuries were developed and dynamical simulations were carried out by using these models.Based on the simulation results of FEM, the biomechanical mechanism of blast injuries ofthe human mandible were investigated and discussed. The main methods and conclusionswere as follows:
Methods and Results:
1. Based on the improved animal model of blast injuries of the pig mandible, anexperimental study was carried out to measure impact load parameters from the pigmandibles that were damaged at the mandibular angle by standard600mg RDX paperelectric detonators at5cm and15cm distances. The experimental results showed that thedata were reliable and representative. The improved animal model of blast injuries of thepig mandible was reasonable and repeatable. The results of the experimental study can beused to validate the FE model and simulated results.
2. Computed tomography (CT) data of the pig mandible was imported into MIMICSsoftware. A three-dimension computer-aided design (CAD) model of the pig mandible wasreconstructed by using certain functions of MIMICS. Then, the original triangular surfacemesh model of the pig mandible was generated by the “remesh” module of MIMICS. Basedon the surface model of the pig mandible, a combined hexahedral-tetrahedral FE model ofthe pig mandible was developed by ANSA software. The results showed that the number ofthe elements and node were36254and38875respectively, and all the elements were solidelements. The FE model of the pig mandible was similar to its anatomical structure. Withlower cost of modeling, the combined hexahedral-tetrahedral FE model of the pig mandiblecan meet the demand of biomechanical research of blast injury of the pig mandible.
3. By choosing appropriate constitutive model, biomechanical parameters and contactalgorithm for the FE models of the pig mandible, finite element analysis (FEA) wasperformed through the LS-DYNA code under impact loads similar to those obtained fromthe experimental study. The FEM of simulation of blast injuries of the pig mandible wasvalidated based on the results of comparison between the results of FE simulation andexperimental study. The results showed that the constitutive models, algorithm and theparameters, which were chosen for the FE model of blast injuries to pig mandible in ourstudy, were reasonable and reliable. The FEM utilized in our study had a fairly capability ofpredicting on blast injuries of the pig mandible.
4. Firstly, the head and facial CT image of Visible Chinese Human were imported intosoftware MIMICS to reconstituted3D computer-aided designing surface mesh models.Then, the model was imported to the finite element pre-processing software ANSA toreconstituted combined hexahedral-tetrahedral FE model of the pig mandible for blastinjuries. The number of the elements and node were26644and27522. The results showedthat the model had good quality and good similarity and met the requires of next stepsimulation absolutely.
5. Based on the previous FE simulation of blast injuries to the pig mandible,compatible material model, internal parameters, boundary condition and algorithm ofcontact in LS-DYNA software were selected. After computation of simulation, the dynamicdamage process, stresses and strains distributions in its various regions under differentinjury conditions(two injured parts,three explosions equivalents,three injured distance)were simulated by using3D FE model of blast injuries of the human mandible. The resultsshowed that the FE model and methods could dynamically simulate dynamic damageprocess of blast injuries to the human mandible, and could dynamically simulate the processof the spreading and the stress distribution patterns of stresses and strains in each region ofthe mandible affected by blast.
Conclusions:
1. The3D FE model of blast injuries of pig mandible were successfullyestablished.The animal experiment results demonstrate the rationality and reliability of theFE model and simulated results.When concerned with the investigation of biomechanicalmechanism of blast injuries, FEM can make up for the insufficiency of traditionalexperimental models.
2. The3D FE model of blast injuries of human mandible were established and thedamage process of the mandible in different injury conditions were simulated successfully.The simulation results show the feasibility and reliability of the applications of FE methodin maxillofacial blast injuries and can provide a reference for maxillofacial blast injurymechanism.
3. The biomechanical analyses of the human mandible blast injuries were carried outsuccessfully, Von Mises stress and effective strain could be used as criteria of judgment andevaluation of bone damage severity and could be used as indicators of finite element simulation predicted of bone damage.
4. In the injury process of blast, the regions of condyle and simoid notch presentedhigh stress and high strain, and produced fracture easily.
5. The3D finite element models and simulation results of our experiments had somedeficiencies and needed to be refined and improved continually.
引文
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