交互式医学图像控制系统在颧眶上颌骨骨折治疗中的应用
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摘要
目的探讨交互式医学图像控制系统(MIMICS)在计算机辅助颧眶上颌骨骨折治疗中的应用价值,为术前进行精确设计及术后良好效果提供依据。方法对10例拟进行颧眶上颌骨骨折坚固内固定术的患者行面部三维CT扫描,使用MIMICS软件获取的图像信息进行三维建模,通过虚拟手术制定手术方案,预测和判断骨折位置的复位情况,最终达到良好的手术效果。结果利用MIMICS软件完成术前三维模型重建,并通过模拟手术制定手术方案,预测术后效果,完成骨折手术,达到预期效果。结论采用MIMICS可实现人头面部的三维重建和术前镜像模拟手术过程,以动画形式模拟颧眶上颌骨骨折手术的复位情况,最终提高了颌面部骨折手术的预测性和精确性。
Objective To discuss the value of Materialise's Interactive Medical Image Control System(MIMICS) about treating the zygomatic-orbital-maxillary fracture in the computer aided surgery, to offer a reliable system for precise surgical planning and good effect. Methods Based on CT images, geometric characteristics of 10 patients' head were collected for a 3 D reconstruction of the human head. Skull, maxilla, mandibula and zygomatic bone were reconstructed and optimized separately by MIMICS. Virtual surgery was applied to develop a surgical plan, to predict and judge the reduction of the fracture position, finally achieve good operation effect. Results MIMICS software was used to reconstruct the preoperative 3 D model, and the simulate operation was applied to make the surgical plan, estimate the result, complete the fracture operation and finally achieve the expected effect. Conclusion MIMICS is a helpful digital tool for computer aided trauma surgery and the prediction of fracture reduction. MIMICS is also a 3 D visualization system for zygomatic-orbital-maxillary fracture surgery, by which surgeons can realize the surgical planning, revising, and preoperative plan making on the computer screen.
Objective To discuss the value of Materialise's Interactive Medical Image Control System(MIMICS) about treating the zygomatic-orbital-maxillary fracture in the computer aided surgery, to offer a reliable system for precise surgical planning and good effect. Methods Based on CT images, geometric characteristics of 10 patients' head were collected for a 3 D reconstruction of the human head. Skull, maxilla, mandibula and zygomatic bone were reconstructed and optimized separately by MIMICS. Virtual surgery was applied to develop a surgical plan, to predict and judge the reduction of the fracture position, finally achieve good operation effect. Results MIMICS software was used to reconstruct the preoperative 3 D model, and the simulate operation was applied to make the surgical plan, estimate the result, complete the fracture operation and finally achieve the expected effect. Conclusion MIMICS is a helpful digital tool for computer aided trauma surgery and the prediction of fracture reduction. MIMICS is also a 3 D visualization system for zygomatic-orbital-maxillary fracture surgery, by which surgeons can realize the surgical planning, revising, and preoperative plan making on the computer screen.
引文
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[22] Westendonff C,Gülicher D,Dammann F,et al.Computer-assisted surgical treatment of orbitozygomatic fractures[J].J Craniofac Surg,2006,17(5):837-842.
[2] Jung HJ,Jung YB,Song KS,et al.Fractures associated with computer-navigated total knee arthroplasty.A report of two cases[J].J Bone Joint Surg,2007,89(10):2280-2284.
[3] Xia JJ,Gateno J,Teichgraeber JF.New clinical protocol to evalu-ate cranio-maxillofacial deformity and to plan surgical correction[J].J Oral Maxillofac Surg,2009,67(10):2093-2106.
[4] Hu YL,Li HY,Qiao G,et al.Computer-assisted virtual surgical procedure for acetabular fractures based on real CT data[J].Injury,2011,42(10):1121-1124.
[5] Yang X,Hua J,Zhu S,et al.Computer-assisted surgical planning and simulation for condylar reconstruction in patients with osteochondroma[J].Br J Oral Maxillofac Surg,2011,49(3):203-208.
[6] ShanYong Z,Liu H,Yang C,et al.Modified surgical techniques for total alloplastic temporomandibular joint replacement:One institution's experience[J].J Craniomaxillofac Surg,2015,43(6):934-936.
[7] Liu Y,Zhu F,Yang L,et al.Study on computer-aided surgrey engineering based on modern engineering technology[J].J Comput Syst,2008,5(1):127-134.
[8] Ostwald J,Berssenbrügge P,Dirksen D,et al.Measured symme-try of facial 3D shape and perceived facial symmetry and attractiveness before and after orthognathic surgery[J].J Craniomaxillofac Surg,2015,43(4):521.
[9] Shen P,Zhao J,Fan L,et al.Corrigendum to “Accuracy evaluation of computer-designed surgical guide template in oral implantology”[J].J Craniomaxillofac Surg,2016,44(6):758.
[10] Gerbino G,Zavattero E,Zenga F,et al.Primary and secondary reconstruction of complex craniofacial defects using polyetheretherketone custom-made implants[J].J Craniomaxillofac Surg,2015,43(8):1356.
[11] 张志愿.口腔颌面外科[M].7版.北京:人民卫生出版社,2012:582.
[12] Jackman TM,Hussein AI,Curtiss C,et al.Quantitative,3-D visualization of the initiation and progression of vertebral fractures under compression and anterior flexion[J].J Bone Miner Res,2015,31(4):777-788.
[13] Buschbaum J,Fremd R,Pohlemann T,et al.Computer-assisted fracture reduction:a new approach for repositioning femoral fractures and planning reduction paths[J].Int J Comput Assist Radiol Surg,2015,10(2):149-159.
[14] Bell RB,Markiewicz MR.Computer-assisted planning,stereolithographic modeling,and intraoperative navigation for complex orbital reconstruction a descriptive study in a preliminary cohort[J].J Oral Maxillofac Surg,2009,67(12):2559-2570.
[15] Herlin C,Koppe M,Béziat JL,et al.Rapid prototyping in craniofacial surgery:using a positioning guide after zygomatic osteotomy-A case report[J].J Craniomaxillofac Surg,2011,39(5):376-379.
[16] Swenne GR,Barth EL,Eulzer C,et al.The use of a new 3D splint and double CT scan procedure to obtain an accurate anatomic virtual augmented model of the skull[J].Int J Oral Maxillofac Surg,2007,36(2):146-152.
[17] Schep NWL,Broeders IAMJ,Werken CVD.Computer assisted orthopaedic and trauma surgery:state of the art and future perspectives[J].Injury,2003,34(4):299-306.
[18] Marmulla R,Hassfeld S,Lüth T,et al.Next generation’s navigation systems[J].Int Congr Ser,2003,1256(1256):467-471.
[19] Brief J,Edinger D,Hassfeld S,et al.Accuracy of image-guided imlantology[J].Clin Oral Implants Res,2005,16(4):495-501.
[20] Ewers R,Schicho K,Wanschitz F,et al.Basic research and 12 years of clinical experience in computer-assisted navigation technology:a review[J].Int J Oral Max Srug,2005,34(1):1-8.
[21] Nijmeh AD,Goodger NM,Hawkes D,et al.Image-guided navigation in oral and maxillofacial surgery[J].Brit J Oral Max Surg,2005,43(4):294-302.
[22] Westendonff C,Gülicher D,Dammann F,et al.Computer-assisted surgical treatment of orbitozygomatic fractures[J].J Craniofac Surg,2006,17(5):837-842.