交互式医学图像控制系统在正颌外科手术中的应用

Application of Materialise＇s interactive medical image control system in orthognathic surgery

目的 探讨交互式医学图像控制系统（MIMICS）在计算机辅助手术中的应用价值，为术前进行精确设计手术方案及达到术后良好效果提供真实可靠依据。方法 对2例正颌外科手术患者的头面部三维CT断层扫描图像，进行识别确定重建对象，对皮肤、皮下组织及骨组织采用灰度阈值法进行自动重建；采用MIMICS软件对获取的医学信息进行分层网格划分，完成建模。根据资深正颁外科医师制订的方案，在模型中完成手术的模拟和软组织形变的预测。结果 完成了包含皮肤、皮下组织和骨组织的患者头面部三维网格模型。模拟了正颌外科手术移动骨质过程，并且以动态动画形式演示，可从任意角度进行观察。实现了正颌外科手术术后软组织形变的可视化预测。结论 利用医学影像资料，采用MIMICS软件可实现人头面部复杂结构的三维重建和分层网格划分，以动态形式完成正颌外科手术的模拟和软组织形变预测。在计算机屏幕前制订手术方案进行医患交流，共同协商，提高了正颌外科手术安全性、精确性和矫治效果。

Objective To evaluate the value of Materialise＇s interactive medical image control system （MIMICS） in the computer aided surgery, and to offer a reliable system for precise surgical planning and good effect of orthognathic surgery. Methods Based on CT images, geometric characteristics of 2 patients＇head were collected for a 3D reconstruction of the human head. Skull, skin, and submucous tissue were reconstructed and optimized separately by MIMICS 10.01. Surgeries were simulated and the soft tissue deformation was predicted according to the surgical planning of experienced surgeons. Results Mesh of skull, skin and submucous tissue were constructed manually for 2 patients. Surgical procedures were simulated and the prediction of soft tissue deformation was realized by MIMICS, which could be visualized in any angle. Conclusion MIMICS is a helpful digital tool for computer aided surgery and the prediction of soft tissue deformation. MIMICS is also a 3D visualization system for orthognathic surgeries, by which surgeons could realize the surgical planning, revising, and the patient-doctor communication on the computer screen.