颅颌面整形外科立体可视化和手术仿真模拟系统的建立

The Establishment of Three-Dimensional Visualization,Quantitative Diagnosis/Simulation Computer-Assisted System for Craniomaxillofacial Surgery

目的为实现颅颌面畸形解剖学研究、诊断分析、手术设计、疗效预测及颅颌面生长发育监测的计算机化、定量化、规范化 .方法应用MicrosoftVisualC++高级编程语言和计算机图形图像三维可视化算法原理 ,开发研制出颅颌面CT图像三维重建、立体结构三维测量和颅颌面整形手术模拟的系统软件 .建立了以CT数据为信息源基于多媒体微型计算机的颅颌面整形外科立体可视化、手术仿真模拟和疗效评价系统 (3DCMFCAS)及相关技术方法 .结果在 3DCMFCAS系统上构建出正常和畸形颅颌面立体结构模型 ,成功进行了颅颌面外科截骨整复手术仿真模拟 ,所创立的三维测量方法项目全面、操作简捷、准确可靠 .3DCMCAS系统的建立为颅颌面畸形基础研究和临床诊断治疗提供了实用有效的技术手段和全新的科学方法 .为整形手术立体定向导航和虚拟现实技术研究奠定了基础 .

Objective In order to achieve the computerization.visualization,standardization and quantitatization of diagnosis,surgical planning and surgical result assessing in craniomaxillofacial plastic surgery,we developed the integrated software package written by Visual C ++ language and set up the computer-assisted three-dimensional visualization,quantitative diagnosis and simulation system for craniomaxillofacial surgery (3DCMFCAS) by using volume data visualizing algorithm and multimedia microcomputer.Methods:Through many experiments on different methods of 3-D reconstruction and comparisons,the surface rendering method that suitable for craniomaxillofacial palastic surgery was chosen as the 3-D model reconstruction method,and a new volume data manipulating method—spacial subregion volume data manipulation was put forward as the operation simulation method that could be operated speedily in microcomputer environment.Results The 3DCMFCAS system include several functional,Modules:CT image inputting module,registering and format converting module,three-dimensional measurement and analysis module,quantitative simulation module,as well as archive of patients.By means of the 3DCMFCAS system and related methods,the life-like three-dimensional model of craniofacial anatomic structures and malformations were reconstructed for qualitative observation and quantitative analysis.The craniomaxillofacial osteotomy procedures were successfully simulated on the 3DCMFCAS system platform.The three-dimensional measuring method created by us possesses features of accurate,precise,easy-operating.The analysis of accuracy of 3-D measurement showed that the average relative error of 11 indices ranged between 0.16%±0.04% and 3.92%± 1.58 %.The coefficients of repeatability of 3-D measurements ranged between 0.409% and 1.365%.Conclusions The clinical application of 3DCMFCAS system indicates that the computerized system provide update instrumentality and practical,effective methods for fundamental research,diagnosis and surgical therapy of craniomaxillofacial malformations.The establishment of the 3DCMFCAS system and related methods provide a basis on which the operation stereotactic navigation and virtual reality technology will be progressively developed.