交互式医学图像控制系统(MIMICS)在颌面部骨折手术中的应用研究

Application of Materialise's Interactive Medical Image Control System(MIMICS) in the Maxillo-facial Trauma Surgery

目的:探讨交互式医学图像控制系统在计算机辅助颌面部骨折手术中的应用价值。为陈旧性的创伤性颌面部不对称患者及严重骨折患者术前精确设计手术方案及达到术后良好效果提供可靠依据。方法:对18例拟进行颌面部骨折复位的创伤患者头面部三维CT断层扫描图像,识别确定重建对象,对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建模。根据颌面创伤外科医生制订的方案在模型中完成手术的模拟和骨折断端镜像重建,预测骨折断端的正常位置恢复颌面部的对称性。结果:完成了颌面骨组织的患者头面部三维重建模型。镜像模拟了颌骨骨折复位手术移动骨断端过程,预测骨折复位的正常解剖位置,并且以动态动画形式演示,可从任意角度进行观察。实现了颌面部创伤手术中骨折断端复位的正确指导,术后骨组织移位的可视化预测。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镜像模拟,可以动态形式完成颌面部骨折手术的模拟复位,尤其对陈旧性、多发性骨折的术前预测骨折断端的复位精度,并提高了骨折复位的准确度和精度。可在计算机屏幕前制定手术方案,进行手术医师术前手术评估和预测,提高了颌面部骨折手术的有效性、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. To offer a reliable system for precise surgical planning and good effect of maxillo-facial trauma surgery. Methods Based on CT images, geometric characteristics of 18 patients＇ head were collected for a 3D reconstruction of the human head. Skull, maxilla, mandibula and zygomatic bone were reconstructed and optimized separately by MIMICS 10.01. Surgeries were simulated and the reduction of the diviated bony deformation was predicted according to the surgical planning of experienced maxillo-facial trauma surgeon. Results Mesh of skull, maxilla, mandibula and zygomatic bone was constructed manually for 18 patients. Surgical procedures were simulated and the prediction of hard tissue deformation was realized by MIMICS, which could be visualized in any angle. Conclusion MIMICS is a helpful digital tool for computer aided trauma surgery and the prediction of fracture reduction. MIMICS is also a 3D visualization system for maxillo-facial trauma surgeries, by which surgeons could realize the surgical planning, revising, and pre-op plan making on the computer screen.