股骨头坏死区三维数字化模型建立及体积估算
wf(2016)
Abstract
背景:髓芯减压联合自体骨移植被广泛应用于修复早期股骨头缺血性坏死,研究者报道采用该项手术治疗成功率差别较大,其原因可能在于穿刺定位不准确以及反复穿刺造成二次损伤有关。目的:通过Mimics软件重建股骨头坏死三维模型,立体再现坏死区病灶,实现对股骨头坏死区域的测量和体积估算。方法:应用多层螺旋CT Syngommvvp VE23A工作站,联合Inspace软件和NeuroDSA软件进行影像重组,将DICOM格式的髋关节CT数据导入Mimics 13.0软件系统,利用Mimics SimuIation计算机软件三维重建股骨头坏死区域,真实再现股骨头的完整形态、坏死区的范围以及坏死区域的立体结构,实现对股骨头坏死区域的测量和体积估算。设计最佳髓芯减压通道,模拟髓芯减压手术,使术者在术中可参照最佳的模拟减压路径实施髓芯减压手术。结果与结论:①36例48髋股骨头缺血性坏死患者中Ⅰ期8髋,占17%;Ⅱ期28髋,占58%;Ⅲ期12髋,占25%;②Ⅰ期股骨头坏死区的体积为(1475.48±647.34) mm3,Ⅱ期为(4571.77±2344.55) mm3,Ⅲ期为(4836.46±2969.33) mm3;③以坏死区域球体的半径为参数在Mimics SimuIation计算机软件模块中模拟髓芯减压术,完全剜除坏死区病灶;④通过Mimics软件模拟髓芯减压,可以使术者在术前更清楚的了解坏死灶信息及空间的立体结构,于Mimics三维视图上虚拟精准髓芯减压路径,为进一步实现实体手术提供理论基础。
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