中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (22): 4172-4175.doi: 10.3969/j.issn.1673-8225.2010.22.045

• 数字化骨科 digital orthopedics • 上一篇    下一篇

计算机辅助设计和快速成型技术制造颜面萎缩衬垫物的可能性

龚振宇1，李国华1，刘彦普2，何黎升2，周树夏2   

  1. 1解放军南京军区福州总医院口腔科，福建省福州市  350025；2解放军第四军医大学口腔医学院颌面外科，陕西省西安市  710032
  • 出版日期:2010-05-28 发布日期:2010-05-28
  • 作者简介:龚振宇☆，男，1973年生，黑龙江省齐齐哈尔市人，汉族，2004年解放军第四军医大学毕业，博士，副主任医师，主要从事口腔颌面部整复研究。
  • 基金资助:

    福建省科技厅青年人才创新基金资助项目(2008F3089)及福建省科技厅青年人才创新基金资助项目(2008 F3088)。

Computer-assisted design and rapid prototyping technology for the underlay of hemifacial atrophy

Gong Zhen-yu1, Li Guo-hua1, Liu Yan-pu2, He Li-sheng2, Zhou Shu-xia2   

  1. 1 Department of Stomotology, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA, Fuzhou   350025, Fujian Province, China; 2 Department of Oral and Maxilafacial Surgery, Stomotological College, the Fourth Military Medical University of Chinese PLA, Xi’an   710032, Shaanxi Province, China
  • Online:2010-05-28 Published:2010-05-28
  • About author:Gong Zhen-yu☆, Doctor, Associate chief physician, Department of Stomotology, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA, Fuzhou 350025, Fujian Province, China zhenyu_gong@yahoo.com.cn
  • Supported by:

    Youth Talent Innovation Fund of Fujian Provincial Science and Technology Ministry, No. 2008F3089*, 2008F3088*

PDF

368

被引次数

2

摘要：

背景：半侧颜面萎缩畸形的整复方法较多，以往常通过制备患者的石膏面模，在上面堆蜡来恢复患者的面形，蜡型用作手术中衬垫的参考。但由于畸形的变化多，矫治设计的难度大，矫治效果不甚理想。
目的：探讨应用计算机辅助设计和快速成型技术制造用于矫正半侧颜面萎缩等凹陷畸形衬垫物的可能性。
方法：对半侧颜面萎缩患者行螺旋CT扫描，利用工作站进行扫描图像的容积三维重建后，重新间隔分层，利用CuteFTP 4.0软件以BMP格式下载。应用课题组自主开发的CT图像处理软件对已下载的二维图像进行过滤、筛减、降噪、校正失真等处理，对图像的边缘轮廓进行提取，得到面颅骨皮质骨边缘轮廓的矢量化线图，将该线图数据输入Surfacer 9.0重建软件，对轮廓曲线进行矢量叠加，从而得到面颅骨的三维三角形面片线框模型及实体模型。将健侧面颅骨的点云数据按镜像对称变换到患侧，这样在患侧骨和健侧镜像之间就形成了充填物的三维模型，为补偿软组织的萎缩，将其外表面点云数据外移1.5 mm。对CAD后的三维Surfacer数据重新分层,在RpDataRepare中完成充填物的轮廓编辑和成型的支撑设置，形成RP项目文件，输出快速原型所需的加工文件.par，制造出衬垫物模板，作为实施手术过程中的参照。
结果与结论：获得了患者颅面骨表面轮廓的三维实体模型，并由计算机辅助设计，快速成型制造出衬垫物模板，并以此为参照完成手术，效果满意。说明应用快速成型技术可以完成半侧颜面萎缩等凹陷畸形的衬垫物的制造，精度高，快捷，在颅颌面外科假体的个体化制造方面有良好的应用前景。

关键词: 体层摄影术, 计算机辅助, 图像处理, 半侧颜面萎缩, 快速成型, 数字化医学

Abstract:

BACKGROUND: There are many methods for repairing the hemifacial atrophy, the most common is preparing plaster facial mold of the patient, with wax piled on the surface to restore the patient's facial shape, and wax pattern serves as a reference of surgical pad. However, the therapeutic effect for the correction and treatment is not satisfactory due to varied abnormality and difficult plans.
OBJECTIVE: To discuss the feasibility of manufacturing underlay for the treatment of hemifacial atrophy using computer-assisted design and rapid prototyping technology.
METHODS: Skull of the hemifacial atrophy patient was scanned with Picker 6000 SCT, and the data obtained were processed in Voxel Q image workstation for 3-D reconstruction with volume rendering technique. After the interval lamination, the images were downloaded at 0.4-mm interval in a BMP format using CuteFTP 4.0 software. Then the transaxial 2-D image data were converted into digitized 2-D contour data by using image processing software developed by experimental team through a series of processes, including filtering, screening, noise reduction, and distortion correction. The edges and contour of the images was extracted to obtain a vector diagram of facial cranial cortical bone contour line. The digitized data were inputted into image processing software of Surfacer 9.0 for vector superposing, thus the 3­D wire frame and solid images of skull could be reconstructed. According to mirror-image symmetry relation, the point-cloud data of facial bone on the normal side was duplicated to the atrophied side. Thus a 3-D model of the underlay was produced between the atrophied bone and the mirror image of normal side. In order to compensate the atrophy of soft tissues, the model was designed 1.5 mm thicker. After the three-dimensional Surfacer data on the CAD were re-stratified, the contour editing of the underlay and the supporting set of prototype were completed in RpDataRepare, forming RP files and creating underlay template through rapidly output of the processing file for rapid prototyping required, as a reference of surgical procedures.
RESULTS AND CONCLUSION: The 3­D solid model of the patient skull bone surface contour was obtained and simulacrum of the underlay was prepared with computer assistance and rapid prototyping. According to the simulacrum, the operation was carried out and got a satisfactory result. The manufacture of underlay for the treatment of hemifacial atrophy could be accomplished by computer assisted design and rapid prototyping in a highly precise and rapid manner. It is a promising technique in the field of individualized underlay making in craniofacial surgery.

中图分类号: