Three-dimensional reconstruction based on DICOM data and its application for orthopedic implants

doi:10.3969/j.issn.2095-4344.2017.07.012

Abstract

Abstract:

BACKGROUND: The output of computed tomography (CT) is Digital Imaging and Communications in Medicine (DICOM), whereas the input of three-dimensional (3D) printing is an object Standard Template Library model represented by a triangular mesh. The process of data handing and forrmat conversion are keys to the combination of these two techniques.

OBJECTIVE: To explore how to convert CT data into a stereoscopic 3D model efficiently.

METHODS: The DICOM in Medicine format data of the patients with femoral fractures were edited and produced by Mimics. We made a 3D model by adjusting the parameters of the 3D printer slicing software, and discussed the significance of 3D model in medical field, especially orthopedics.

RESULTS AND CONCLUSION: Mimics software is the bridge to connect two-dimensional CT scan images and 3D images, to create a 3D model by editing the data of DICOM which comes from the CT scanner, with a 3D printing technology. The 3D Model can help doctors for routine clinical diagnosis and treatment, to improve the communication between doctors and patients and the quality of clinical medical teaching. 3D printing also makes medicine more personalized, remote, minimally invasive, and promote the development of medicine to the direction of digital medicine.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Tissue Engineering, Fractures, Bone, Computer-Aided Design

CLC Number:

R318

Li Jing, Yang Long, Wang Jian-ji, Liu Qin, Zou Qiang, Sun Yu, Ma Min-xian, Ye Chuan. Three-dimensional reconstruction based on DICOM data and its application for orthopedic implants[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(7): 1046-1051.

Figures/Tables 1

2.1 DICOM文件的处理利用Mimics软件可将各种二维的扫描数据(CT，MRI图像)导入到软件中，经过数据阈值的选择、三维图像的生成及三维图像后处理可精确重建三维数字模型，并以通用的计算机辅助设计(Computer Aided Design，CAD)、标准模板库(Standard Template Library，STL)、快速成型(Rapid Proto-typing，RP)、有限元分析(Finite Element Analysis，FEA)等数据进行输出，在个人计算机上可进行大规模的数据转换处理。DICOM数据导入是Mimics模型建造的第一步(图1A)，Mimics软件会自动定义前(Anterior)、后(Posterior)、左(Left)、右(Right)4个方向，手动定义图像的上(Top)和下(Bottom)2个方向。通过Draw Profile Line来对DICOM数据进行编辑(图1B)，并利用Calculate将选择好阈值的DICOM数据模型生成为三维数据模型(图1C)，但由于DICOM数据阈值选择偏差及患者自身骨质结构的差异至断层扫描图像自身的模糊而造成骨干部具有较多孔洞，需要对模型进行更深层次的处理，计算后的三维模型经过掩码编辑(EditMask)命令能够有效填充骨干中的孔洞样结构，由于这些孔洞并不是骨干本身具有的，因此经过编辑的三维图像并不会影响后期的计算。通过编辑后的得到的数字模型边界清晰，可平移、缩放、平面任意切割、角度任意旋转，清楚、直接地再现组织器官的三维立体结构。在Mimics软件中处理DICOM最后的一项是软件对三维图像进行光滑(Smoothing)的过程(图1D)，可以使模型粗糙的表面变得光滑，填充内部存在的肉眼难以识别的的微小孔洞使模型后期能够在3D打印切片软件中成功生成Gcode，减少模型尖刺和突起的出现。在这个参数下会保证实验中的模型不失真，模型表面光滑，经过光滑后的模型去掉了由于CT扫描机所产生的的噪声而使模型表面粗糙的问题。 2.2 3D打印的调试通过调节3D打印机切片软件中的Extruder Temperature、Plate Temperature、infill、 Feedrate/Travel Speed、Layer Height、supporter、Shells等将STL文件制作3D打印机可识别的Gecod文件(图2)，表1为各项参数的意义及对后续模型打印的影响。实验中在经过8 h打印后，可获得经患者二维的DIOCM数据制作的与患者病变部位大小、形状相符的1∶1模型(图3B)，1∶1三维立体模型能够真实、直观地再现骨折部位的实际情况(图3A)，支持并指导临床医生进行手术，使骨折复位达到或接近达到解剖复位(图3C)。"

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