New aspects of breast volume measurement using 3-dimensional surface imaging

Precise and objective calculation of breast volume is helpful to evaluate the aesthetic result of breast surgery, but traditional methods are unsatisfactory. Three-dimensional (3D) scanning of the body surface allows reproducible and objective assessment of the complex breast region but requires further investigation before clinical application. The main goal of this study was to investigate the precision and accuracy of breast volume measurement using 3D body scanning. Five independent observers standardized the 3D scanning method using 2 dummy models (n = 200) and examined its applicability with 6 test subjects and 10 clinical patients (n = 2220). Breast volume measurements obtained with the 3D-scanner technology were compared with reference measurements obtained from test subjects through nuclear magnetic resonance imaging. The mean deviation of the breast volume measurements of 1 test subject by all observers, expressed as percentage of volume, was 2.86 +/- 0.98, significantly higher than the deviation for the dummy models, 1.65 +/- 0.42 (P < 0.001). With respect to all clinical patients, the mean measurement precision obtained preoperatively was less precise than that obtained postoperatively (3.31 +/- 1.02 versus 1.66 +/- 0.49, respectively). Interobserver differences in measurement precision were not statistically significant. The mean breast volumes obtained by nuclear magnetic resonance imaging (441.42 +/- 137.05 mL) and 3D scanning (452.51 +/- 141.88 mL) significantly correlated (r = 0.995, P < 0.001). Breast volume measurement with 3D surface imaging represents a sufficiently precise and accurate method to guarantee objective and exact recording.     

Objective breast symmetry evaluation using 3-D surface imaging

This study develops an objective breast symmetry evaluation using 3-D surface imaging (Konica-Minolta V910^® scanner) by superimposing the mirrored left breast over the right and objectively determining the mean 3-D contour difference between the 2 breast surfaces. 3 observers analyzed the evaluation protocol precision using 2 dummy models (n = 60), 10 test subjects (n = 300), clinically tested it on 30 patients (n = 900) and compared it to established 2-D measurements on 23 breast reconstructive patients using the BCCT.core software (n = 690). Mean 3-D evaluation precision, expressed as the coefficient of variation (VC), was 3.54 ± 0.18 for all human subjects without significant intra- and inter-observer differences (p > 0.05). The 3-D breast symmetry evaluation is observer independent, significantly more precise (p < 0.001) than the BCCT.core software (VC = 6.92 ± 0.88) and may play a part in an objective surgical outcome analysis after incorporation into clinical practice.     

Accuracy and repeatability of bladder volume measurement using ultrasonic imaging

We assessed 6 methods for calculating bladder volume from ultrasonic cross-sectional scans. The technique that used the largest number of features from the scans gave the best results. For volumes greater than 150 ml. an accuracy of 0.87 and repeatability of +/- 9 per cent (standard deviation) were obtained.     

Validation of quantification of breast implant capsule surface area and volume using magnetic resonance imaging.

Capsular contracture has been among the most frequent and frustrating complications of augmentation and reconstructive mammoplasty with silicone breast implants. Experimental evaluation of methods designed to modify the capsule has been limited by the lack of an effective method for quantification of contracture. It has been suggested that measurement of capsule surface area would be the most direct way to quantify capsular contracture. A method using magnetic resonance imaging for calculation of implant surface area is demonstrated; validation of this method using silicone phantoms with geometrically known surface areas is presented. The surface areas of two implants were also measured in a human subject; this represents the first reported measurement of an implant capsule surface area in vivo. Calculation of surface area according to the tiling method appears to be valid, whereas the circumference method consistently underestimates capsule surface area. Although clinical correlation has not been proved, it is hoped that further experimental studies of capsular contracture will incorporate this quantitative method.     

乳房体积测量方法的进展

<正>乳房是女性重要的第二性征,拥有一个形态完美的乳房可以提高女性的自信。随着整形美容事业的兴起,隆乳术也成为整形科常见手术。为了便于术前和术后效果的比较,预计填充乳房组织容量,如何进行直观且有理论说服力的测量,人们尝试了多种乳房体积测量的方法,现综述如下。     

女性乳房体积测量的研究现状

乳房体积的测量可以较准确地估算现有的乳房体积以及需增减的体积,以指导术前设计,减少盲目性,增加科学性和准确性。乳房体积测量在临床工作中主要用于五个方面：①正常人群的乳房体积调查;②确定隆乳术所需假体的容积;③乳房缩小术后对称性的评估;     

Diagnostic and interventional imaging techniques in breast cancer

Imaging plays a critical role in the diagnosis and management of breast cancer. Two-view mammography and ultrasound form the mainstay of breast imaging and are essential components of the triple assessment. Digital mammography is rapidly replacing analogue mammography, and recent advances such as digital tomosynthesis add a third dimension to conventional 2D mammographic images. The versatility of ultrasound allows assessment of the breast and axilla as well as accurately targeted interventions, from the simple diagnostic core biopsy to preoperative tumour localization. It also guides large volume biopsies and excision of certain benign lesions, which in some cases can obviate surgical excision. Newer ultrasound techniques being applied to the breast and axilla include elastography and the use of intradermal microbubbles to guide the radiologist to the sentinel axillary node. Breast MRI is a powerful modality in assessing breast cancer. It can provide accurate information on size and multifocality of lesions, particularly those that are mammographically challenging such as lobular cancers, and it is also used to assess response to neoadjuvant chemotherapy and guide surgical management. CT scans, and in selected cases Positron Emission Tomography, play important roles in the assessment of metastatic disease.     

扩张皮肤三维图像及面积、体积测量软件的开发和应用

目的 介绍用于测量扩张皮肤面积和体积,并形成三维图像的专用软件。方法 通过输入扩张皮肤的基底面、正中横截面和纵截面作为基本参数,扩张皮肤表面的其它部位三维坐标经过图形平滑过渡（插值计算）获得。软件是用Ｃ语言编制,运行在Ｗｉｎｄｏｗｓ下。结果据此测量面积和体积并形成三维图像。经初步验证其最大误差小于４％。结论 结合以往的三维表面转换成平面测量扩张面积的方法,该软件为测量扩张皮肤提供了一种可行的方法     

Evolution of 3D surface imaging systems in facial plastic surgery

Recent advancements in computer technologies have propelled the development of?3D imaging systems. 3D surface-imaging is taking surgeons to a new level of communication with patients; moreover, it provides quick and standardized image documentation. This article recounts the chronologic evolution of 3D surface imaging, and summarizes the current status of today's facial surface capturing technology. This article also discusses current 3D surface imaging hardware and software, and their different techniques, technologies, and scientific validation, which provides surgeons with the background information necessary for evaluating the systems and knowledge about the systems they might incorporate into their own practice.     

Comparison of pre- and postoperative orbital volume using three dimensional CT imaging in zygoma fracture patients

The aims of this study were (1) to assess the difference between the volume of the traumatized and non-traumatized orbit, (2) to determine the critical change in orbital volume that will result in enophthalmos, and (3) to analyze the correlation between volume discrepancy and clinical outcome in maxillofacial trauma patients. Twenty-seven surgically managed patients with a fracture of the orbitozygomatic complex were included in this study. Preoperative and postoperative volume measurements of both orbits were compared, using software whose accuracy was confirmed in a preliminary experimental study in dry skulls. The correlation between volume discrepancy and clinical enophthalmos was statistically assessed before and after surgery. Preoperatively, there was an increase in orbital volume in 26 of 27 cases, with a range of 0.04–6.02 cc compared with the intact orbits. The mean volume difference between the orbits was 3.01±1.64 cm³ in the preoperative period, and this decreased to 1.02±1.29 cm³ following operation (P<0.01). Five patients (19%) showed clinical enophthalmos with a mean volume difference of 4.77±0.18 cm³ preoperatively. Clinical enophthalmos persisted postoperatively in only one of five enophthalmic patients, in whom the volume discrepancy was greater than 4 cm³. Our data suggested that the technique described here is an easy and accurate method of assessing the volume of the orbit. Orbital volume measurement may help the surgeon to predict volume to be restored and to avoid probable complications. Received: 15 March 2000 / Accepted: 2 August 2000     

Comparison of the single breath and volume recruitment techniques in the measurement of total respiratory compliance in anesthetized infants and children

Total respiratory compliance (Crs) has not previously been measured from the static pressure-volume (P-V) curve during spontaneous breathing in anesthesized infants and children. A single breath test and a volume recruitment maneuver for measuring Crs were applied to 18 infants and children breathing spontaneously during halothane anesthesia in order to determine the usefulness and reliability of these noninvasive tests for measuring static compliance during anesthesia. Crs from the single breath test (Crssb) was determined from the mask pressure plateau (P) during a brief end-inspiratory airway occlusion and the lung volume (V) from the passive expiration following release of the occlusion. Crs from the volume recruitment maneuver (Crsvr) was determined from P and V during a series of expiratory occlusions at progressively higher lung volumes. The P-V curves fit a polynomial curve with the convexity toward the pressure axis in most patients, and Crsvr was the tangent to the curve in the mid-tidal range. The tallest four patients did not show respiratory muscle relaxation during the occlusions with either test, and the single breath test could not be completed in an additional two patients. In the 12 patients (59-89 cm in height) in whom both tests were successful, Crssb correlated with, and was similar to, Crsvr. The intrasubject coefficient of variation was less with the single breath test (9.4 +/- 6.7%) than with the volume recruitment maneuver (15.0 +/- 7.1%). The authors conclude that both tests are simple, reliable, and rapid and give similar results for Crs in spontaneously breathing children (59-89 cm in height) anesthetized with halothane.     

2D与3D增强T2*加权血管成像序列在肝脏应用的比较

目的 评估正常志愿者肝脏二维(2D)和三维(3D)增强T2^*加权血管成像(ESWAN)序列的R2^*值稳定性以及幅度图、相位图图像质量.方法 对17名健康志愿者前瞻行上腹部双回波T1W、脂肪抑制T2W、2D ESWAN及3D ESWAN序列扫描,并平均间隔20.76天进行第2次扫描.由2名观察者分别使用包全肝右叶下段和在肝右叶下段放置3个ROI求均值的两种方法测量两ESWAN序列的R2^*值,并对幅度图、相位图图像质量进行评分.采用组内相关系数(ICC)检验观察者间R2^*值测量的一致性.结果 2名观察者对2D和3D ESWAN序列R2^*值测量一致性良好(ICC值> 0.95).两种方法测量的2D和3D ESWAN R2^*值间无差异(P均 >0.05,ICC均 >0.98).两次扫描2D ESWAN的R2^*值和3D ESWAN的R2^*值差异均无统计学意义(P=1.00、0.97).2名观察者对两序列幅度图和相位图的评分一致性很好(Kappa值均 >0.75),2D、3D ESWAN幅度图及相位图评分差异均无统计学意义(P均> 0.05).结论 采用2D和3D ESWAN序列均能得到稳定的肝脏R2^*值和高质量的幅度图、相位图,但3D ESWAN适用于诊断肝脏弥漫性病变;2D ESWAN更适用于诊断肝脏局限性病变.     

乳房体积生物立体测量系统的研制

目的　利用立体视觉方法建立乳房体积测量系统 ,并探讨其准确性和精确程度。方法　通过采用两台CCD摄相机从两个不同视角观察乳房模型 ,运用激光投射仪和光栅获得计算机能识别的平行采样点 ,依靠计算机图像处理技术和生物立体测量技术 ,求取乳房模型表面采样点的三维坐标 ,设计乳房体积测量运算模式 ,在Windows下编制程序 ,建立乳房体积测量和分析系统 ,应用所建的测量系统和水体积置换术分别对 12例乳房模型进行体积测量 ,并将两种测量方法及其结果进行比较和统计分析 ,观察其精确性和准确性。结果　本系统测量乳房体积实现了数据的快速处理 ,测试空间范围为12 0mm× 14 0mm× 80mm ,特点是快速、非接触性和非侵入性。与水体积置换方法比较 ,P =0 .4 73>0 .0 5 ,差值的 95 %可信区间为 - 14 .0 2～ 7.0 8ml。结论　本系统可应用于乳房体积测量 ,简捷而且精确 ,为临床工作提供了一种有效手段 ,并为软组织形态分析的开展提供了一种新的理论基础。     

乳房体积测量器在乳房整形中的应用

目的使两侧体积不等的乳房在行乳房整形术后获得对称、满意的效果.方法使用自制的乳房体积测量器,应用计算乳房标准体积的方法,对隆乳和缩乳的患者进行测量并计算,从而选择不同容积的置入假体和切除不同体积的乳房组织.结果本组32例患者,经过3个月至2年的随访,其中有2例单侧隆乳患者因原乳腺组织局部缺损,术后外形欠佳,其余患者术后两侧乳房的体积基本对称,效果较为理想.结论术前只有较准确地测量出乳房体积,计算出既符合美学要求又能满足患者愿望的乳房体积,并选择适当容积的隆乳假体或切除适当体积的乳房组织,才能保证术后两侧乳房体积的对称,使手术效果更加理想.