三维表面取模后转换成二维平面测量扩张皮肤面积

目的探求可靠实用的测量扩张皮肤面积的方法。方法先将三维表面上的扩张皮肤通过表面取模后,分剪成二维平面。通过扫描仪直接输入后,利用计算机处理累计其像素点,从而客观测量出扩张皮肤面积。同法测量扩张基底面积和缺损面积后,能确定扩张后额外皮肤面积是否能满足修复需要。结果经初步论证,其最大误差小于3%。结论这一技术可望在临床和动物实验研究中提供扩张皮肤面积测量的可靠指标。     

三维表面取模后转换成二维平面测量扩张皮肤面积

目的探求可靠实用的测量扩张皮肤面积的方法。方法先将三维表面上的扩张皮肤通过表面取模后，分剪成二维平面。通过扫描仪直接输入后，利用计算机处理累计其像素点，从而客观测量出扩张皮肤面积。同法测量扩张基底面积和缺损面积后，能确定扩张后额外皮肤面积是否能满足修复需要。结果经初步论证，其最大误差小于３％。结论这一技术可望在临床和动物实验研究中提供扩张皮肤面积测量的可靠指标。     

三维表面取模后转换成二维平面测量扩张皮肤面积

目的 探求可靠实用的测量扩张皮肤面积的方法。方法 先将三维表面上的扩张皮肤通过表面取模后，分剪成二维平面。通过扫描仪直接输入后，利用计算机处理累计其像素点，从 而客观预测出扩张皮肤面积。同法测量扩张基底面积和缺损面积后，能确定扩张后额外皮肤面积是否能满足修复需要。结果 经初步论证，其最大误差小于３％。结论 这一技术可望在临床和动物实验研究中提供扩张皮肤面积可靠指标。     

皮肤软组织扩张器注水量与扩张面积的关系

目的　通过测量皮肤软组织扩张器注水量与相应的扩张面积，初步探讨两者间的相互关系。方法　本组7例病人分别于面、肩、胸、臀部埋入7个不同容量的扩张器，将每次注水扩张后的皮肤三维表面取模后转换成二维平面，应用计算机图象处理软件测定每次注水量与相对应的扩张面积。结果　随扩张器内注水量的增加，其皮肤扩张面积也随之增加，但注水量达扩张器额定容积的130％～180％时，扩张面积即不再增加，趋向一个平台期。结论　扩张器注水扩张并非没有限制，最多达设计容量的130％～180％时，即使再增加注水量，也不会增加皮肤的扩张面积。     

图像分析技术辅助软组织扩张术的临床研究

目的探讨图像分析技术辅助皮肤软组织扩张术治疗增生性瘢痕的临床疗效。方法对48例增生性瘢痕患者随机分为对照组(23例)和观察组(25例)。对照组采用传统方法行软组织扩张术。观察组采用图像分析技术辅助软组织扩张术;一期置入扩张器前对瘢痕部位行三维激光扫描,并模拟切除瘢痕,计算缺损面积;二期术前行三维激光扫描测量扩张皮肤面积,确定能足够修复皮肤缺损时行二期手术。同时比较两组患者的注水时间、注水量、切口愈合时间、皮瓣成活率,以及术后6个月时切口瘢痕增生情况和患者的满意度。结果观察组与对照组相比,其注水时间、注水量及切口愈合时间减少,皮瓣的成活率增高(P0.05)。术后6个月,观察组切口瘢痕的增生率降低,患者的满意度提高(P0.05)。结论采用图像分析技术辅助皮肤软组织扩张术,可以为皮肤扩张程度及切除范围提供依据,从而改善增生性瘢痕的治疗效果,提高患者的满意度。     

皮肤扩张术计算机辅助测量与设计系统的研究与应用

目的：探索与评价计算机辅助三维形貌测量技术在皮肤扩张术方面的应用。方法：应用自行开发的皮肤扩张术计算机辅助三维形貌测量与设计系统,利用近景立体摄影技术对临床病例的扩张部位进行三维数据采集与处理,得到三维数字模型,并计算表面积等,与手工测量结果进行比较验证。利用该软件计算任意曲线长度和任意区域面积功能,辅助手术设计。结果：计算机测量结果误差小于5%,具有很高的精确性和可重复性;自1999年3月起在临床初步应用11例共16个扩张部位,效果较为满意。结论：该系统可为皮肤扩张术扩张皮瓣移转的时机选择、切口设计、结果预测等提供参考依据。     

计算机辅助技术在软组织扩张术中的临床应用

目的探讨三维激光扫描技术对人体不同部位扩张皮肤的表面积测量方法及通过注水量推算扩张面积,为临床选择扩张器的容量提供参考。方法对35例不同年龄段的患者分别进行头部、颈部、胸部及下肢扩张器置入前、后的数码摄像,术后1周进行注水前后三维激光扫描,测量扩张皮肤的表面积。手术分期进行:I期,根据瘢痕的大小及形状在邻位放置皮肤扩张器,术后每周定期注水,每次注水量为扩张器容量的10%,持续注水3个月;Ⅱ期,通过Geomagic Qualify 13.0检测软件对三维激光扫描结果进行扩张皮肤面积的测量,当皮肤扩张量达到要求后,取出扩张器,行扩张皮瓣转移修复瘢痕切除后创面。结果注水量与皮肤扩张面积呈正相关。皮肤软组织扩张表面积大小依次为:头顶面颊部颈部额部胸部,大腿外侧大腿内侧;扩张表面积与修复部位有关,每扩张1.0 cm×1.0 cm需要注水量为:头顶(3.30±0.56)ml、额部(9.10±3.12)ml、面颊部(6.70±1.15)ml、颈部(8.01±2.26)ml、胸部(10.02±1.47)ml、大腿内侧(7.31±2.52)rnl、大腿外侧(6.60±1.73)ml。结论对头顶、颈部、胸部及下肢瘢痕,采用扩张器置人行皮瓣扩张能较好地修复瘢痕切除后创面;扩张器内注水量与扩张表面积呈正相关;术前采用Angel色素分析软件及结合激光点云和逆向工程方法,为选择扩张器的大小、扩张皮瓣表面积及手术预构等方面提供临床指导。     

计算机在皮肤外扩张面积测算中的应用

应用皮肤外扩张器使皮肤扩张后,运用计算机图像测量技术,以实现对所得“额外”皮肤组织面积的精确测算,得到了较为满意的结果,并就其特点进行了讨论。认为计算机图像技术在整形外科中的应用有良好的前景。     

计算机在皮肤外扩张面积测算中的应用

应用皮肤外扩张器使皮肤扩张后，运用计算机图像测量技术，以实现对所得＂额外＂皮肤组织面积的精确测算，得到了较为满意的结果，并就其特点进行了讨论。认为计算机图像技术在整形外科中的应用有良好的前景。     

计算机在皮肤外扩张面积测算中的应用

应用皮肤外扩张器使皮肤扩张后，运用计算机图像测量技术，以实现对所得“额外”皮肤组织面积的精确测算，得到了较为满意的结果，并就其特点进行了讨论，认为计算机图像技术在整形外科中的应用有良好的前景。     

Novel Imaging Analysis System to Measure the Spatial Dimension of Engineered Tissue Construct

The measurement of the spatial dimensions of tissue‐engineered constructs is very important for their clinical applications. In this study, a novel method to measure the volume of tissue‐engineered constructs was developed using iterative mathematical computations. The method measures and analyzes three‐dimensional (3D) parameters of a construct to estimate its actual volume using a sequence of software‐based mathematical algorithms. The mathematical algorithm is composed of two stages: the shape extraction and the determination of volume. The shape extraction utilized 3D images of a construct: length, width, and thickness, captured by a high‐quality camera with charge coupled device. The surface of the 3D images was then divided into fine sections. The area of each section was measured and combined to obtain the total surface area. The 3D volume of the target construct was then mathematically obtained using its total surface area and thickness. The accuracy of the measurement method was verified by comparing the results with those obtained from the hydrostatic weighing method (Korea Research Institute of Standards and Science [KRISS], Korea). The mean difference in volume between two methods was 0.0313 ± 0.0003% (n = 5, P = 0.523) with no significant statistical difference. In conclusion, our image‐based spatial measurement system is a reliable and easy method to obtain an accurate 3D volume of a tissue‐engineered construct.     

应用计算机辅助测量乳房体积及其临床应用

目的 研究乳房体积准确的实际测量方法。方法 通过照片扫描或数字相机采取乳房正前位、正侧位和下侧位的轮廓图，使用专用测量软件或数学计算方法，测算21例共42例乳房体积。结果 提供的3种测量方法，其平均误差分别为4．9％、8．2％和9．3％，并且能测量轮廓图的形状和改变前后体积大小变化。结论 计算机辅助测量方法测量乳房体积准确可靠，临床上可用于选定乳房假体大小或乳房缩小切除的组织量等于辅助设计。     

Three-dimensional magnetic resonance imaging based on time-of-flight magnetic resonance angiography for superficial cerebral arteriovenous malformation--technical note

Direct surgery remains important for the treatment of superficial cerebral arteriovenous malformation (AVM). Surgical planning on the basis of careful analysis from various neuroimaging modalities can aid in resection of superficial AVM with favorable outcome. Three-dimensional (3D) magnetic resonance (MR) imaging reconstructed from time-of-flight (TOF) MR angiography was developed as an adjunctive tool for surgical planning of superficial AVM. 3-T TOF MR imaging without contrast medium was performed preoperatively in patients with superficial AVM. The images were imported into OsiriX imaging software and the 3D reconstructed MR image was produced using the volume rendering method. This 3D MR image could clearly visualize the surface angioarchitecture of the AVM with the surrounding brain on a single image, and clarified feeding arteries including draining veins and the relationship with sulci or fissures surrounding the nidus. 3D MR image of the whole AVM angioarchitecture was also displayed by skeletonization of the surrounding brain. Preoperative 3D MR image corresponded to the intraoperative view. Feeders on the brain surface were easily confirmed and obliterated during surgery, with the aid of the 3D MR images. 3D MR imaging for surgical planning of superficial AVM is simple and noninvasive to perform, enhances intraoperative orientation, and is helpful for successful resection.     

Automated measurement of fracture callus in radiographs using portable software

The development of software applications that assist the radiographic evaluation of fracture healing could advance clinical diagnosis and expedite the identification of effective treatment strategies. A radiographic feature regularly used as an outcome measure for basic and clinical fracture healing research is new bone growth, or fracture callus. In this study, we developed OrthoRead, a portable software application that uses image‐processing algorithms to detect and measure fracture callus in plain radiographs. OrthoRead utilizes an optimal boundary tracking algorithm to semi‐automatically segment the cortical surface, and a novel iterative thresholding selection algorithm to then automatically segment the fracture callus. The software was validated in three steps. First, algorithm accuracy and sensitivity were analyzed using surrogate models with known callus size. Second, the callus area of distal femur fractures measured using OrthoRead was compared to callus area manually outlined by orthopaedic surgeons. Third, the callus area of ovine tibial fractures was measured using OrthoRead and compared to callus volume measured from micro‐CT. The software had less than a 5% error in measuring surrogate callus, and was insensitive to changes in image resolution, image rotation, and the size of the analyzed region of interest. Strong positive correlations existed between OrthoRead and clinicians (R² = 0.98), and between 2D callus area and 3D callus volume (R² = 0.70). The average run time for OrthoRead was 3 s when using a 2.7 GHz processor. By being accurate, fast, and robust, OrthoRead can support prospective and retrospective clinical studies investigating implant efficacy, and can assist research on fracture healing mechanobiology. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1224–1233, 2016.     

Three-dimensional visualization of neurovascular relationships in the posterior fossa: technique and clinical application

OBJECT: The goal of this study was to describe the authors' technique for three-dimensional (3D) visualization of neurovascular relationships in the posterior fossa at the surface of the brainstem. This technique is based on the processing of high-resolution magnetic resonance (MR) imaging data. The principles and technical details involved in the accurate simultaneous visualization of vessels and cranial nerves as tiny structures are presented using explicit and implicit segmentation as well as volume rendering. METHODS: In this approach 3D MR constructive interference in steady state imaging data served as the source for image processing, which was performed using the Linux-based software tools SegMed for segmentation and Qvis for volume rendering. A sequence of filtering operations (including noise reduction and closing) and other software tools such as volume growing are used for a semiautomatic coarse segmentation. The subsequent 3D visualization in which implicit segmentation is used for the differentiation of cranial nerves, vessels, and brainstem is achieved by allocating opacity and color values and adjusting the related transfer functions. This method was applied to the presurgical evaluation in a consecutive series of 55 patients with neurovascular compression syndromes and the results were correlated to surgical findings. The potential for its use, further developments, and remaining problems are discussed. CONCLUSIONS: This method provides an excellent intraoperative real-time virtual view of difficult anatomical relationships.     

数字化骨科临床研究平台的构建及应用

目的 构建一组能在个人电脑(PC)上高速运行的三维可视化数字骨科临床研究平台系统.方法 2007年1月至2009年6月,收集三组资料,包括:自多层螺旋CT机图像工作站导出的300余例涉及骨创伤、关节、脊柱、骨肿瘤患者的薄层原始数据(DICOM格式);部分应用较为广泛的内置入物器械原型;20名健康志愿者(男10名,女10名;年龄21～30岁,平均24.5岁)的全身多层螺旋CT机扫描后的薄层原始数据.应用计算机及信息通讯领域的前沿技术,通过改进算法、改进人机交互方式、软硬件性能优化及相关逆向工程技术,创建一组能容纳海量数据及便于临床医牛广泛参与的数字化骨科临床研究平台软件包.结果 通过整合交叉学科前沿技术及大量的创新性工作,创建多功能数字化骨科临床研究平台,并将其命名为Superlmage系统.Superlmage系统能在目前丰流配置的PC上高速运行,自由编辑,兼容Windows XP/Vista、Unix及Linux等操作系统,数据读取支持主流品牌CT机导出的DICOM3.0标准数据,并实现了高精度的三维霞建成像;伪彩渲染的多平面重组成像;高速、便捷的三维图像交互式分割及编辑.SuperImage系统还附带一组信息丰富的数字化资料库,包括三维数字化骨骼、数字化内置人物虚拟模型器械库及患者数字化信息资料库,且支持数字化远程动态信息交互.结论 数字化骨科临床研究平台可满足临床医生的日常工作及科研需求,如精准的术前设计、术后随访、高败的数字化资料管理、远程信息交互、仿真的数字化虚拟教学及部分数字骨科解剖学研究等.     

Two- and three-dimensional optical coherence tomography to differentiate degenerative changes in a rat meniscectomy model

Optical coherence tomography (OCT) is an attractive tool for evaluating cartilage. We developed an OCT system that reconstructs and analyzes a three-dimensional (3D) OCT image by determining the cartilage surface and cartilage-bone boundary from the image taken with currently available OCT devices. We examined the usefulness of 3D renderings of OCT images. In a rat meniscectomized model, the tibia was harvested after 0, 2, 4, or 8 weeks (n = 6). We scanned 300 slices in the y-plane to cover a 4 × 3 × 6-mm section (x-plane; 10 µm × 400 pixels, y-plane; 10 µm × 300 pixels, z-plane; 12.66 µm × 500 pixels) of the medial tibial cartilage. The cartilage surface line and the cartilage-bone boundary were plotted semi-automatically. Slices from 300 two-dimensional (2D) sequential images were systematically and visually checked and corrected, as necessary. We set a region of interest in the cartilage and quantified the cartilage volume in the 3D image. The Osteoarthritis Research Society International (OARSI) histological score was also obtained. The cartilage volume determined using 3D OCT images was 0.291 ± 0.022 mm³ in the normal, 0.264 ± 0.009 mm³ at 2 weeks, 0.210 ± 0.012 mm³ at 4 weeks, and 0.205 ± 0.011 mm³ at 8 weeks. The cartilage volume significantly decreased at 4 and 8 weeks and was significantly correlated with the OARSI histological score (r = −0.674; P = .002). Although the 3D image information could be obtained from the 2D images, the 3D OCT images provided easier-to-understand information because the 3D reconstructed cartilage provided information about the smoothness of the surface, the area, and depth of the defect at a glance.     

Intraoperative three-dimensional reconstruction of power Doppler vascular images.

We have developed a simple method for reconstructing a three-dimensional (3D) image in the operating room from sequentially scanned intraoperative two-dimensional (2D) power Doppler images using a personal computer and commercially available software. During three operations, 2 for cerebral aneurysm and 1 for cerebral tumor, intracranial vessel images were digitally transferred to a personal computer by freehand scanning over the dura mater or surface of the brain with a 7.5-MHz linear probe. A series of 2D images were converted to a smaller file, and 3D image was reconstructed with volume-rendering software. It took about 15 minutes to reconstruct of the initial 3D image. In the cases of cerebral aneurysm, the vessels connected to the lesion or running nearby were easily identified on the image. In the tumor case, the anatomical relation between the vascular structures and the tumor was clear. This simple 3D reconstruction method provides spatial information about intracranial vascular structures that is useful in intraoperative surgical planning.     

鼻唇沟区域软组织的三维可视化重建

目的 通过获取鼻唇沟区域连续软组织切片图像,初步建立鼻唇沟区域软组织三维可视化模型.方法 将鼻唇沟区域软组织标本行连续切片,染色后用专业微距照相系统获取切片图像数据,进行三维重建及重建后可视化应用.结果 ①成功探索了大块软组织标本石蜡切片的制作方法;②组织学显示鼻唇沟内外侧纤维及脂肪含量、肌肉附着有明显差别;③重建出的鼻唇沟区域数字化模型有良好的展示特性,并可进行简单的可视化应用.结论 三维重建软件对大块软组织进行可视化应用是可行的.三维模型为临床解剖的学习和外科医师的手术模拟提供了良好的平台.     

基于三维重建和有限元分析的股骨头坏死围塌陷期保髋新技术的临床应用

目的对围塌陷期股骨头坏死进行三维重建和有限元分析定量研究,为确定保髋手术指征和优化保髋方案提供依据。方法首先基于患者的CT和MRI资料,运用Mimics软件进行三维重建和坏死区的形态学定量研究;接着建立股骨头坏死个体化三维有限元模型,运用ABAQUS软件进行量化的有限元分析和保髋手术规划。结果实现了坏死区的形态、位置、体积、体积百分比、负重区投影面积和面积百分比的三维可视化,进而运用正蛙位和失稳分型定性判断疾病的预后和治疗方案;在此基础上,运用个体化三维有限元模型模拟改良髓芯减压、打压植骨、腓骨支撑、空心加压螺钉内稳定的手术操作,通过von Mises Stress冯米斯应力、SSR（stress／strength ratio）应力／强度比值和SED（strain energy density）应变能密度等指标确定保髋手术指征和优化保髋方案。结论三维重建和有限元分析进一步从坏死区形态和生物力学方面进行定量研究,完善了股骨头坏死围塌陷期“微观辨证论治体系”体系,有助于进一步明确保髋手术指征,优化保髋方案,提高保髋疗效。