应用计算机辅助投射条纹测试技术测量乳房的三维形貌

目的研究应用计算机辅助投射条纹测试技术(computer-aided projecting fringe measure-ment,CAPFM)测量乳房三维形貌。方法基于CAPFM基本原理和软件编程技术研制乳房三维形貌测量系统,采用该系统测量塑料人体模特乳房三维形貌,并与直尺法和体积置换测量法(volume replaced measurement,VRM)相比较。结果研究表明应用该系统测量乳房具有以下优点:⑴非接触性三维测量,测量准确度与直尺法和VRM法无明显差别;⑵测量速度快,采集数据仅需0.5s,测量总耗时约2~3min;⑶自动化程度高,测量过程基本由计算机软件控制;⑷线性项目测量灵敏度达0.6mm,体积达1ml,可以完全满足临床需要。结论应用CAPFM测量乳房三维形貌的方法,具备临床应用可行性和先进性。     

乳房快速测量系统的研制

目的：研制及验证一套快速简便、准确实用的乳房基本数据测量系统，并为后续研究奠定基础。方法：使用数码相机按照技术要求采集乳房模型正侧位片，以Microsoft Visual C^＋＋6．0语言开发该系统专用软件，测量乳头间距、乳房基底宽度等项目，并与常规的尺测法相比较。结果：该系统能快速简便地完成乳房绝大部分基本尺寸的测量，且测量结果与常规的尺测法相比较，两者的准确度无明显差别。结论：该系统在进行乳房形态的研究、辅助乳房整形的诊断和治疗上是准确实用的。     

计算机辅助设计乳房三维重建及体积测量系统的研制

目的应用CAD技术开发建立乳房三维重建及乳房体积测量的系统软件，指导临床乳房癌术后一期乳房再造的术前设计。方法收集2006年1月至2007年12月间的16例乳腺MRI检查的影像学资料．数据以医学数字成像和通信标准文件格式刻输出。应用VTK、ITK、FLTK等C^＋＋6．0程序软件编程技术进行乳房三维重建及体积测量。结果（1）开发建立了乳房再造计算机辅助设计系统；（2）通过计算机编程进行乳房边界的界定，完成了乳房三维重建：（3）在重建乳房三维立体图像的基础上，通过计算各层面及其厚度和体积，再将各层体积叠加计算出乳房体积。结论应用CAD系统三维重建乳房，具有双侧对称度高，美观、逼真的优点；应用CAD系统测量乳房体积技术精确度高，测算速度快；CAD系统乳房三维重建及乳房体积测量软件有助于乳房一期再造的术前设计。     

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。     

单个牙磨耗量计算机三维测量对比研究

目的：通过自行开发研制的计算机三维辅助测量方法与传统牙刷机磨耗测量方法比较，对牙磨耗量的计算机三维测量系统进行评价。方法：用牙刷机进行模拟牙磨耗，用传统称重法，通过电子天平测试件的重量变化，失水法计算测试材料的密度，换算成体积。同时用计算机辅助三维测量系统计算体积丧失量，对实验结果比较分析。结果：三维计算机辅助测量所得的体积丧失量与传统的称重法测得的丧失量相近，两者间无统计学差异(P＞O．05)。结论：自行开发研制的计算机三维辅助测量法可以较精确、快速地实现牙磨耗量的测定。     

微笑特征计算机测量分析系统的研制和开发

目的：开发实用性强、重复性好的微笑特征计算机测量分析系统，为正畸临床及相关研究提供有效工具。方法：利用数码照相机采集患者休息位及微笑位的正面像；在Windows 2000 Professional环境下应用Microsoft Visual C^ 6．0语言开发系统；使用该系统对患者正面像进行定点测量，其中休息位有10个标志点，微笑位有21个标志点，可得到29项微笑特征指标。结果：该系统具有良好的重测性并具有以下特点：测量数据准确；测量项目丰富；使用方便快捷；数据处理功能完善；兼容性较好。结论：该系统可为正畸临床病例诊断、矫治计划制定及疗效评价提供指导，同时也是相关科学研究的有效工具。     

CT数据三维重建测量乳房体积在乳房整形中的应用

目的探讨应用三维重建技术测量乳房体积和乳房假体体积,及其在乳房整形中的应用前景。方法由CT影像扫描系统获得患者胸部的基本CT数据（层厚3mm）,将CT的二维数据导入计算机,应用MINICS软件及MagicRP软件对59例胸廓或乳房不对称患者进行乳房体积差测量及乳房假体体积测量．根据测量结果为患者选择体积适当的假体。术后测量患者双侧乳房各种径线,并评价其术后效果。结果59例患者术后双侧乳房基本对称,乳房形态理想,取得了满意的效果。结论本方法测量乳房体积准确可靠,在测量乳房和乳房假体体积方面具有实际的应用价值。     

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。     

应用三维扫描技术测量分析假体隆乳术后乳房形态变化的研究

目的 应用三维扫描技术准确客观地测量并分析隆乳术后乳房三维形态的变化。方法 双侧隆乳者18例（36只乳房）,均为圆形硅凝胶假体,采用胸肌下平面置入。假体体积平均为232．2ml,高度平均为3．46cm,其中低突型12只（h〈3．0cm）,中突型16只（3．0≤h＜4．0cm）,高突型8只（h≥4．0cm）。应用三维扫描仪采集术前及手术后1个月后的乳房三维图像,并用Geomagicl0．0软件测量乳房体积、突度、对称性等参数。结果 获得隆乳前后36只乳房的体积、突度等参数。术后乳房增加的体积与假体体积基本相当（P〉0．05）,乳房突度的增加值小于假体高度,术后乳房突度比预期突度（术前突度＋假体高度）减少12．9％,其中低型、中突型、高突型分别为5．2％、15．1％、20．2％。结论 三维扫描技术能在临床上简便、快捷、准确、非接触性地测量乳房的三维形态,为术前设计及术后评估提供科学性的指导,是理想的乳房形态测量工具。     

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。     

Breast volume measurement in 125 Chinese young women

The author carried out measurement of breast volume and the body surface anatomy in 125 unmarried young women. Through the measurement and analysis, the author came to the following conclusions: 1. The characteristics of body build of Chinese young women are: a. The mean height: 159.00 cm-160.00 cm; The mean weight: 50.40 kg-60.00 kg; The standard weight: height minus 110. b. The mean chest circumference difference, 2.0 cm. c. The mean distance from nipple to the supra-sternal notch is 19.05 cm, that of between nipples 20.0 cm, forming a equilateral triangle. d. The average breast volume, 310-330 ml; The standard breast volume, 250-350 ml; if the body weight is over the standard, the breast volume increases by 20 ml every 1.0 kg in body weight. e. The standard breast forward projection: 3.0 cm-4.0 cm. 2. Variables of the breast volume are: a. The breast volume is positively correlated with weight, chest circumference, waist circumference and buttock circumference, but negatively with height. b. The breast volume is closely related to difference between the chest circumference across the nipple and that across the horizontal line just under the armpits. The correlative equation can be approximately represented as V = 250 + 50 x D + 20 x OW (D = difference OW = overweight). c. The nipple position is not dependent on the height, but varies with the breast volume, that is, the nipple position lowers 1.0 cm with every increase of 300 ml in the breast volume. 3. The breast volume calculating table is derived from the radius and forward projection of breasts.(ABSTRACT TRUNCATED AT 250 WORDS)     

Familial Severe Gigantomastia and Reduction with the Free Nipple Graft Vertical Mammoplasty Technique: Report of Two Cases

Background. Gigantomastia, characterized by massive breast enlargement during adolescence or pregnancy, is thought to be caused by an abnormal and excessive end organ response to a normal hormonal milieu. The amputation technique with the free nipple–areola graft is the mainstay for severe macromastia, but it has been criticized because it results in a flattened, nonaesthetic breast with poor projection. This report presents two sisters with unusual, excessive breast enlargement. Methods. The measured distance from the sternal notch to the nipple was 50 cm for the first case and 55 cm for the second case. The free nipple graft transplantation based on the vertical mammoplasty technique was used, and an average of 4,200 g of breast tissue per breast was removed. To increase breast projection, superior dermoglandular flaps were used Results. The follow-up period was 24 months. The patients had long-lasting, pronounced breast mound projection, and the level of satisfaction for both cases was very high.Conclusion The ideal geometric structure of the breast is rather conical, and the authors believe that reshaping the breast tissue in a vertical plane using the vertical mammoplasty technique may be more effective in the long term and may provide better projection.     

Superior Pedicle Mammaplasty without Parenchymal Incisions after Massive Weight Loss

Background: After considerable weight loss, the breast suffers significant deformation. The ptotic breast is characterized by a lack of superior pole, tissue excess in the inferior pole, down-migration of nipple-areola complex (NAC) with redundancy of skin tissue. The authors describe a mastopexy technique based on a modulated and progressive reshaping, back rotation, and suspension of mammary gland parenchyma without parenchymal incisions. Methods: Forty-five patients with bilateral moderate or severe breast ptosis underwent mastopexy from January 2011 to January 2014 with complete detachment of breast from the pectoralis major muscle and the plication of parenchyma without any parenchymal incision. Patients were followed up for one year, reporting any complication, and measuring the jugulum–NAC distance. The outcomes were assessed by the patients as well as the surgical team. Results: The aesthetic outcomes were good or excellent in all patients. The new mammary contour and the distance between the jugular fossa and the nipple were stable during this time with a good filling of upper pole. No major complications were reported. Conclusions: This technique gave good breast shape, long-term projection, and upper pole fullness, without parenchymal incisions. It restores breast shape and projection, especially in post-bariatric patients. A similar technique has not been described yet.     

Immediate nipple reconstruction with thoracodorsal artery perforator flap in breast reconstruction by latissimus dorsi myocutaneous flap in patients with Poland's syndrome

Loss of long‐term projection is the major disadvantage of nipple reconstruction using local flaps. We report a technique of immediate perforator flap nipple reconstruction in breast reconstruction by latissimus dorsi (LD) myocutaneous flap in patients with Poland's syndrome. From March 2007 to July 2012, 12 female patients (age range, 15–21 years) underwent breast reconstructions and immediate nipple reconstructions. A thoracodorsal artery perforator (TAP) flap was simultaneously raised on the LD muscle flap and folded by itself to form the nipple. Both the LD flap and TAP flaps survived postoperatively. The nipple projection was measured by a caliper, and the average loss was 29% by the 1‐year follow‐up. Eleven patients considered the aesthetic appearance of reconstructed breast and nipple to be very good or good. The immediate nipple reconstruction with TAP flap could be safely performed and results in considerable satisfaction in breast reconstruction by LD myocutaneous flap in patients with Poland's syndrome. © 2015 Wiley Periodicals, Inc. Microsurgery 36:49–53, 2016.     

Triple-V flap: nipple reconstruction using a modified C-V flap technique for long-lasting improvement of projection

Background

Reconstruction of the nipple–areola complex is the last procedure in breast reconstruction after mastectomy. Various techniques have been described, but the creation of a long-lasting projection represents a challenge in plastic surgery causing frequent nipple projection loss.

Methods

From December 2008 and September 2010, we performed 43 nipple reconstructions using our new technique named “triple-V flap.” This procedure is similar to C-V flap but uses a further V limb area that is de-epithelialized and provides significant support to the new nipple. Clinical assessment was performed with a caliper measuring nipple projection at 1, 6, and 12 months after the surgical procedure.

Results

We evaluated the triple-V nipple reconstruction technique in 43 patients. Reconstructed nipple projection ranged between 3.3 and 6.4 mm (mean 4.8 mm). Mean decrease in nipple projection was 0.2 mm at 1 month, 1.4 mm at 6 months, and 1.6 mm at 1 year. After 1 year, mean nipple projection decrease was 34 %.

Conclusions

Our triple-V technique allows the maintenance of long-lasting projection of the reconstructed nipple at 12 months after surgery. Ease and speed of execution made our technique usable in all patients who need to complete the breast reconstruction process. Level of Evidence: Level IV, therapeutic study.     

Long-term follow-up of a modified Anton-Hartrampf nipple reconstruction

This study was performed to determine the degree of shrinkage over time in nipple projection after reconstruction. Nipple-areolar reconstruction was performed using the modified Anton-Hartrampf technique, and pigmentation was achieved with tattooing. This study looked at 28 consecutive patients with nipple reconstruction performed at The Milton S. Hershey Medical Center of the Penn State Geisinger Health Systems between September 1989 and November 1993. Two patients were lost to follow-up and 3 patients died of breast cancer. Thus, 23 patients and a total of 32 nipples were investigated. Initial measurements of nipple projection were taken 2 weeks postoperatively. Patients were followed an average of 38.7 months (range, 11-66 months). Ten patients (18 nipples) had tissue expansion and implantation for breast mound reconstruction. Thirteen patients (14 nipples) had autologous breast mound reconstruction. The mean decrease in projection of the tissue expansion and implantation group was 76.7+/-9.7%. The mean decrease in projection of the autologous reconstruction group was 64.3+/-12.1%. The mean decrease in projection for the entire group was 71.3+/-21.9%. Comparison between the two groups using a two-sample t-test showed p = 0.0047. The authors concluded that there is a significant reduction in nipple projection over time using the modified Anton-Hartrampf technique regardless of the type of breast mound reconstruction. In addition, their results also indicated that nipple projection on the breast mound reconstructed with an autologous musculocutaneous flap technique achieved a better long-term outcome. This study is potentially helpful in planning the initial size of the reconstructed nipple papule to match the opposite normal nipple. Additional studies need to be performed on other types of nipple-areolar reconstruction.     

国人隆乳术前后乳房相关参数的变化

为了掌握隆乳术后乳房及相关部位体表参数的变化规律，借以为手术设计提供依据，预测术后效果，指导临床工作。通过对受术者进行术前、术后乳房及相关部位体表测量，应用ＧＲＡＦＴＯＯＬ软件对数据进行分析，获得标准体形及身高与胸围的关系曲线和隆乳术前后经乳头胸围标准参数的变化数值。结果发现，我国（尤其是南方）隆乳受术者，乳房及胸廓的发育状况与标准体形相差甚大。矮身材者通过隆乳术，其胸围可达到美学标准，而高身材者由于受自身条件的限制及审美观点的差异，其胸围难以达到美学标准。