基于CT扫描数据的鼻腔鼻窦三维模拟手术的研究

目的 研究基于CT扫描数据的鼻窦、颈内动脉、眶壁及病变组织三维(3D)重建模型指导鼻内镜手术的可行性及实用性.资料与方法 采集11例住院患者的鼻窦CT薄层扫描图像,利用自主研发的三维重建软件FitMe DICOM viewer对所采集数据进行图像分割和三维可视化重建,并评估重建质量及对手术的应用价值.结果 选择CT薄层扫描图像数据进行分割和重建,分割后的图像边界清晰、完整,数据无丢失.重建的结构清晰、连续,可以真实反映鼻窦、颈内动脉、眶壁及病变组织结构的实际情况,为术者提供符合空间想象的图像,以指导鼻内镜手术.结论 利用FitMe DICOM viewer软件对二维CT图像进行分割,方法简单实用,分割效果理想,重建后的3D模型三维效果逼真,立体感强,既能够显示鼻腔内部各结构的情况,又能准确反映鼻窦及病变组织与周围各结构的空间位置关系,为临床和教学奠定了基础.

Three-dimensional Reconstruction and Virtual Surgery of Nasal Cavity and Paranasal Sinuses Based on CT Scanning Data

Purpose To investigate the feasibility of three-dimensional (3D) reconstruction of nasal cavity and paranasal sinuses based on CT data for guiding endoscopic sinus surgery. Materials and Methods The data of thin slice CT scan of paranasal sinuses were transferred to 3D visualization workstation based on a set of FitMe DICOM viewer software for image segmentation and 3D reconstruction. The scoring time for structures in 3D and 2D imaging among different people were compared. Results The post-segmentation images were clear and complete, and the model of reconstruction was continuous with real time structure display. After adjusting the transparency of the 3D images, the overlapping structure could be seen. Additionally, the anatomic landmarks could be measured by the software. The model provided spatial imagination to guide endoscopic sinus surgery. Conclusion Image segmentation and 3D reconstruction based on CT data in the FitMe DICOM viewer software is simple and practical. The nasal cavity and paranasal sinuses 3D model is stereoscopic. The nasal cavity and the surrounding structures can be displayed.