隨著台灣人口老化，髖部病例呈現上升趨勢，為改善醫療品質與落實醫病告知義務，本研究擬發展電腦輔助髖部醫病解說與術前規劃系統。現今醫學影像存取與傳輸系統(PACS)已成為臨床標準配備，雖然其中也有距離與角度量測工具，但臨床上醫師仍然需藉由定義參數評估股骨破裂程度。雖然CT與MRI可以提供三維影像判讀，但隨著健保限制，臨床上仍仰賴X光判讀。本研究著重於影像邊界擷取演算法開發與醫學參數自動計算開發，結合此兩項技術建構一具備有醫病解釋功能與X光術前規劃功能電腦系統，系統架構分為: (1)股骨傾幹角計算與評估(2)破裂股骨復位模擬(3)DHS植入模擬(4)病灶區域手動標示與量測(5)衛教資料，其中破裂股骨復位模擬與DHS植入模擬並佐以實際案例驗證本系統可行性，幫助臨床診斷與術前規劃。 The picture archiving and communication system (PACS) has become a standardized method of clinical practice in the modern age. Though there are many measuring and image-processing tool provided by PACS system, including distance and angles measurement, it is still inconvenient for the orthopedic surgeon to use the tool to measure the anatomic characteristics and to differentiate the disease category and stage classification. In this study, a computer aided explanation and pre-operative planning system was developed for improving the medical quality and patient-doctor relationship for the surgery of hip fracture. With X-ray images available, we developed computational algorithms for image contour segmentation and anatomic parameters evaluation on the hip joints. A prototype system was then proposed for patient-doctor relationship improvement and preoperative planning. The system primarily includes the following functions: (1) automatic neck shaft angle evaluation, (2) virtual reduction of femur bones, (3) DHS implant preoperative planning, (4) design of a tool for region marking, and (5) health education information. Two clinical cases were employed for demonstrating the feasibility of the entire process, especially on virtual femur bone reduction and DHS implant simulation. The proposed system has made a solid foundation as it can be expanded to help clinical diagnosis and preoperative planning of hip surgery.
