| 摘要: | 傳統的腦部手術，醫師只能憑藉著術前影像(CT, MRI, CTA, DSA)、腦部解剖學專業和臨床經驗，規劃合適的手術路徑；手術過程中，如果不甚傷害了腦動脈，輕則造成顱內出血，重則造成病人嚴重的後遺症甚至死亡；本研究將結合CT影像輔助手術導航系統、血管分割系統與混合實境(MR, Mixed Reality)系統以即時3D視覺化方式將患部投影在病患上，提供患部、病患與手術器械空間位置資訊，幫助醫師術前精確規劃可避開腦動脈的安全手術路徑，並於術中精準定位。本研究重點分為兩部分，血管影像分割與混合實境部分。
血管分割部分，將電腦斷層腦血管影像(CTA, Computed Tomography Angiography)經過2D影像前處理與影像辨識，完成血管2D影像分割後作三維重建，將重建完成的血管與動脈瘤3D model提供醫師作精準規劃。重建血管結果顯示，解剖學特徵重要部分 如
circle of Willis 、 Cerebral Artery 、 Cerebral Vein 與顱內動脈瘤 皆有建構出 協助醫師依據
血管特徵做出安全手術的路徑規劃； 另 由模擬3D血管重建結果顯示血管直徑幾何最大誤差約為1 pixel，表示血管分割、重建結果失真程度低。
混合實境部分，經導航系統完成血管瘤、病人與MR眼鏡影像特徵板(marker)註冊(registration)後，最終藉由MR眼鏡即時顯示動脈瘤、病人和手術器械畫面，輔助醫師做更直觀規劃安全手術路徑、3D手術導航以及降低腦部手術腦動脈損傷的風險。又經MR 眼鏡相機量測 marker 空間方位精準度實驗 顯示，NDI與camera量測marker 的位移總誤差平均絕對值與角度總誤差平均絕對值為5.25mm 與 7.8°;CTA(Computed Tomography
Ang iography) image performs 2D image preprocessing and image recognition. After finishing
2D image segmentation, the system using processed image to do 3D reconstruction. It will
provide doctor vessel and surgical target 3D model to help doctor p recisely plan surgical path.
The reconstruction result show s brain anatomy important part, for example , Circle Of Willis,
Cerebral Artery, Cerebral Vein and A neurysm . Above parts have been reconstructed. It will
help doctor plan safe surgical path depending on vessel f eature. In addition, the simulation of
3D reconstruction experiment result shows that m aximum value of g eometric error of vessel
diameter is under 1 pixel. It means vessel image segmentation and 3D reconstruction result
close to reality.
MR system part, by using brain surgical navigation system, after finishing registration of
A neurysm , patient and feature board (called marker) of MR glasses, it will timely show
A neurysm , vessel on patient displayed by MR glasses. It support doctor more i ntuitively plan
s afe surgical path, 3D surgical navigation and low down risk of s urgical accident of damaged
cerebral artery. In addition, the MR glasses measure marker spacing error experiment shows
of NDI and camera measuring marker s position and angular total average a bsolute value is
5.25mm and 7.8° |
