應用於股骨轉子間骨折回復手術之C-arm based 手術導引系統

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姓名

楊遠祥(Yuan-Hsiang Yung) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

應用於股骨轉子間骨折回復手術之C-arm based 手術導引系統
(C-arm based surgical navigation system applied for reduction of intertrochanteric fracture)

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摘要(中)

近年來C-arm已成為骨科手術中最常被使用的工具之一。但是由於C-arm有限的視野以及二維影像的限制，使得醫生在為了得知器械與骨骼之空間關係的同時，必須拍攝大量的C-arm影像，造成承受高輻射劑量的風險。在股骨轉子間骨折回復手術中，最關鍵的步驟即為將Guide Pin從股骨外側以正確的方位鑽入股骨頭，此過程往往需要大量的C-arm影像進行確認。為改善C-arm使用上之缺點及立體定位的限制，本研究發展一套以C-arm影像為主的骨科手術導引系統，通過光學式定位裝置所提供之空間資訊以及模擬C-arm的投影成像過程，本系統能在手術中提供器械與骨骼的空間關係，並即時顯示在電腦螢幕上，以協助醫生能更準確進行鑽孔及後續置放植入物的動作。
本研究利用光學式定位裝置追蹤骨骼、器械與C-arm的空間關係，並將校正器裝設於C-arm接收端，通過其上的附加標記計算X光之有效發射源，以修正諸如重力等因素所造成的投影誤差，並建構X光投影模式。通過全域性法(Global Method)校正C-arm影像之針墊變形與S-shape扭曲變形，並利用投影幾何原理，以球體模擬股骨頭，在術中提供醫生器械鑽入深度之導引資訊。
本研究所發展之系統已進行過系統整體精度驗證之實驗，其定位精度為1.07±0.33mm、方向精度為1.92±1.28°，鑽入深度導引之平均誤差為0.61±0.27mm。

關鍵字(中)

★ C-arm
★ 手術導引系統
★ 影像扭正

關鍵字(英)

★ C-arm
★ Surgical navigation system
★ image dewarp

論文目次

摘要 I
目錄 II
圖目錄 IV
表目錄 VII
表目錄 VII
第一章序論 1
1-1 研究動機 1
1-2 文獻回顧 2
1-3 研究方法簡介 3
1-4 論文架構 6
第二章系統架構 7
2-1 硬體架構 7
2-1-1 光學式定位裝置 8
2-1-2 校正器 11
2-1-3 手術器械 11
2-2 軟體介紹 15
2-3 系統操作流程 15
第三章 C-arm影像校正與立體定位 22
3-1 座標系統定義 22
3-2 建立座標系統轉換關係 24
3-3 手術鑽頭座標系統及校正器座標系統對正 27
3-3-1 手術鑽頭座標系統對正 27
3-3-2 校正器座標系統對正 29
3-4 附加標記自動辨識 30
3-4-1 偵測影像圓形邊界 31
3-4-2 影像對比強化 32
3-4-3 辨識鋼珠位置 33
3-4-4 去除雜訊 35
3-5 影像扭曲與校正 36
3-6 建構投影模式 41
3-7 計算股骨頭近似球之球心與半徑 44
3-7-1 反投影計算股骨頭近似球之球心 45
3-7-2 計算股骨頭近似球半徑 48
第四章實驗結果與討論 51
4-1 影像扭正實驗 51
4-2 器械鑽入深度導引實驗 54
4-3 系統整體精度實驗 56
4-4 誤差分析 60
4-4-1 光學式定位裝置誤差 60
4-4-2 校正器座標系統誤差 60
4-4-3 附加標記偵測誤差 62
4-4-4 影像扭正誤差 62
4-4-5 有效發射源計算誤差 62
4-4-6 人為操作誤差 63
第五章結論 65
參考文獻 67

參考文獻

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指導教授

曾清秀(Ching-Shiow Tseng)

審核日期

2005-7-27

推文