椎體成形術之塌陷椎體復位模擬與分析

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姓名

林宏哲(Hung-che Lin) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

椎體成形術之塌陷椎體復位模擬與分析

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摘要(中)

椎體成形術中，通常只使用兩張X光影像醫師診斷及進行術前規劃，但由於脊椎的幾何結構複雜，上述資料無法提供醫師足夠的資訊。在術中，為了補強脊椎的結構強度，必須將骨水泥打入脊椎中進行加強，但其作業上必須一直拍攝多張C-Arm來觀看目前骨水泥的灌注情形，導致醫療人員的輻射量大增。為了讓醫師在術前對於骨水泥灌注量有一個大致上的掌握，本研究發展自動塌陷椎體復位技術，其概念為使病患塌陷之椎體經由變形技術復原成破損前的樣子，最後利用變形前後之體積差異提供給醫師作為骨水泥灌注量之參考，本椎體自動復位技術重點包含：(1)病患本身三維椎體模型重建輸入，(2)自動尋找塌陷椎體的表面位置，(3)自動尋找塌陷椎體於變形復位後的表面位置，(4)保留椎體原有特徵之限制，藉此完成椎體復位變形。本研究藉由數個模擬塌陷椎體模型驗證自動塌陷椎體復位技術之可靠度，並以實際病患案例進行變形復位，針對體積變化的合理性進行探討與分析，說明本研究提出之方法的可行性。

摘要(英)

In vertebroplasty surgery, the surgeons usually use two pieces of X-ray images for diagnosis and surgical planning. Because of the complicated geometry in spine, such information is usually not rich enough for decision making. During surgery, the surgeons inject bone cement into the center of the collapsed spinal vertebra to stabilize and strengthen the crushed bone. It is necessary for the surgeons to take plenty of C-arm images to realize the real time position and orientation of the tools as well as the cement. The increasing radiation exposure for this kind of surgery will probably bring the surgeons some diseases in the future. To assist the surgeons knowing the volume of the bone cement injected, this research intends to develop an auto-reduction of subsided vertebral. The idea is to deform collapsed vertebra into its normal shape, and then to use the volume difference as a bone cement perfusion reference. The proposed auto-reduction technique mainly contains the following features : (1)input patient 3D vertebral model, (2)compute the surface of vertebral body, (3)evaluate the objective surface of the deformed vertebral body, and (4)retain the origin al feature of the vertebra. In this study, several examples, including artificial models and real patient models, are employed to demonstrate the feasibility of the proposed method.

關鍵字(中)

★ 椎體成形術
★ 塌陷椎體復位
★ 骨水泥體積
★ 三維模型變形

關鍵字(英)

★ vertebroplasty
★ collapsed spinal vertebra reduction
★ bone cement volume
★ 3D model deformation

論文目次

摘要 I
Abstract II
致謝 III
目錄 IV
圖目錄 VI
表目錄 IX
第一章緒論 1
1.1前言 1
1.2研究背景 2
1.3研究目的與方法 3
1.3.1研究目的 3
1.3.2研究方法 8
1.4 論文架構 11
第二章文獻回顧 12
2.1.1脊椎結構 12
2.1.2骨質疏鬆所導致的椎體骨折 14
2.2三維模型變形演算法 16
2.2.1自由變形技術(Free-form Deformation) 16
2.2.2骨架驅動的變形技術(Skeleton-driven Deformation) 17
2.2.3基於模型特徵的變形技術(Feature-based Deformation) 17
2.3模型變形最佳化解法 20
2.3.1線性變形能量函數的最佳化計算 20
2.3.2非線性變形能量函數的最佳化計算 22
第三章塌陷椎體變形復位方法 23
3.1前言 23
3.2塌陷椎體表面繪製 23
3.3欲變形後椎體表面繪製 25
3.4.1變形模擬-Laplacian限制 29
3.4.2變形模擬-稀疏矩陣與最佳化求解 32
3.5椎體變形改良-自動變形 33
3.5.1自動化變形-計算椎體表面 35
3.5.2自動化變形-計算塌陷椎體變形後表面位置 37
3.6模型變形後之虛擬X光校正 40
第四章自動椎體變形復位驗證與範例討論 44
4.1前言 44
4.2椎體自動變形復位之可靠度驗證 44
4.3病患案例 52
4.3.1病患案例-Biconcave與Wedge複合型骨折探討 60
4.4變形椎體-骨髓針穿刺應用 63
第五章結論與未來展望 68
5.1結論 68
5.2未來展望 69
參考文獻 70

參考文獻

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指導教授

賴景義

審核日期

2013-7-9

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