電腦輔助下顎骨切割與重建手術規劃

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莊曜瑋(Yao-Wei Zhuang) 查詢紙本館藏

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機械工程學系

論文名稱

電腦輔助下顎骨切割與重建手術規劃
(Computer-assisted planning of the mandible reconstructive surgery)

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摘要(中)

隨著電腦科技的快速發展及電腦斷層掃描的普及，電腦輔助手術
規劃系統受到廣泛的重視。下顎骨對於人體顏面的外觀與機能都相當
重要，當為了治療而切除部分區段時，必須重建下顎骨以恢復原有功
能，但是在手術中，因缺乏事先的流程細節規劃，導致產生不定因素
影響手術進行。為此本研究著重於下顎骨切割與重建手術，經理解手
術流程並分析醫師所需的輔助資訊，建構一以三維影像操作為基礎的
電腦輔助下顎骨手術規劃系統。
為達成電腦輔助規劃下顎骨手術流程的目標，將系統架構分為：
(1)三維影像顯示，(2)三維模型建構，(3)切除範圍設定，(4)腓骨切割
模擬，(5)重建骨板設計。本研究擬達成協助醫師在術前先行規劃切
除範圍，再以此設定模擬切除結果，進行重建手術的腓骨切割規劃，
以及固定重建區域的重建骨板設計，並且輸出於實際手術中可應用之
輔具。

摘要(英)

Due to the rapid development of three-dimensional medical images,
computer-aided surgery planning has been received extensive attention in
many kinds of surgery. Mandible is one of the important organs in human
body as it can affect facial appearance and mastication. When part of the
mandible must be removed for treatment, it has to be reconstructed for
restoring its original function. But, significant uncertainty usually exists
in preoperative planning because of the lack of effective computer aided
system for preoperative planning. For this reason, the purpose of this
study is to develop a computer aided preoperative system for the
reconstruction of the mandible. By understanding the operative process
and analyzing what kind of auxiliary information needed, we develop a
three-dimensional image-based auxiliary mandible surgery planning
system, which is mainly divided into the following five features: (1)
three-dimensional image display, (2) 3D model construction, (3) cutting
range setting, (4) simulation of fibula cutting and (5) reconstruction plate
design. It can assist doctors to determine the range of the mandible that
should be cut. It can also help doctors to plan the segments of fibula used
for fill in the part removed. Finally, several designs are output to a rapid
prototyping machine for the manufacturing of the jigs in mandible
reconstruction surgery.

關鍵字(中)

★ 骨板設計
★ 重建規劃
★ 電腦輔助
★ 下顎骨手術

關鍵字(英)

★ reconstruction plate designing
★ reconstruction planning
★ computer-aided
★ mandible surgery

論文目次

摘要............................................................................................................. I
Abstract ......................................................................................................II
誌謝...........................................................................................................III
目錄.......................................................................................................... IV
圖目錄...................................................................................................... VI
表目錄........................................................................................................X
第一章緒論...............................................................................................1
1.1 前言...............................................................................................1
1.2 文獻回顧.......................................................................................2
1.3 研究目的與方法.........................................................................10
1.3.1 研究目的...........................................................................10
1.3.2 研究方法...........................................................................11
1.4 論文架構.....................................................................................13
第二章下顎骨三維模型建構 ................................................................14
2.1 前言.............................................................................................14
2.2 立體渲染三維影像顯示............................................................15
2.3 區域自動分離與顯示.................................................................15
2.4 三角網格模型建構......................................................................18
2.5 下顎骨三維模型建構與應用....................................................20
第三章下顎骨切除範圍設定與分析 ....................................................27
3.1 前言.............................................................................................27
3.2 基準面設定.................................................................................27
3.3 腫瘤區域設定.............................................................................29
3.4 切除區域設定.............................................................................32
3.5 缺損區域量測分析.....................................................................40
3.6 完整下顎骨切除範圍設定範例................................................42
第四章下顎骨重建輔助規劃 ................................................................51
4.1 前言.............................................................................................51
4.2 腓骨重建下顎骨外形.................................................................52
4.2.1 下顎骨輪廓設定...............................................................56
4.2.2 腓骨切割方式設計...........................................................56
4.2.3 輔助資訊輸出...................................................................62
4.3 骨板設計.....................................................................................62
4.3.1 基本元件...........................................................................65
4.3.2 骨板放置曲線設定...........................................................68
4.3.3 基本元件放置與連結.......................................................72
4.3.4 應用輸出...........................................................................79
4.4 實際範例.....................................................................................79
第五章結論與未來展望 ........................................................................85
5.1 結論.............................................................................................85
5.2 未來展望.....................................................................................86
參考文獻...................................................................................................88

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指導教授

賴景義(Jiing-yih Lai)

審核日期

2010-8-2

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