基于CTA的在体女性盆腔静脉血管网数字化三维模型构建的方法及意义

目的:探讨利用CTA原始数据集构建在体女性盆腔静脉血管网数字化三维模型的方法及意义。方法:基于双源CTA技术,获取1例宫颈癌患者的Dicom 3.0原始二维断层图像数据集。利用Mimics 10.01软件分别对骨盆、盆腔动脉血管网以及盆腔静脉血管网进行三维重建并配准融合。结果:构建的盆腔静脉血管网数字化三维模型可以清楚地显示下腔静脉、髂总静脉、髂外静脉、髂内静脉及其初级属支,以及双侧卵巢静脉等。与重建的骨盆、盆腔动脉血管网配准融合后,各支静脉血管的解剖走形及引流区域变得更加清晰明确。结论:基于CTA的计算机三维重建技术是一种研究女性盆腔静脉血管网的好方法,具有较大的运用价值。     

男性尿道直肠瘘数字化三维重建的初步应用

目的：基于CT扫描图象建立精确的男性尿道直肠瘘数字化模型,探讨其在临床诊断及治疗中的应用。方法：选择1例男性尿道直肠瘘病例,进行尿道CT连续断层扫描,扫描结果导入Mimics软件中进行三维重建,利用三维重建模型指导临床。结果：建立男性尿道直肠瘘及周围结构的三维立体模型,可以方便地从任意角度和方向观察瘘管情况,测量有关的数据;还可以在数字化模型上进行手术设计。结论：男性尿道直肠瘘的数字化三维模型能够更直观、准确地反映病变部位的三维立体结构。对男性尿道直肠瘘的诊断、手术规划等有较大帮助。     

女性尿道阴道瘘数字化三维重建在临床治疗中的初步应用

目的:基于CT扫描图象建立精确的女性尿道阴道瘘数字化模型,探讨其在临床诊断及治疗中的应用。方法:选择1例女性尿道阴道瘘病例,进行尿道CT连续断层扫描,扫描结果导入Mimics软件中进行三维重建,利用三维重建模型指导临床。结果:建立女性尿道阴道瘘及周围结构的三维立体模型,可以方便地从任意角度和方向观察瘘管情况,测量有关的数据;还可以在数字化模型上进行手术设计。结论:女性尿道阴道瘘的数字化三维模型能够更直观、准确地反映病变部位的三维立体结构。对女性尿道阴道瘘的诊断、手术规划等有较大帮助。     

高分辨MSCT薄层重组在常规胸部体检中的应用

目的：探讨多排螺旋CT（MSCT）高分辨薄层重组对体检中肺部疾病的诊断价值,以及MSCT薄层重组与常规CT扫描图像质量及诊断准确率对照。方法：搜集做64排常规CT扫描同时行薄层重组的2473例体检病例中筛选的97例患者进行回顾性分析。结果：97例患者在常规CT扫描中有80例可以显示病变,而在MSCT薄层重组中97例均有阳性发现;其中双肺弥漫性病变79例（两肺间质纤维化78例,肺内多发转移瘤1例）,肺结核3例,肺内孤立结节12例,早期中央型肺癌1例,先天性支气管闭锁1例以及纵隔肿瘤1例;MSCT薄层重组图像可清晰显示肺内小叶间隔线增厚、弥漫分布的囊性病变、肺内结节的细微征象。结论：MSCT薄层重组在胸部体检中的诊断阳性率、细节分辨率、图像质量及确诊率均优于常规CT,可作为肺内病变尤其是早期肺癌筛查方法之首选。     

上颌第一前磨牙三维模型的建立与研究

目的：建立上颌第一前磨牙三维模型,以辅助牙体解剖学数字化教学和指导临床根管治疗术。方法：对人离体上颌第一前磨牙通过ConebeamCT扫描,获得DICOM格式影像,将获得的影像定位后利用Mimicsl0．0三维重建软件采集牙釉质、牙本质及髓腔的点数据,然后将采集到的点数据导入到MagicslO．0软件进行面网格化,将网格化后的图像标本进行光滑处理后保存,再次利用MimicslO．0三维重建软件进行数据处理,最终获得清晰的牙体及根管系统三维立体图像。结果：准确的建立了包含牙釉质、牙本质、牙髓腔的三维立体模型。结论：本实验方法建立的上颌第一前磨牙的三维模型,具有极高的真实性和精确性,对辅助教学、指导临床根管治疗都具有重要意义。为牙体解剖教学和口腔临床应用提供了一种简捷而精确的建模方法。     

构建基于患者个体化的Stanford B型主动脉夹层计算流体力学数值模拟分析模型（英文）

目的：探索简便、高效、精确的构建基于真实人体解剖形态结构的Stanford B型主动脉夹层计算流体力学数值模拟分析模型的方法。方法：利用Siemens Sensation Cardiac64层螺旋CT薄层扫描技术,基于1mm层厚获取6例Stanford B型主动脉夹层连续断层DICOM格式图像,导入Materialise MIMICS v12.11软件,界定目标区域后生成三维动脉模型,经网格优化处理去除低质量及相交面网格,保存结果输出,导入TGrid5.0软件,对主动脉面网格模型进行几何修复,使面网格扭曲率〈0.75,采用自由分网方式生成Stanford B型主动脉夹层计算流体力学分析体网格模型,并对所构建模型进行血流属性、流场边界等界定,初步验证模型的有效性。结果：通过初步计算求解,确定所构建的6例Stanford B型主动脉夹层计算流体力学分析模型分别包含1857030,1820501,1844181,1849651,1858246及1814914个四面体单元。结论：利用64层螺旋CT薄层扫描技术获取DICOM格式连续断层CT图像可快速、准确地构建Stanford B型主动脉夹层计算流体力学数值模拟分析模型,为进一步的计算流体力学分析奠定了良好的基础。     

高分辨MSCT 薄层重组在常规胸部体检中的应用

目的:探讨多排螺旋CT(MSCT)高分辨薄层重组对体检中肺部疾病的诊断价值,以及MSCT薄层重组与常规CT扫描图像质量及诊断准确率对照。方法:搜集做64排常规CT扫描同时行薄层重组的2473例体检病例中筛选的97例患者进行回顾性分析。结果:97例患者在常规CT扫描中有80例可以显示病变,而在MSCT薄层重组中97例均有阳性发现;其中双肺弥漫性病变79例(两肺间质纤维化78例,肺内多发转移瘤1例),肺结核3例,肺内孤立结节12例,早期中央型肺癌1例,先天性支气管闭锁1例以及纵隔肿瘤1例;MSCT薄层重组图像可清晰显示肺内小叶间隔线增厚、弥漫分布的囊性病变、肺内结节的细微征象。结论:MSCT薄层重组在胸部体检中的诊断阳性率、细节分辨率、图像质量及确诊率均优于常规CT,可作为肺内病变尤其是早期肺癌筛查方法之首选。     

DR和CT对人鼠股动脉结扎诱导的侧支血管显像能力的对比研究

目的：探讨数字化X线摄影（digital radiography,DR）和电子计算机断层扫描成像（Computed Tomography,CT）对大鼠股动脉结扎诱导的侧支血管显像能力的对比,方法：28只健康SD大鼠,右侧行股动脉结扎,存活1w,采用明胶一四氧化三铅混合物行血管造影观察大鼠后肢侧支血管形成情况并分别采用DR及CT进行摄片,观察DR及cT对侧支血管的显像能力结果：DR及CT均显示在股动脉结扎处血管连续性中断,并出现不同数量的侧支血管;DR对新生侧支血管的显影分辨率和清晰度明显高于CT,且远端股动脉显影较CT清晰,CT横断面成像具有放射状伪影结论：经DR拍摄的侧支血管的显像能力较CT清晰,利用DR可以直观清晰的将其显像     

构建基于患者个体化的Stanford B型主动脉夹层计算流体力学数值模拟分析模型

目的:探索简便、高效、精确的构建基于真实人体解剖形态结构的Stanford B型主动脉夹层计算流体力学数值模拟分析模型的方法.方法:利用Siemens Sensation Cardiac 64层螺旋CT薄层扫描技术,基于1mm层厚获取6例Stanford B型主动脉夹层连续断层DICOM格式图像,导入Materialise MIMICS v12.11软件,界定目标区域后生成三维动脉模型,经网格优化处理去除低质量及相交面网格,保存结果输出,导入TGrid 5.0软件,对主动脉面网格模型进行几何修复,使面网格扭曲率<0.75,采用自由分网方式生成Stanford B型主动脉夹层计算流体力学分析体网格模型,并对所构建模型进行血流属性、流场边界等界定,初步验证模型的有效性.结果:通过初步计算求解,确定所构建的6例Stanford B型主动脉夹层计算流体力学分析模型分别包含1857030,1820501,1844181,1849651,1858246及1814914个四面体单元.结论:利用64层螺旋CT薄层扫描技术获取DICOM格式连续断层CT图像可快速、准确地构建Stanford B型主动脉夹层计算流体力学数值模拟分析模型,为进一步的计算流体力学分析奠定了良好的基础.     

结合薄层CT技术建立下颌第一前磨牙三维有限元模型

目的结合薄层CT技术建立下颌第一前磨牙三维有限元模型。方法对正常人下颌第一前磨牙进行薄层CT扫描及图像处理,通过Matlab和ANSYS软件建立三维有限元模型,并加载验证模型力学分析的可行性。结果建立了包含髓腔的下颌第一前磨牙的三维有限元模型,得到101564个单元,144053个节点。载荷后的应力分布主要集中在颊尖部位和根尖部位,牙颈部受力较小。结论薄层CT技术与Matlab和ANSYS软件相结合,建立包含髓腔的下颌第一前磨牙的三维有限元模型,精度高、速度快,使用灵活,为后期的楔缺模型建立和分析奠定了基础。     

Biomechanical Study on the Novel Biomimetic Hemi-Pelvis Prosthesis

A pelvic endoprosthesis is the primary means of pelvic reconstruction after internal hemipelvectomy. In this study, a novel biomimetic hemipelvic prosthesis, including an artificial ilium, an artificial acetabulum, and an artificial pubis, was developed. A Finite Element Method （FEM） was carried out to investigate the biomechanical performance of a pelvis reconstructed with biomimetic hemipelvic prosthesis. Two models, including the reconstructed pelvis and the original pelvis （control model）, were established according to the geometry from CT data of a human male patient with pelvic bone sarcomas. The FE models predict that the biomeehanical function of the pelvic ring can be reestablished using this prosthesis. Results show that the body force loaded on the S 1 vertebra is restored and transferred towards the sacro-iliac joint, and along the ilium onto the bearing surface of the artificial ilium, then to the artificial acetabulum and pubis. Von Mises stresses observed in this reconstructed pelvis model are still within a low and elastic range below the yielding strength of cortical bone and Ti6A14V. The values of deformation and strain of the reconstructed pelvis are close to the data obtained in the original pelvis. With the partial replacement of the pubis, little influence is found towards the pubis symphysis. However, the interface between the prosthesis and pelvic bone may become the critical part of the reconstructed pelvis due to the discontinuity in the material properties, which results in stress shielding and deformation constraining. So a biomimetic flexible connection or inter layer to release the deformation of pelvis is suggested in future designing.     

Collision tumor with inflammatory breast carcinoma and malignant phyllodes tumor: a case report and literature review

Background

Pelvic reconstruction after hemipelvectomy can greatly improve the weight-bearing stability of the supporting skeleton and improve patients’ quality of life. Although an autograft can be used to reconstruct pelvic defects, the most suitable choice of autograft, i.e., the use of either femur or tibia, has not been determined. We aimed to analyze the mechanical stresses of a pelvic ring reconstructed using femur or tibia after hemipelvectomy using finite element (FE) analysis.

Methods

FE models of normal and reconstructed pelvis were established based on computed tomography images, and the stress distributions were analyzed under physiological loading from 0 to 500 N in both intact and restored pelvic models using femur or tibia.

Results

The vertical displacement of the intact pelvis was less than that of reconstructed pelvis, but there was no significant difference between the two reconstructed models. In FE analysis, the stress distribution of the intact pelvic model was bilaterally symmetric and the maximum stresses were located at the sacroiliac joint, arcuate line, ischiatic ramus, and ischial tuberosity. The maximum stress in each part of the reconstructed pelvis greatly exceeded that of the intact model. The maximum von Mises stress of the femur was 13.9 MPa, and that of the tibia was 6.41 MPa. However, the stress distribution was different in the two types of reconstructed pelvises. The tibial reconstruction model induced concentrated stress on the tibia shaft making it more vulnerable to fracture. The maximum stress on the femur was concentrated on the connections between the femur and the screws.

Conclusions

From a biomechanical point of view, the reconstruction of hemipelvic defects with femur is a better choice.     

Reconstruction of the STS 14 (Australopithecus africanus) pelvis

The study reports a reconstruction of the sacrum in STS 14 based on extrapolation from the measurements of the first two sacral vertebrae of STS 14 and of the angle formed by the anterior surfaces of their vertebral bodies. Reconstruction is based on comparisons of, and extrapolation from, sacra of Pan troglodytes, Homo sapiens, and Australopithecus afarensis. The reconstructed sacrum has an anterior sacral curvature of 39°. The two ossa coxae were also completed by mirror imaging of one side by the other. With the pelvis completely reconstructed, the pelvic dimensions for the antero-posterior (AP) diameters of the pelvic inlet, midpelvis, and pelvic outlet are 85, 68, and 69 mm and the corresponding transverse (TR) diameters are 109, 88, and 103 mm, respectively. The posterior sagittal diameters in the three pelvic planes are small compared to the anterior sagittal diameters. This analysis indicates that the STS 14 pelvis is platypelloid in the three pelvic planes; i.e., all the AP diameters are smaller than the corresponding TR diameters. This makes the STS 14 pelvis similar to that to Al 288-1, save for a less pronounced degree of platypelloidy at the inlet in the former. © 1995 Wiley-Liss, Inc.     

The use of three-dimensional model construction of virtual technology in orthopedic treatment

ObjectiveThe objective of this study is to explore the construction of a digital three-dimensional model of virtual technology that plays an auxiliary role in orthopedic treatment.MethodsThree fracture patients were selected, with no abnormality was observed in bone examination, no musculoskeletal disease in the past; and spiral CT scan of the spine and pelvis, upper limbs, and lower limbs was performed. The virtual technology was used to build a digital 3D model, mainly using the editing software Mimics10.0 software. In addition, the virtual three-dimensional model was verified by virtual surgery, data storage security, work efficiency of the model, model validity, three-dimensional characteristics of the model, the interaction mode of the model, and the data accuracy of the model were studied.ResultsThe digital 3D model was successfully established by Mimics10.0 software. The data fitting efficiency was very high. The data storage security of the 3D model was greatly improved compared with the 2D model, and the work efficiency was improved by at least 50%. There was also a significant change in the accuracy and interaction of data acquisition. Therefore, the detection of digital 3D model work through virtual surgery simulation fully demonstrated the positive auxiliary role of 3D model in orthopedic treatment.ConclusionThe digital 3D model based on Mimics10.0 software is efficient and accurate in obtaining data. It is very effective for subsequent adjuvant therapy in the field of orthopedics, reducing the probability of misdiagnosis by doctors, saving time and improving efficiency, reducing patient's physical pain and unnecessary economic expenses.     

Kinematic measurement of the lumbar spine and pelvis in the normal population

Spinal and pelvis motion has been studied by a variety of different methods, the majority of which have a number of limitations. The present study investigated motion characteristics of the lumbar spine and pelvis using a three-dimensional optoelectronic system. The aim of our study was to determine kinematic parameters of spine and pelvis during trunk flexion, extension and lateral bending in normal, healthy subjects. Kinematic motion analysis was performed on 63 asymptomatic volunteers for four different trunk motions. This study has shown that the pelvis range of motion is affected by the gender Contribution of pelvic movement to trunk flexion was 50%, while pelvic angle was significantly higher in women. During lateral bending female subjects had statistically significant higher values of vertebral arc with respect to male subjects. During extension the contribution of pelvic movement was 45%. There was no significant difference found in total angle, pelvic angle and vertebral arc.     

A new reconstruction of Sts 14 pelvis (Australopithecus africanus) from computed tomography and three-dimensional modeling techniques

The purpose of this study is to propose a new reconstruction of the australopithecine Sts 14 pelvis from original fossils. Digital models created from CT images allow us to perform mirroring operations, select valid regions after digital interposition, and reassemble parts. The key-element of the reconstruction is the sacroiliac joint, restored from right and left articular surfaces, which places of the pubic symphysis close to the sagittal plane. The complete pelvis is obtained by 3D model mirroring of hip-bone and sacrum. The present reconstruction of the Sts 14 pelvis is consistent with Schmid's (1983) [Folia Primatol. 40, 283-306, 1983] and Häusler and Schmid's A.L. 288-1 [J. Hum. Evol. 29, 363-383, 1995] pelvic reconstructions by illustrating a relatively platypelloid shape of the pelvic cavity and laterally inclined iliac blades. The pelvic morphology suggests that australopithecines had a less posteriorly tilted sacrum in erect posture than modern humans. As compared with Lovejoy's [Am. J. Phys. Anthropol. Suppl. 50, 460, 1979] A.L. 288-1 pelvic reconstruction, the less transversely flattened shape of the Sts 14 pelvic cavity led to obstetrical mechanics characterized as in humans by ante-ischiatic birth and a curved trajectory. We deduce a human-like movement of rotation and flexion of the fetal skull in the Sts 14 pelvic cavity.