基于MRI快速建立前交叉韧带三维数字化模型初步报道

吴冰; 陆伟; 田毅; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲; 叶建平; 张吉帅

doi:10.13418/j.issn.1001-165x.2014.05.015

中国临床解剖学杂志 ›› 2014, Vol. 32 ›› Issue (5) : 571-575. DOI: 10.13418/j.issn.1001-165x.2014.05.015

断层影像解剖

基于MRI快速建立前交叉韧带三维数字化模型初步报道

吴冰^1，2，　陆伟^2,3，　田毅⁴，　王大平^2,3，　朱伟民^2,3 ，　欧阳侃²柳海峰²，　彭亮权²，　李皓²，　冯文哲²，　叶建平⁴，　张吉帅⁴

作者信息 +

A preliminary report of fast establishment of three-dimensional digital models of anterior cruciate ligament based on MRI

WU Bing ^1,2, LU Wei ^2,3, TIAN Yi ⁴ , WANG Da-ping ^2,3, ZHU Wei-min ^2,3, OU Yang-kan ², LIU Hai-feng ², PENG Liang-quan ², LI Hao², FENG Wen-zhe ², YE Jian-ping ⁴, ZHANG Ji-shuai ⁴

Author information +

文章历史 +

摘要

目的　研究利用MRI二维图像快速建立前交叉韧带(ACL)三维数字化模型的方法，并评估模型的真实可靠程度。方法　选择 20 例临床诊断为ACL断裂患者的术前健侧MRI图像资料，导入自主开发的ACL快速分割技术软件（3D MIA ）进行图像分割，再以面绘制方式进行三维重建，建立膝关节及ACL三维数字化模型，测量模型的ACL长度、宽度、厚度及与人体三个解剖平面的角度，所得数据与前期解剖研究结果进行统计学的分析对比，评估模型的可靠程度。结果造模包括膝关节各骨性结构及前后交叉韧带，平均造模时间18 min，测量得到ACL长(39.80±1.86)mm、宽(5.80±1.83)mm、厚(9.96±1.26)mm；ACL与冠状面夹角(27.58±3.64)°、与矢状面夹角(39.82±4.01)°、与水平面夹角(22.27±4.23)°。与前期研究获得的相应数据对比，经独立样本t 检验，差异均无显著性意义(P>0.05)。结论利用自主开发的ACL分割技术及三维重建软件可以快速且较准确地建立健侧 ACL三维数字化模型，为计算机辅助ACL手术系统及实现ACL临床仿真个体化解剖重建提供了参考基础。

Abstract

Objective　To investigate the method of quickly establishing three-dimensional digital model of anterior cruciate ligament (ACL) using magnetic resonance imaging (MRI), and to evaluate authenticity and reliability of the model.　Methods　Contralateral knee joint MRI data of 20 cases of patients with clinical diagnosis of ACL rupture were selected. These data were imported into independent development of 3D-MIA software, and were segmented by the method of independent invention of ACL fast segmentation technology, and then three-dimensional substance digital models of ACL and the knee joint were established by carrying through three-dimensional reconstruction on the basis of surface rendering. The length, width, thickness, and the angle of ACL and the human body planes were measured on models. The results were compared with that of early anatomical results.　Results　Three-dimensional digital models included bones and cruciate ligaments of the knee joint . The average building time was 18 minutes. The mean length, width and thickness of ACL were (39.80±1.86), (5.80±1.83) and (9.96±1.26) mm respectively, and the angle formed by ACL and the coronal plane, sagittal plane, horizontal plane were (27.58±3.64)°, (39.82±4.01)° and (22.27±4.23)° respectively. Compared with the corresponding data of previous researches, by independent sample t-test, there was no significant difference (P>0.05).　Conclusions　A relatively reliable three-dimensional digital model of ACL and the knee joint can be quickly established using the novel ACL segmentation technology and 3D-MIA software, laying an foundation for establishing a complete set of computer aided ACL operation system and realizing the dream of simulational, individualized and anatomical reconstruction of ACL in the future.

导出引用

吴冰, 陆伟, 田毅, 王大平, 朱伟民, 欧阳侃, 柳海峰, 彭亮权, 李皓, 冯文哲, 叶建平, 张吉帅. 基于MRI快速建立前交叉韧带三维数字化模型初步报道[J]. 中国临床解剖学杂志. 2014, 32(5): 571-575 https://doi.org/10.13418/j.issn.1001-165x.2014.05.015

TUN Bing, LIU Wei, TIAN Yi, WANG Da-Beng, SHU Wei-Min, OU Yang-Kan, LIU Hai-Feng, BANG Liang-Quan, LI Hao, FENG Wen-Zhe, XIE Jian-Beng, ZHANG Ji-Shuai. A preliminary report of fast establishment of three-dimensional digital models of anterior cruciate ligament based on MRI[J]. Chinese Journal of Clinical Anatomy. 2014, 32(5): 571-575 https://doi.org/10.13418/j.issn.1001-165x.2014.05.015

中图分类号： R602

参考文献

[1] Suomalainen P, Moisala A S, Paakkala A, et al. Double-bundle versus single-bundle anterior cruciate ligament reconstruction: randomized clinical and magnetic resonance imaging study with 2-year follow-up
[J]. Am J Sports Med, 2011, 39(8): 1615-1622.

[2] Frobell RB, Roos EM, Roos HP, et al. A randomized trial of treatment for acute anterior cruciate ligament tears
[J]. N Engl J Med, 2010, 363(4): 331-342.

[3] 蔡道章，膝关节前交叉韧带损伤治疗的历史变革与发展
[J]. 中华关节外科杂志(电子版)，2013，7（1）：1-2.

[4] Siebold R, Ellert T, Metz S, et al. Femoral insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry and arthroscopic orientation models for double-bundle bone tunnel placement-a cadaver study
[J]. Arthroscopy, 2008, 24(5): 585-592.

[5] 陆伟，王大平，欧阳侃，等. 前交叉韧带股骨后外束足迹解剖变异与双束重建骨道定位的对策
[J]. 中国运动医学杂志， 2013 ，32 (1)：24-29.

[6] Hussein M, van Eck CF, Cretnik A, et al. Individualized anterior cruciate ligament surgery: a prospective study comparing anatomic single-and double-bundle reconstruction
[J]. Am J Sports Med, 2012, 40(8): 1781-1788.

[7] 陆伟，王大平，肖德明. 前交叉韧带重建股骨足迹精确定位的解剖与临床研究
[J]. 中国临床解剖学杂志, 2011, 29(5):513-516.

[8] 王成焘, 陈晓军,钱理为. 数字医学与计算机辅助手术
[J]. 中国医疗器械杂志, 2007, 31(5): 313-323.

[9] Yasuda K, van Eck C F, Hoshino Y, et al. Anatomic single-and double-bundle anterior cruciate ligament reconstruction, Part 1 Basic Science
[J]. Am J Sports Med, 2011, 39(8): 1789-1799.

[10] 陈文栋，李彦林，许鹏, 等. 正常人与尸体膝关节MRI二维图像重建前交叉韧带三维模型的比较研究
[J]. 中国修复重建外科杂志, 2011, 25(11): 1314-1318.

[11] Margier J, Tchouda SD, Banihachemi JJ, et al. Computer-assisted navigation in ACL reconstruction is attractive but not yet cost efficient
[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 1-9
[Epub ahead of print] PubMed PMID: 24441732.

[12]陈文栋, 李彦林, 许鹏, 等. 基于MRI建立膝关节前交叉韧带三维数字化模型
[J]. 中国组织工程研究与临床康复, 2011, 15(52): 9725-9728.

[13]吴辉群, 严培培, 耿兴云, 等. 基于Mimics软件虚拟人膝关节三维图像融合实验
[J]. 中国组织工程研究与临床康复, 2011, 15(48): 8943-8946.

[14]王健全, 敖英芳, 刘平, 等. 前交叉韧带股骨止点临床解剖学研究
[J]. 中国运动医学杂志, 2007, 26(3): 266-270.

[15]Ferretti M, Doca D, Ingham S M, et al. Bony and soft tissue landmarks of the ACL tibial insertion site: an anatomical study
[J]. Knee Surg Sports Traumatol Arthrosc, 2012,20(1): 62-68.

[16]Schreiber VM, van Eck CF, Fu FH. Anatomic double-bundle ACL reconstruction
[J]. Sports Med Arthrosc, 2010, 18(1): 27-32.