Hsieh Ming-Shium, Tsai Ming-Dar, Yeh Yi-Der
Department of Orthopaedics and Traumatology, Taipei Medical University Hospital, Taipei Medical University, 252, Wu Hsing Street, 11031 Taipei, Taiwan, ROC.
Comput Biol Med. 2005 May;35(4):347-71. doi: 10.1016/j.compbiomed.2004.03.002.
This paper describes an image analysis method that evaluates bone morphology of hip structures including the femur stem, trochanter, neck and head, acetabulum, and pelvis to automate hip diagnoses and surgical managements. On every CT transverse section, radial B-spline curves are used to approximate the ellipse-like acetabulum and femur head and stem. The femur neck is approximated as trapezoid-like and the pelvis horizontally symmetrical structure. The centers of the ellipse-like structures from transverse sections are used to determine 3D axes of the femur stem, head, and acetabulum. The centerlines of the neck or the pelvis on the sections are used to determine the neck axis or pelvis centerplane. Boundary changes of these structures are recognized as concave, convex and hole features that are then identified as fractures, tumors, and spurs. Based on the geometric evaluations of these structures and features, hip surgeries including tumor dissect and bone graft, open reduction using plates, screws and nails, and arthroplasty are automatically managed to achieve the normal hip function including dissection of tumors and reduction of dislocations and angular deviations between the hip structures. This prototype system can be used as a qualitative and quantitative tool for the diagnosis of various hip diseases and for the planning of accurate surgical procedures. A series of examples and four case studies illustrate this automated method can be used to accurately diagnose hip diseases and manage hip surgeries, and train operators.
本文描述了一种图像分析方法，该方法可评估髋部结构的骨形态，包括股骨柄、转子、颈部和头部、髋臼以及骨盆，以实现髋部诊断和手术管理的自动化。在每一个CT横断面上，使用径向B样条曲线来近似椭圆状的髋臼以及股骨头和股骨柄。股骨颈近似为梯形，骨盆为水平对称结构。利用横断面上椭圆状结构的中心来确定股骨柄、股骨头和髋臼的三维轴线。利用这些断面中颈部或骨盆的中心线来确定颈轴或骨盆中心平面。这些结构的边界变化被识别为凹、凸和孔洞特征，然后被确定为骨折、肿瘤和骨刺。基于对这些结构和特征的几何评估，包括肿瘤切除和骨移植、使用钢板、螺钉和钉子进行切开复位以及关节成形术在内的髋部手术能够自动进行管理，以实现正常的髋部功能，包括肿瘤切除以及髋部结构之间脱位和角度偏差的复位。该原型系统可作为一种定性和定量工具，用于诊断各种髋部疾病以及规划精确的手术程序。一系列示例和四个案例研究表明，这种自动化方法可用于准确诊断髋部疾病、管理髋部手术以及培训操作人员。
