van Veldhuizen Willemina A, van der Wel Hylke, Kuipers Hennie Y, Kraeima Joep, Ten Duis Kaj, Wolterink Jelmer M, de Vries Jean-Paul P M, Schuurmann Richte C L, IJpma Frank F A
Department of Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands.
Department of Oral and Maxillofacial Surgery/3D Lab, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands.
J Clin Med. 2023 May 30;12(11):3767. doi: 10.3390/jcm12113767.
Knowledge about anatomical shape variations in the pelvis is mandatory for selection, fitting, positioning, and fixation in pelvic surgery. The current knowledge on pelvic shape variation mostly relies on point-to-point measurements on 2D X-ray images and computed tomography (CT) slices. Three-dimensional region-specific assessments of pelvic morphology are scarce. Our aim was to develop a statistical shape model of the hemipelvis to assess anatomical shape variations in the hemipelvis. CT scans of 200 patients (100 male and 100 female) were used to obtain segmentations. An iterative closest point algorithm was performed to register these 3D segmentations, so a principal component analysis (PCA) could be performed, and a statistical shape model (SSM) of the hemipelvis was developed. The first 15 principal components (PCs) described 90% of the total shape variation, and the reconstruction ability of this SSM resulted in a root mean square error of 1.58 (95% CI: 1.53-1.63) mm. In summary, an SSM of the hemipelvis was developed, which describes the shape variations in a Caucasian population and is able to reconstruct an aberrant hemipelvis. Principal component analyses demonstrated that, in a general population, anatomical shape variations were mostly related to differences in the size of the pelvis (e.g., PC1 describes 68% of the total shape variation, which is attributed to size). Differences between the male and female pelvis were most pronounced in the iliac wing and pubic rami regions. These regions are often subject to injuries. Future clinical applications of our newly developed SSM may be relevant for SSM-based semi-automatic virtual reconstruction of a fractured hemipelvis as part of preoperative planning. Lastly, for companies, using our SSM might be interesting in order to assess which sizes of pelvic implants should be produced to provide proper-fitting implants for most of the population.
了解骨盆的解剖形状变异对于骨盆手术中的选择、适配、定位和固定至关重要。目前关于骨盆形状变异的知识大多依赖于在二维X线图像和计算机断层扫描(CT)切片上的点对点测量。对骨盆形态进行三维区域特异性评估的研究较少。我们的目的是建立一个半骨盆的统计形状模型,以评估半骨盆的解剖形状变异。使用200例患者(100例男性和100例女性)的CT扫描图像进行分割。采用迭代最近点算法对这些三维分割图像进行配准,以便进行主成分分析(PCA),并建立半骨盆的统计形状模型(SSM)。前15个主成分(PC)描述了90%的总体形状变异,该SSM的重建能力导致均方根误差为1.58(95%CI:1.53 - 1.63)mm。总之,我们建立了一个半骨盆的SSM,它描述了白种人群体中的形状变异,并且能够重建异常的半骨盆。主成分分析表明,在一般人群中,解剖形状变异大多与骨盆大小的差异有关(例如,PC1描述了68%的总体形状变异,这归因于大小)。男性和女性骨盆之间的差异在髂骨翼和耻骨支区域最为明显。这些区域经常受到损伤。我们新开发的SSM未来的临床应用可能与基于SSM的骨折半骨盆半自动虚拟重建相关,作为术前规划的一部分。最后,对于公司来说,使用我们的SSM可能会很有意义,以便评估应该生产哪些尺寸的骨盆植入物,为大多数人群提供适配良好的植入物。
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