三维摄影系统应用于颌面部脂肪个体化设计移植充填治疗的初步报告  

A preliminary report of the use of three dimensional photogrammetry system(3dMD) for the individualized therapy of autologous fat grafting in craniomaxillofacial area

作　　者：李彪[1] 沈国芳[1] 赵泽亮[1] 张雷[1] 于洪波[1] 王旭东[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面外科,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2012年第4期298-305,共8页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市自然科学基金(10ZR1418000);上海市卫生局课题(2009077);上海市高校创新团队发展计划资助项目;上海交通大学医工(理)交叉研究基金(YG2010MS55)~~

摘　　要：目的:将三维图像获取及处理技术应用于面部脂肪移植充填治疗,使之能直观地呈现出患者期望的术后效果,并相对准确地确定面部微小凹陷填充部位和体积。方法:对4例自觉面部部分区域凹陷的患者应用此方法进行充填,术后密切随访观察。首先采用三维照相系统3dMD获取患者面部三维图像,并使用该系统自带的图像处理软件和手术模拟软件(3dMD Patient和3dMD Vultus),依照患者的具体要求进行填充术后效果模拟。将模拟图像与患者术前三维图像进行比较分析,由软件描记确定需要填充的部位和范围,并计算出需要填充脂肪的量。术中依照术前所确定的填充部位、范围和填充量,进行脂肪注射填充。在术后3周内对患者进行随访观察,拍摄面部三维照片,记录其术后效果。结果:术后随访照片显示,患者术后肿胀消退后(术后2～3周),面部填充效果与治疗计划中的模拟充填效果基本一致。结论:在脂肪移植填充治疗中,此方法以每个患者期望的术后效果三维图形为基础,制订个体化治疗方案,可以使临床医师与患者就其具体的就诊要求进行更好的交流和沟通,并直观地了解患者所期望的治疗效果,使面部微小畸形脂肪移植充填的治疗方案设计实现个体化、可视化和精确化。PURPOSE： To present a new precisely quantitative autologous fat grafting technique in cranial and maxillofacial area using three-dimensional image acquisition and processing system.METHODS： This new method was used in 4 patients in our study.First of all,a three-dimensional photograph of the patient’s face was taken before surgery.The surgeon did the simulation of the postoperative effect according to the patient’s requirements.Then the computer calculated the volume and marked the area of fat grafting automatically by comparing the simulative 3D image with the preoperative 3D picture.The follow up clinical data of each patient was recorded and collected by three dimensional pictures 3 weeks after surgery.RESULTS： The follow up records showed that the postoperative effect at 2-3 weeks was satisfactory and coincident with the preoperative simulation after the regression of facial swelling.CONCLUSION： The 3D photogrammetry system can help the clinician to understand the requirement of the patient more exactly and make the individualized treatment plan based on the desired post-operative effect of the patient.The clinician could be aware of the location and the mount of injected fat so that the expected postoperative effect of the patient could be achieved.

关 键 词：脂肪移植填充 三维 照相 个体化治疗 

分 类 号：R782.2[医药卫生—口腔医学]