基于三维CT的颅面骨骼对称性测量研究  

Quantitative analysis of craniofacial skeleton asymmetry by three-dimensional computed tomography

作　　者：王瑞晨 李桂珍 柳春明 贾赤宇 高全文 韩岩 

机构地区：[1]解放军医学院&解放军总医院整形外科,北京100853 [2]309医院烧伤整形科

出　　处：《中华整形外科杂志》2013年第6期435-439,共5页Chinese Journal of Plastic Surgery

基　　金：北京市自然科学基金（7072075）

摘　　要：目的建立一套应用三维CT影像对颅面部骨骼畸形进行三维定量分析的方法。方法应用Mimics10．0软件对20例面部不对称患者的CT图像进行三维重建，将患者颅面部三维影像以对称平面为基准面，调整三维模型在系统坐标系内的位置，标记标志点并提取三维坐标。以其中1例半侧颜面萎缩患者为例，对前后间隔4周的两阶段的测量结果，以及两侧成对分布标志点的三维坐标数值行t检验。结果所有标志点在前后间隔4周的两阶段提取的三维坐标数值差异无统计学意义（P〉0．05）；标志点的三维坐标数值显示，患者面中线处标志点偏移中线的距离从上至下逐渐增加，至颏下点偏移达（2．63±0．54）mm，成对分布标志点患侧较健侧存在三维方向上的偏移，最明显的下颌角点患侧较对侧向内、向前、向上分别偏移10．21、9．26和6．30mm。结论应用三维CT影像和软件对颅面部骨骼形态进行全面测量分析的方法，测量结果准确、直观，为颅面部畸形的详细诊断和治疗提供了可靠依据。Objective To present a method of quantitative diagnosis of craniofacial skeleton deformities based on three-dimensional computed tomography （3D CT）. Methods 20 cases with facial asymmetric deformities underwent 3D CT and the 3D images were reconstructed by Mimics 10. 0 （Belgium）. Anatomical landmarks were located and the coordinate of the landmarks obtained. Axial images of 1 patient with Romberg disease was used as representative case. The differences in the distance between the right landmarks and the left were calculated and analyzed. Results The measurement results were not significantly different between two stages with an interval of 4 weeks （ P 〉 0.05 ） , showing a reproducible resutls. The deviation of landmarks at facial midline increased gradually from upward to downward, reaching （2.63 ± 0.54） mm at menton point. Paired landmarks showed asymmetry in three dimensions, especially gonion point on the left side, which was deviated 10.21 mm inward, 9.26 mm forward, 6. 30 mm upward, compared to the opposite side. Conclusions The method of 3D CT quantitative analysis can provide precise information in the diagnosis and treatment planning of facial asymmetry deformity.

关 键 词：成像 三维 体层摄影术 螺旋计算机 颅颌面外科 

分 类 号：R816.98[医药卫生—放射医学]