PACS框架内的CBCT图像牙科后处理模块的临床运用探索  

Exploration of the clinic application of dental post-processing module of cone beam CT images within the picture archiving and communication system(PACS)

作　　者：郑昊 潘笑 林梓桐[3] Zheng Hao;Pan Xiao;Lin Zitong(Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Department of Information,Nanjing Stomatological Hospital,Nanjing 210008,China;Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Department of Preventive Dentistry,Nanjing Stomatological Hospital,Nanjing 210008,China;Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Department of Dentomaxillofacial Radiology,Nanjing Stomatological Hospital,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院、南京大学口腔医学研究所、南京市口腔医院信息科,江苏210008 [2]南京大学医学院附属口腔医院、南京大学口腔医学研究所、南京市口腔医院预防口腔科,江苏210008 [3]南京大学医学院附属口腔医院、南京大学口腔医学研究所、南京市口腔医院口腔颌面医学影像科,江苏210008

出　　处：《中国口腔种植学杂志》2025年第1期40-46,共7页Chinese Journal of Oral Implantology

基　　金：南京大学中国医院改革发展研究院课题项目(NDYG2023013);南京大学医学院附属口腔医院“3456”骨干人才资助项目(0222M509);南京大学医学院附属口腔医院2015学科带头人后备人才资助项目(0223A204)。

摘　　要：目的探索医学影像存档与通信系统(picture archiving and communication system,PACS)框架内的锥形束CT(cone beam CT,CBCT)牙科处理模块在种植患者图像后处理及分析测量中的作用。方法研发内嵌于PACS的牙科后处理模块(包括曲面重组和连续多轴牙科重建)。选取南京市口腔医院3种CBCT设备共计270例种植患者的CBCT图像,由1名影像科医师进行种植区域图像重建及骨量测量。方法1为使用上传至PACS的医学数字成像与通信(digital imaging and communications in medicine,DICOM)数据使用该牙科处理模块进行图像重建及骨量测量,方法2为使用各CBCT设备刻录生成的光盘数据并使用光盘自带的图像后处理软件进行图像重建及骨量测量。计算2种方法的时长并进行统计学分析,统计2种方法骨量测量结果的一致性,同时对使用2种方法的影像科医技人员及种植科医师共计10人开展问卷调查,评估2种方法的使用满意度。结果3种CBCT设备使用2种方法的图像上传/刻录、图像打开时长、图像后处理时长及总时长均具有显著的统计学差异,方法1所耗时长较方法2明显缩短(P<0.001),2种方法骨量测量结果具有良好的一致性。使用者满意度的问卷调查表明方法1优于方法2(P<0.001)。结论内嵌于PACS的图像后处理模块适用于种植患者CBCT图像后处理及测量分析,可显著提升临床工作效率。Objective To explore the clinical application of a dental post-processing module for cone beam CT(CBCT)images embedded within the picture archiving and communication system(PACS)for preoperative implant evaluation.Methods A PACS-embedded dental post-processing module,including curved planar reformation(CPR)and continuous multi-axis dental reconstruction,was developed.A total of 270 CBCT images from implant patients in our hospital(scanned using three different CBCT systems,90 cases per system)were analyzed by a radiologist for bone volume assessment.Method 1 used CBCT digital imaging and communication in medicine(DICOM)data uploaded to PACS,applying the embedded dental post-processing module for reconstruction and measurement.Method 2 utilized CD-ROM data exported from each CBCT device along with the corresponding built-in image processing software.The durations of image upload,opening,post-processing,and total time for both methods were recorded and statistically analyzed.Consistency in bone volume measurements was assessed,and a questionnaire on user satisfaction was completed by 10 radiologists and implantologists.Results Significant differences in image processing times were observed between the two methods for all three CBCT systems.Method 1 significantly reduced total processing time compared to Method 2(P<0.001),with consistent bone volume measurement results between the two methods.User satisfaction surveys indicated that Method 1 was superior to Method 2(P<0.001).Conclusion The PACS-embedded post-processing module is suitable for CBCT image analysis and measurement in implant patients,significantly enhancing clinical efficiency.

关 键 词：医学影像存档与通信系统 锥形束CT 曲面重组 连续多轴牙科重建 

分 类 号：R783.6[医药卫生—口腔医学]