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目的:建立基于PHILIPS Brilliance 64排螺旋计算机断层扫描(CT)精细扫描图像的全颈椎三维有限元模型,并验证该模型的准确性,以期用于临床及理论研究。方法:选取本院30名健康成年女性为研究对象,以层厚0.625 mm的64排螺旋CT连续扫描颈部得到DICOM格式的CT断层图像,利用正版三维重建软件mimics 16.0,Geomagic Studio2013,和有限元分析软件ANSYS 12.1处理CT扫描数据,创建全颈椎三维有限元模型,依据文献资料及CT结果在该模型上分别模拟头颅前屈、后伸、左右侧弯和左右旋转等自由活动,观察椎体最大应力集中部位和两侧椎动脉血流参数。结果:(1)建立C1-C7活动节段的三维有限元模型,包括7个椎体、6个间盘、主要的韧带,解剖形态和活动功能方面与人体生理状态一致;(2)本模型在前屈、后伸、左右侧弯和左右旋转条件下,颈椎自由活动度与参考文献相似,经验证可靠。结论:本研究采用CT扫描后获取的全颈椎空间结构信息建立全颈椎三维有限元模型,经验证有效,关节前屈状态、后伸状态下等效应力分布图清晰且合理,还可以准确反映其复杂的解剖结构及空间毗邻关系,为临床诊断提供可靠的影像资料,实用性强,更加符合临床要求,可进一步用于中医手法诊断及颈椎相关疾病的临床研究。
OBJECTIVE: To establish a three-dimensional finite element model of cervical spine based on 64-slice spiral computed tomography (CT) scan with PHILIPS Brilliance and to verify the accuracy of the model for clinical and theoretical research. Methods: Thirty healthy adult women in our hospital were selected as the study object. DICOM CT images were obtained by continuously scanning the neck with 64-slice spiral CT with 0.625 mm slice thickness. Using the genuine 3D reconstruction software mimics 16.0, Geomagic Studio 2013, and finite element Analysis software ANSYS 12.1 CT scan data to create a three-dimensional cervical finite element model, based on the literature and CT results in the model were simulated head flexion, extension, left and right side bending and left and right rotation and other free activities, vertebral body was observed the largest Stress concentration site and bilateral vertebral artery blood flow parameters. Results: (1) The three-dimensional finite element model of C1-C7 active segment was established, which consisted of seven vertebrae, six intervertebral discs and main ligaments. The anatomy and activities of C1-C7 were consistent with the physiological status of human body. (2) In the flexion, extension, left and right side bending and left and right rotation, cervical freedom of motion similar to the reference, proven reliable. Conclusion: In this study, the three-dimensional finite element model of the cervical spine was established by using the information of spatial structure of the whole cervical spine obtained after CT scan. It is validated that the equivalent stress distribution in the flexion and extension state is clear and reasonable, Complex anatomical structure and spatial adjacency relationship, providing reliable image data for clinical diagnosis, which is more practicable and more in line with clinical requirements. It can be further used in TCM diagnosis and clinical research of cervical spine-related diseases.