CN111557732A

CN111557732A - Foot arch image model reconstruction method

Info

Publication number: CN111557732A
Application number: CN202010370369.7A
Authority: CN
Inventors: 段常青; 何晓浩; 刘莉; ***; 孙淑霞; 昌俊涛; 郭峰; 周瑾瑜; 商涯钧
Original assignee: Chongqing Jiulongpo District Hospital Of Traditional Chinese Medicine
Current assignee: Chongqing Jiulongpo District Hospital Of Traditional Chinese Medicine
Priority date: 2020-05-06
Filing date: 2020-05-06
Publication date: 2020-08-21
Anticipated expiration: 2040-05-06
Also published as: CN111557732B

Abstract

The invention relates to the technical field of arch model reconstruction, and discloses an arch image model reconstruction method which comprises X-ray plain film, MSCT scanning inspection, MSCT scanning, MPR, MIP, SSD and 3D VR reconstruction. The invention adopts X-ray plain film combined with MSCT scanning, MPR, MIP, SSD, 3D VR reconstruction and other various examination means to reconstruct and image in multiple angles and multiple directions to achieve the purpose of comprehensively judging the damaged condition of foot muscles, tendons and ligaments of a patient.

Description

Foot arch image model reconstruction method

Technical Field

The invention relates to the technical field of arch model reconstruction, in particular to an arch image model reconstruction method.

Background

The arch is an important part of a human body during standing, walking and loading, and the elasticity of the arch can buffer the shock generated by the ground to the body and simultaneously has the function of protecting blood vessels and nerves of the sole from being pressed. The arch of the foot is formed by connecting tarsal bones and metatarsal bones through ligaments and joints, and can be divided into an inner longitudinal arch, an outer longitudinal arch and a transverse arch. The medial longitudinal arch is higher and is composed of calcaneus, talus, navicular bone, 1 st to 3 rd cuneiform bones, 1 st to 3 rd metatarsal bones and the connection between the calcaneus bones, and is mainly maintained by structures such as tibialis posterior tendon, flexor digitorum tendon, plantar quadratus, plantar aponeurosis, calcaneus plantar ligament and the like; the lateral longitudinal arch is lower and is composed of calcaneus, cuboid, 4 th and 5 th metatarsus and the connection among the calcaneus, the cuboid, the 4 th and 5 th metatarsus, and the lateral longitudinal arch is mainly maintained by structures such as fibula long muscle health, plantar long ligament, calcaneal-cuboid plantar ligament and the like; the transverse arch is composed of the bases of the cuboid bones, the 1 st to 3 rd cuneiform bones and the 1 st to 5 th metatarsal bones and the connection between the bases, and can be divided into the front part and the rear part of the transverse arch, and is mainly maintained by structures such as the long tendon of the fibula, the anterior tendon of the tibialis and the transverse head of the adductor pollicis muscles.

The abnormal shape or structure of the foot is commonly called foot deformity, the foot arch damage is caused by ankle joint damage or foot injury, the measured value of the foot arch deviates from the normal reference value of the foot arch in clinical medicine after tarsal bone fracture and/or serious damage (contracture, damage and loss) to muscles and ligaments for maintaining the function of the foot arch, and the foot arch damage is related to the change of the medial and lateral longitudinal arches and the transverse arch. The arch damage causes the elasticity of the foot to be reduced or lost and thus the foot cannot walk or stand for a long time, and at the same time, the supporting function of the lower limbs of the person to the whole body is remarkably lowered and the center of gravity of the body is shifted to the inner side because the soles are flattened, thereby forcing the function of the whole body and the spine to be changed. Arch damage is therefore severe to the human body and can have significant adverse effects on physical health, particularly physical strength and durability.

Currently, ankle surgery research is mostly evaluated from two aspects of fresh corpse specimens and finite element models. Clinically, in order to provide a diagnosis basis for relevant patients, a reasonable treatment scheme is formulated for foot surgeons and supporting orthopedic specialists, and a proper treatment means and a later-stage rehabilitation training scheme are selected, a plurality of methods are adopted for clinically detecting the arch diseases, but different detection means are provided for calcaneus fracture only during ankle fracture detection, and the research on image diagnosis research and clinical application of change of the overall arch radian of the foot is limited. Therefore, the inventor develops an arch image model reconstruction method, which is to obtain a whole foot bone living body model by combining X-rays with a plurality of post-processing methods such as multi-layer spiral CT (MSCT).

Disclosure of Invention

Based on the problems, the invention provides an arch image model reconstruction method, which combines X-ray plain film with MSCT scanning, adopts multiple checking means such as MPR, MIP, SSD, 3DVR reconstruction and the like to combine multi-angle and multi-azimuth reconstruction imaging to obtain a living arch model, and divides the metatarsal columns to obtain static, simple, clear and visible arch image data and accurate arch evaluation data.

In order to solve the technical problems, the invention provides the following technical scheme:

an arch image model reconstruction method comprises the following steps:

s1: firstly, carrying out X-ray plain film and MSCT scanning examination to determine the negativity and the positivity, and carrying out volume scanning by adopting a compliant body position of a patient during scanning;

s2: performing MSCT scanning on the positive patient, scanning the lower tibiofibula 1/3 and extending to the full feet;

s3: carrying out full-length CT scanning and three-dimensional modeling on the ankle;

s4: adopting MPR, MIP, SSD and 3DVR reconstruction to respectively obtain image anatomical models of foot bones, muscles, tendons and ligaments; reconstructing the metatarsal ranks, and reconstructing a metatarsal rank longitudinal arch along the long axis of each metatarsal;

s5: measuring the arch radian of the patient to obtain arch radian data, and comparing and analyzing the arch radian data of the patient with a clinical normal arch radian reference value to obtain arch radian change data;

s6: and judging the damage condition of the muscles, the tendons and the ligaments of the feet of the patient according to the data obtained in the steps S1 to S5, and providing guiding reference for repairing the muscles and the tendons and reconstructing the ligaments.

Further, the arch radian measurement method of the patient in step S5 is as follows:

the measurement process includes the following five measurement points: talar head lowest point 1, lowest point 2 where the calcaneus is in contact with the horizontal, 1 st metatarsal head lowest point 3, calcaneal cuboid joint lowest point 4, and 5 th metatarsal head lowest point 5 where it is in contact with the horizontal;

the measured angles include the following four angles: inner longitudinal bow angle: angle 213, outside longitudinal bow angle: angle 245, anterior bow angle: angle 254, rear bow angle: angle 452.

Compared with the prior art, the invention has the beneficial effects that: the invention carries out X-ray plain film combined MSCT scanning on the full length of the ankle part, and adopts multiple examination means such as MPR, MIP, SSD, 3DVR reconstruction and the like to carry out multi-angle and multi-azimuth reconstruction imaging, respectively obtains the image anatomical data of bones, muscles, tendons and ligaments, and simultaneously measures the arch radian to obtain the key angle and data related to the arch, thereby obtaining the arch radian change data, achieving the purpose of comprehensively judging the foot muscles, tendons and ligament damage condition of a patient, providing guidance reference for the muscle, tendon repair and ligament reconstruction of the patient, providing diagnosis basis for the patient, providing effective reference for the individualized scheme formulated by clinical treatment, and providing effective guidance opinions for the foot surgeon and the brace orthopedic specialist to formulate the reasonable treatment scheme, select the treatment means and the later-stage rehabilitation training scheme; the static living body arch model obtained through three-dimensional imaging can rotate at any angle, and is divided into two-dimensional imaging of the metatarsal columns to obtain static, concise, clear and visible arch image data and accurate arch evaluation data. And combining a plurality of reconstruction methods to obtain a 3D image of the bones, muscles, tendons and ligaments of the whole foot.

Drawings

Fig. 1 is a graph showing the points of measurement of arch camber for an embodiment of the present invention, where 1 is the lowest point of the talus head, 2 is the lowest point of the calcaneus in contact with the horizontal, 3 is the lowest point of the 1 st metatarsal head, 4 is the lowest point of the calcaneus-cuboid joint, and 5 is the lowest point of the 5 th metatarsal head in contact with the horizontal.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail below with reference to examples and accompanying drawings, and the exemplary embodiments and descriptions thereof are only used for explaining the present invention and are not meant to limit the present invention.

Example (b):

an arch image model reconstruction method comprises the following steps:

s1: firstly, X-ray plain film and MSCT scanning examination are carried out to determine the negativity and the positivity of the patient, and the patient adopts a compliant body position during scanning to carry out volume scanning so as to achieve the purpose of not influencing the examination due to the limited injured body position;

s2: MSCT scanning is carried out on the positive patient, the lower tibiofibula 1/3 is scanned and extended to the full foot, the original tomographic image is obtained, and series post-processing reconstruction is carried out;

s4: adopting MPR, MIP, SSD and 3DVR reconstruction to respectively obtain image anatomical models of foot bones, muscles, tendons and ligaments; reconstructing the metatarsal ranks, and reconstructing a metatarsal rank longitudinal arch along the long axis of each metatarsal; the 3DVR has three-dimensional, stereoscopic display, rotatable different angles and accessible regulation threshold value and shows the characteristics of skeleton, muscle, tendon and the various organizational structure of ligament, and the 3DVR of bone joint rebuilds the principle and does: different tissue conditions are shown from skin to bone; the pathological conditions of the tendon and the fracture are displayed by observing from different angles; displaying the spatial relationship and local condition of the fracture from the whole to the local; MIP reconstruction is characterized in that: clearly displaying fracture lines and bone diseases, and observing the overall condition of the fracture, wherein the MIP of the region of interest is particularly important for displaying the fracture; the MIP reconstruction principle of the bone joint is as follows: 3D MIPP generally observes the conditions of fracture, muscle, tendon and ligament, and carefully displays the conditions of fracture and tendon and ligament injury in different directions through the MIP of interest; MPR reconstruction characteristics: the pathological changes are displayed from different directions and layers, and the pathological changes can be clearly displayed on fractures, tendons and ligaments without overlapping; MPR reconstruction principle: displaying the details of the fracture, which is an important supplement of 3DVR and MIP reconstruction, and is a non-main display mode; CPR reconstruction characteristics: is a special MPR and can display details of irregular fracture, tendon and ligament; CPR reconstruction principle: a complete display, displayed from the center layer;

s5: measuring the arch radian of the patient to obtain arch radian data, and comparing and analyzing the arch radian data of the patient with a clinical normal arch radian reference value to obtain arch radian change data; referring to fig. 1, the arch radian measurement method of the patient in this embodiment is as follows: the measurement process includes the following five measurement points: talar head lowest point 1, lowest point 2 where the calcaneus is in contact with the horizontal, 1 st metatarsal head lowest point 3, calcaneal cuboid joint lowest point 4, and 5 th metatarsal head lowest point 5 where it is in contact with the horizontal; the measured angles include the following four angles: inner longitudinal bow angle: 213, and the clinical normal reference value is 113-130 degrees; outer longitudinal bow angle: the angle 245, and the clinical normal reference value is 130-150 degrees; front bow angle: an angle 254, a clinical normal reference value is more than 13 degrees; rear bow angle: an angle 452, a clinical normal reference value is more than 16 degrees; it should be noted that the sum of the inner angles of the lateral longitudinal bow angle, the front bow angle and the rear bow angle is 180 degrees; the measurement method is innovated, and five metatarsal column longitudinal arch data are obtained;

The MSCT in the invention is multilayer spiral CT detection, MPR is multiplanar reconstruction, MIP is maximum density projection, and SSD is spiral CT three-dimensional surface covering. In the embodiment, the affected foot image is obtained through X-ray plain film, and the negative and positive are preliminarily judged; 3D reconstruction is carried out through multilayer spiral CT thin-layer scanning and multi-plane reconstruction technology, the fracture condition of a patient can be displayed in a three-dimensional and visual mode, the anatomical structure of the joint can be observed in a three-dimensional mode from different angles, joint lesions which are hidden can be found in time, small fracture misdiagnosis can be effectively prevented, and the diagnosis accuracy is improved; the method comprises the steps of performing thin-layer scanning on the affected limb of a patient by using multilayer spiral CT, reconstructing a bony arch image of the living body of the patient by adopting MPR, MIP, SSD and 3DVR reconstruction technologies, performing three-dimensional modeling, and obtaining accurate arch radian static entity data by using a three-dimensional measurement method.

Because the arch is mainly maintained by bone ligaments under general conditions, muscles directly related to the foot are inactive in most of the time of the loading period, the passive effect is exerted only when gastrocnemius muscle is intermittently contracted to control the front and back swing and the muscle foot bears excessive load, and the dynamic stabilization device effect is exerted in the propulsion period, the static arch three-dimensional measurement data are undistorted reliable data, and effective arch radian data can be measured; the curved surface stereo reconstruction image is carried out along the walking of the relevant muscles, tendons and ligaments, the meaningful images of the damaged muscles, tendons and ligaments can be independently extracted and reconstructed, and the anatomical conditions of the images of the damaged muscles, tendons and ligaments (tearing, contracture and damage) are comprehensively analyzed.

The above is an embodiment of the present invention. The embodiments and specific parameters in the embodiments are only for the purpose of clearly illustrating the verification process of the invention and are not intended to limit the scope of the invention, which is defined by the claims, and all equivalent structural changes made by using the contents of the specification and the drawings of the present invention should be covered by the scope of the present invention.

Claims

1. An arch image model reconstruction method is characterized by comprising the following steps:

s4: adopting MPR, MIP, SSD and 3D VR reconstruction to respectively obtain image anatomical models of foot bones, muscles, tendons and ligaments; reconstructing the metatarsal ranks, and reconstructing a metatarsal rank longitudinal arch along the long axis of each metatarsal;

2. The method for reconstructing an arch image model according to claim 1, wherein the arch curvature measuring method of the patient in step S5 is as follows: