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공개용과 상업용 DICOM STL 파일변환 프로그램으로 출력한 삼차원 프린팅 쇄골 골절 모델의 품질비교
오왕균(Wang-Kyun Oh),김형균(Hyeong-Gyun Kim) 대한방사선과학회(구 대한방사선기술학회) 2018 방사선기술과학 Vol.41 No.1
The recent 3D printing technology is used in various medical, manufacturing, and education fields and is more efficient in terms of production process, time, and cost than existing production. Especially in fracture surgery, interest and research have been focused on improving accuracy, shortening of operation time and recovery time, and reducing reoperation. However, because of the financial and technical problems of the 3D printer and the file conversion program, the 3D printing is made directly at the hospital, and it is not generally used for diagnosis of fracture and surgical research. In this study, to solve those problems, clavicle CT imaging was switched into Osirix Open Source DICOM Viewer, Stereolithography file conversion programs and commercial Terarecon 3D DICOM Viewer, file conversion programs, and then clavicle fracture model was directly made through 3D printer of fused filament fabrication wire additive processing method, and then the accuracy of the shape was compared and analyzed. Clavicle fracture models printed in two methods were blind-tested on clinicians of general hospitals orthopedics and radiologic technicians with over 10 years of experiences, and then their analysis opinions of resolution reviews were analyzed. The result showed no difference. The 3D printing model with open source DICOM STL file conversion program used was applicable to clinical, so it is considered useful in precision diagnosis of fracture and operation plans.
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임기선(Ki Seon Lim),오왕균(Wang Kyun Oh),이태수(Tae Soo Lee) 한국방사선학회 2013 한국방사선학회 논문지 Vol.7 No.5
류마티스성 관절염 등의 관절 질환이나 내반 변형 등을 동반한 환자에게 정형외과적으로 인공슬관절 치환술을 시행하는데 수술용 금속정을 삽입할 때 대퇴체부의 휨 정도로 인해 대퇴피질부에 손상을 주거나 2차 골절 등의 부작용을 유발하기도 한다. 이때 대퇴체부의 중심 좌표값을 알면 금속정이 해부학적 모양의 중심으로 삽입될 수 있어 이러한 부작용을 예방할 수 있을 것이다. 본 연구에서는 인공슬관절 치환술이 필요한 10명의 환자와 대퇴골 질환이 없는 정상군 10명의 대퇴부 단층촬영영상을 이용하여 3차원 좌표값을 찾은 후 Matlab을 이용하여 중심좌표값을 찾아 해부학적 모양을 반영한 그래프를 얻었고, 구간별 3차원 곡률반경 값을 구하였다. 그 결과 실험군의 대퇴골 평균 곡률반경과 표준 편차는 758.15±206.3 mm로 측정되었고, 정상군은 1672.97±395.6 mm로 측정되었다. 측정된 결과는 통계적 유의성 확보를 위해 f-검정을 실행하여 두 집단간 평균의 차이를 검증하였다. 이 결과로 미루어 실험군의 대퇴체부 휨 정도가 더 심함을 확일할 수 있었으며 이러한 영상 분석방법을 이용하여 해부학적 중심점을 찾는다면 인공슬관절 치환술 같은 정형외과적 수술에 도움이 될 것이라 사료된다. For some patients with joint illnesses such as rheumarthritis or varus deformity, the total knee arthroplasty (TKA) procedures are performed. However, when inserting metal cutting guide for the procedures, due to the femoral shaft bowing, complications such as the cortex of the femoral shaft damages or secondary fractures can be caused. If the central coordinate value of the femoral shaft is known, the metal cutting guide could be inserted into the anatomical center, so such complications can be prevented. In this study, CT images of femoral shafts of 10 individuals in the experiment group who are in need of receiving the total knee arthroplasty procedures and those of 10 individuals in the control group without illness in the femoral shaft have been utilized to locate the 3-dimensional coordinate values. Then, Matlab was utilized to identify the central coordinate value in order to obtain a graph reflecting the anatomical shapes as well as to acquire the 3-dimensional radial curvature values by section. As a result, the average curvature range and standard deviation of femoral shafts of the experiment group was determined to be 758.15±206.3 mm whereas the that of the control group was determined to be 1672.97±395.6 mm. The statistical significance of the measured results was verified through f-distribution analysis. Based on these results, it was verified that the level of curvature of the femoral shaft of the experiment group was higher. If the anatomical central points are located and analyzed using this methodology, it would be helpful in performing orthopedic operations such as the total knee arthroplasty.
ScienceON
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