眼眶和颌面部计算机辅助手术：预测手术结果的患者特定有限元模型
Orbital and Maxillofacial Computer Aided Surgery: Patient-Specific Finite Element Models To Predict Surgical Outcomes
摘要：
本文讨论了计算机辅助手术应用的临床相关性提出的一个重要问题，即用于自动构建解剖结构的患者特定有限元（FE）模型的方法。从这个角度来看，提出了一种方法，基于一种称为网格匹配方法的技术，随后是一个过程，纠正网格不规则性。网格匹配算法从现有通用模型生成患者特定体积网格。网格正则化过程基于与FE参考单元和当前单元相关的雅可比矩阵变换。这种方法用于生成患者特定的有限元模型，首先应用于计算机辅助颌面外科手术，更准确地说，患者面部软组织的有限元弹性建模。对于每名患者，计划的截骨术（下颌骨、上颌骨、下巴）被用作边界条件，以使FE面部模型变形，从而预测手术的美学结果。我们的方法成功地生成了七个FE患者特异性模型。对于一名患者，FE模型的预测与从计算机断层扫描测量的患者术后外观进行定性比较。然后，我们的方法被应用到计算机辅助眼眶手术。因此，评价了11个患者特异性眼眶软组织FE多孔弹性模型的生成。这些模型用于预测眼眶手术减压的后果。更确切地说，平均定律是从针对每个患者模型进行的模拟中推断出来的。这一定律将截骨术的大小（即手术姿势）和眼球的后移（手术姿势的后果）联系起来。
英文摘要：
This paper addresses an important issue raised for the clinical relevance of Computer-Assisted Surgical applications, namely the methodology used to automatically build patient-specific Finite Element (FE) models of anatomical structures. From this perspective, a method is proposed, based on a technique called the Mesh-Matching method, followed by a process that corrects mesh irregularities. The Mesh-Matching algorithm generates patient-specific volume meshes from an existing generic model. The mesh regularization process is based on the Jacobian matrix transform related to the FE reference element and the current element. This method for generating patient-specific FE models is first applied to Computer-Assisted maxillofacial surgery, and more precisely to the FE elastic modelling of patient facial soft tissues. For each patient, the planned bone osteotomies (mandible, maxilla, chin) are used as boundary conditions to deform the FE face model, in order to predict the aesthetic outcome of the surgery. Seven FE patient-specific models were successfully generated by our method. For one patient, the prediction of the FE model is qualitatively compared with the patient's post-operative appearance, measured from a Computer Tomography scan. Then, our methodology is applied to Computer-Assisted orbital surgery. It is, therefore, evaluated for the generation of eleven patient-specific FE poroelastic models of the orbital soft tissues. These models are used to predict the consequences of the surgical decompression of the orbit. More precisely, an average law is extrapolated from the simulations carried out for each patient model. This law links the size of the osteotomy (i.e. the surgical gesture) and the backward displacement of the eyeball (the consequence of the surgical gesture).
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