arXiv:2412.09962eess.IV2024-12中稿 · IPCAI 2025被引 4

用AI生成患者专属健康膝关节影像,辅助手术规划

Generating 3D Pseudo-Healthy Knee MR Images to Support Trochleoplasty Planning

  • 用小波扩散模型生成病变区域的健康替代影像
  • 49例数据中,沟角、深度和分型均显著改善
  • 适合骨科医生做软骨成形术前精准设计

目的:髌骨发育不良(TD)是青少年常见畸形,导致前膝疼痛和不稳。手术如滑车成形术需精确规划以重塑股骨滑车沟,但目前缺乏标准化术前方案。本研究旨在生成患者特异性的伪健康膝关节磁共振影像,理论上可与患者髌骨对齐,辅助术前规划。方法:采用小波扩散模型(WDM)生成个性化、解剖合理的滑车区伪健康MRI。模型在健康受试者膝关节MRI上训练,推理时掩蔽患者TD病变区域,替换为伪健康版本。由骨科医生测量术前术后滑车角(SA)、滑车沟深度(TGD)及Déjour分型。代码已公开。结果:在49例膝关节MRI中,该方法显著改善了SA、TGD及Déjour分类。结论:研究表明WDM在提供个性化术前指导方面具有潜力,通过生成解剖合理影像,有望提升滑车成形术精度,推动更微创手术发展。

原文摘要 · Abstract (English)

Purpose: Trochlear Dysplasia (TD) is a common malformation in adolescents, leading to anterior knee pain and instability. Surgical interventions such as trochleoplasty require precise planning to correct the trochlear groove. However, no standardized preoperative plan exists to guide surgeons in reshaping the femur. This study aims to generate patient-specific, pseudo-healthy MR images of the trochlear region that should theoretically align with the respective patient's patella, potentially supporting the pre-operative planning of trochleoplasty. Methods: We employ a Wavelet Diffusion Model (WDM) to generate personalized pseudo-healthy, anatomically plausible MR scans of the trochlear region. We train our model using knee MR scans of healthy subjects. During inference, we mask out pathological regions around the patella in scans of patients affected by TD, and replace them with their pseudo-healthy counterpart. An orthopedic surgeon measured the sulcus angle (SA), trochlear groove depth (TGD) and Déjour classification in MR scans before and after inpainting. The code is available at https://github.com/wehrlimi/Generate-Pseudo-Healthy-Knee-MRI . Results: The inpainting by our model significantly improves the SA, TGD and Déjour classification in a study with 49 knee MR scans. Conclusion: This study demonstrates the potential of WDMs in providing surgeons with patient-specific guidance. By offering anatomically plausible MR scans, the method could potentially enhance the precision and preoperative planning of trochleoplasty, and pave the way to more minimally invasive surgeries.

医学影像生成模型手术规划

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