用MRI生成高精度3D假健康股骨滑车模型,指导精准手术规划。
Towards MR-Based Trochleoplasty Planning
- 基于隐式神经表示与小波扩散模型,从普通MRI重建亚毫米级3D目标形态。
- 在25名患者上验证,显著改善滑车角(SA)和沟槽深度(TGD)。
- 无需CT即可完成,降低辐射,适合临床术前与术中使用。
为治疗滑车发育不良(TD),当前方法主要依赖低分辨率临床磁共振(MR)扫描和外科医生经验,手术规划缺乏标准化,微创技术应用有限,结果不一致。本文提出一种新流程:从常规临床MR扫描生成患者特异性的超分辨率3D伪健康目标形态。首先,利用隐式神经表示(INR)构建各向同性超分辨率MR体数据;其次,通过多标签自定义训练网络分割股骨、胫骨、髌骨和腓骨;最后,训练小波扩散模型(WDM)生成滑车区域的伪健康目标形态。相比以往生成低分辨率3D MR图像的工作,本方法可实现亚毫米级分辨率的3D形状生成,适用于术前与术中参考。这些目标形态可作为重塑股骨滑车沟的术前蓝图,同时保持原生髌骨关节面。此外,本方法无需额外CT,减少辐射暴露。在25例TD患者上评估显示,生成的目标形态显著改善了滑车角(SA)和滑车沟深度(TGD)。代码与交互式可视化已公开于https://wehrlimi.github.io/sr-3d-planning/。
原文摘要 · Abstract (English)
To treat Trochlear Dysplasia (TD), current approaches rely mainly on low-resolution clinical Magnetic Resonance (MR) scans and surgical intuition. The surgeries are planned based on surgeons experience, have limited adoption of minimally invasive techniques, and lead to inconsistent outcomes. We propose a pipeline that generates super-resolved, patient-specific 3D pseudo-healthy target morphologies from conventional clinical MR scans. First, we compute an isotropic super-resolved MR volume using an Implicit Neural Representation (INR). Next, we segment femur, tibia, patella, and fibula with a multi-label custom-trained network. Finally, we train a Wavelet Diffusion Model (WDM) to generate pseudo-healthy target morphologies of the trochlear region. In contrast to prior work producing pseudo-healthy low-resolution 3D MR images, our approach enables the generation of sub-millimeter resolved 3D shapes compatible for pre- and intraoperative use. These can serve as preoperative blueprints for reshaping the femoral groove while preserving the native patella articulation. Furthermore, and in contrast to other work, we do not require a CT for our pipeline - reducing the amount of radiation. We evaluated our approach on 25 TD patients and could show that our target morphologies significantly improve the sulcus angle (SA) and trochlear groove depth (TGD). The code and interactive visualization are available at https://wehrlimi.github.io/sr-3d-planning/.
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