阅读说明：本技术 3d打印个性化骨科内植物构建及生物力学优化处理方法 (The building of 3D printing personalization orthopedic implant and biomethanics optimized treatment method ) 是由 刘宏伟 蒋俊锋 顾勇 张文 翁益平 徐南伟 张云坤 魏辉 王庆 周鑫叠 李栋 于 2019-08-09 设计创作，主要内容包括：本发明属于图像信息处理技术领域,公开了一种3D打印个性化骨科内植物构建及生物力学优化处理方法,首先对CT图像进行预处理；然后进行CT图像的分割；之后重建好典型的三维骨骼模型,以典型模型为模板,对其它骨骼基于模板进行三维骨骼模型的修复重建处理；对面向骨骼解剖复位的数字化网格配准算法进行研究；对经置钉方案优化的个性化手术导板进行设计；对个性化人工关节假体的几何形态匹配与力学性能进行优化；对三维模型进行打印,进行基于三维打印的骨科植入物治疗。本发明对于缩短骨科术前规划周期、提高个性化内植物植入效率和力学性能、减少手术时间和手术创伤,以及促进骨科内植物产业发展均有着重要的理论意义和临床应用价值。(The invention belongs to technical field of image information processing, a kind of 3D printing personalization orthopedic implant building and biomethanics optimized treatment method are disclosed, CT image is pre-processed first；Then the segmentation of CT image is carried out；Good typical three-dimensional skeleton model is rebuild later, and using typical model as template, the reconstruction for carrying out three-dimensional skeleton model based on template to other bones is handled；The digitlization mesh registration algorithm resetted towards skeleton dissection is studied；Personalized surgical guide through setting nail scheme optimization is designed；The geometric shape of personalized artificial articular prosthesis is matched and is optimized with mechanical property；Threedimensional model is printed, the orthopaedics implant treatment based on 3 D-printing is carried out.The present invention is for shortening orthopaedics preoperative planning horizon, improve personalized implants implantation efficiency and mechanical property, reduce operating time and operation wound, and orthopedic implant industry development is promoted to have important theory significance and clinical value.)

1. a kind of 3D printing personalization orthopedic implant building and biomethanics optimized treatment method, which is characterized in that the 3D Print personalized orthopedic implant building and biomethanics optimized treatment method the following steps are included:

Step 1 pre-processes CT image；Then the segmentation of CT image is carried out；Good typical three-dimensional bone mould is rebuild later Type, using typical model as template, the reconstruction for carrying out three-dimensional skeleton model based on template to other bones is handled；

Step 2, normal bone more for bone defect and registration bone application entity boolean's difference operation, find out corresponding personalization The shape of orthopaedics implant；

Step 3 optimizes geometric shape matching and the mechanical property of personalized artificial articular prosthesis；

Step 4 carries out three-dimensional segmentation, three-dimensional vanning, structure optimization, self-adapting slicing operation to threedimensional model to be printed；

Step 5 prints threedimensional model, carries out the orthopaedics implant treatment based on 3 D-printing.

2. 3D printing personalization orthopedic implant building as described in claim 1 and biomethanics optimized treatment method, It is characterized in that, in the segmentation of CT image, by the way that CT faultage image is established corresponding relationship with the template faultage image divided, The fringe region for being difficult to divide is split referring to template；Specific implementation includes: that the CT image of the two is first done non-rigid to match Standard is iterated optimization using the methods of Snake model or level set using the cut-off rule in template image as initial value；Pass through Isosurface extraction or algorithm based on contour line, obtain the surface model of three-dimensional bone；Fit the immediate bone mould of shape Plate, it is real further according to the skeleton model deformation alignment that Curvature varying, extreme point, CT image grayscale value tag rebuild template to CT The reparation of existing skeleton model.

3. 3D printing personalization orthopedic implant building as described in claim 2 and biomethanics optimized treatment method, It is characterized in that, constructs the reference model of normal bone, pass through matching between the registration and bone block and reference model between optimization bone block Standard realizes preferable alignment；It is obtained with reference to skeleton model by the template mesh of mirror image healthy bone or parametric deformation.

4. 3D printing personalization orthopedic implant building as described in claim 1 and biomethanics optimized treatment method, It is characterized in that, carries out the anatomical reduction of bone, consider the successively iteration optimization of geometric match and mechanics functional rehabilitation, building includes The constrained energy equation of institute, carries out the Optimization Solution of overall model.

5. 3D printing personalization orthopedic implant building as described in claim 1 and biomethanics optimized treatment method, It is characterized in that, geometric shape matching and the mechanical property of the personalized artificial articular prosthesis optimize, and pass through group distribution type and one Two kinds of personalized artificial joint prostheses implants design schemes of change type, the standardization implantation material and three that traditional diamond-making technique is made The personalized implantation material of dimension printing is implemented in combination with.

6. 3D printing personalization orthopedic implant building as described in claim 1 and biomethanics optimized treatment method, It is characterized in that, the orthopaedics implant treatment based on 3 D-printing includes: that surgery planning is led with simulated maneuver, foundation operation Plate, personalized bone plate, four part of personalized articular prosthesis.

Technical field

The invention belongs to technical field of image information processing more particularly to a kind of 3D printing personalization orthopedic implant structures It builds and biomethanics optimized treatment method.

Background technique

Currently, the immediate prior art: before traditional bone surgery, doctor generally passes through the Imaging Methods such as X-ray, CT Understand the state of an illness, surgery planning and simulation are then carried out in two-dimentional drawing or brain.This method is difficult intuitively to understand sick and wounded bone Bone region, it is difficult to carry out complicated surgical simulation, and professional skill to doctor and imagination have higher requirement.And number Model is compared, and 3 D-printing physical model provides environment more true to nature.Doctor can make accurate diagnosis in the preoperative, formulate Detailed operation plan assesses risk that may be present in art, and the operation practice on mock-up, when so as to shorten operation Between, improve success rate of operation.By manufacturing the three-dimensional entity model of sick and wounded bony site 1: 1, the bone of suitable types can be selected in advance Surgical implant carries out deformation process to general implantation material, further shortens operating time.

The operation of the complicated or neighbouring vital tissue of anatomical structure generally has higher requirement to Intraoperative position, for example, crushing Property fracture reset need to determine the position and direction squeezed into of positioning screw in art.Conventional method often relies on the solution of doctor Cut open knowledge and experience, due to the individuation of patient anatomy and the deficiency of doctors experience, if entry point, into nail direction and Length mistake can lead to operative failure, or even jeopardize patient vitals.

Surgical guide is designed by digitizing solution, using three-dimensional printing technology quick Fabrication, by guide plate and patient in art It is relatively fixed, it can be used for determining entry point, into nail direction, and then improve success rate of operation, reduce operating difficulty, ensure patient Safety.Compared with conventional freehand sets nail method, it is more accurate that nail is set using guide plate auxiliary；Nail method phase is set with computer navigation Than 3 D-printing guide plate is easy to operate, low in cost, and can reduce x-ray fluoroscopy number in art, reduces amount of radiation.

It is good between orthopaedics implant and patient bone to be bonded the incipient stability for matching and can guarantee prosthese, keep stress equal Even conduction is conducive to Bone Ingrowth and the healing at " prosthese-bone " interface, is implantation material basis steady in a long-term.For skeleton Individual difference, the orthopaedics implant of produced in conventional processes different model, doctor selects most suitable model, when then performing the operation Burr is deep or processes adjustment to implantation material, to realize the matching between prosthese and bone.But this method will lead to operation wound Greatly, operating time is long, causes the complication such as Periprosthetic fracture；Adjustment deformation changes the biomechanical property of implantation material, increases Add its postoperative risk for loosening, being broken.

Three-dimensional printing technology, which is designed and manufactured to orthopaedics implant, brings unprecedented good opportunity.According to the bone of patient Bone model, is designed and 3 D-printing goes out personalized orthopaedics implant, is directly realized by good matching, when so as to shorten operation Between, reduce postoperative complication, improve surgical quality.In addition, comparing with traditional formula manufacture that subtracts, 3 D-printing is more suitable for processing Personalized orthopaedics implant with complex surface shape, manufacturing cost are low.

Domestic and international present Research analysis

(1) application of the 3 D-printing in orthopedic treatment

It is preoperative that threedimensional model is reconstructed according to CT picture of patient, the bone entity mould of 1:1 is prepared using three-dimensional printing technology Type facilitates doctor and accurately understands the topography of skeletal tissue and the relationship of lesion and surrounding structure, discusses and formulate Operation plan.Document " clinical application of the printing technique in children's hip dislocation overhaul technology " is to dislocation of hip joint patient bone Basin model carries out 3 D-printing, and surgery planning and surgical simulation are carried out on physical model.Since 3 D-printing model can be quasi- The solid shape and anatomical structure for really intuitively reflecting the preoperative deformity of pelvis keep operation more accurate reliable, effectively reduce hand The art time, improve surgical effect.Document " Three-dimensional biomodeling in complex Mandibular reconstruction and surgical simulation:prospective trial " utilize three-dimensional The mandible model of printing, preoperative pre-bending reconstruction titanium plate, makes it fit in model surface completely, saves and bends titanium plate step in art Suddenly, reduce the time of jawbone defect prosthesis.Document " personalized three-dimensional prints bionical bone preoperative diagnosis model " is no The shape of printer model is taken into consideration only as natural skeleton, inside should also have the fine reticular structure of cancellous bone, power It learns performance and is more nearly patient's personal feature, the planning of operation plan can more accurately be carried out by making doctor in the preoperative.It is based on The printable three-dimensional skeleton model of CT image reconstruction, still needs to a large amount of manual interaction, processing takes time and effort at present；3 D-printing Technology print speed, in terms of defect, also limit its surgery planning and simulation in application.Document 《Computer assisted orthopaedic surgery with image based individual templates》 The research for setting nail in pedicle of lumbar vertebral arch using 3 D-printing surgical guide earliest, hereafter promotes rapidly, has been widely used in closing Section, cervical vertebra, thoracic vertebrae and other complexity bone surgery.It is tiny for pedicle for cervical vertebra arch, set the big problem of nail risk, document 《Deviation analysis of C2 translaminar screw placement assisted by a novel Rapid prototyping drill template:a cadaveric study " preoperative determining screw sizes, design merging Track carries out screw merging under the surgical guide auxiliary of 3 D-printing when operation, easy to be accurate, shortens operating time, Reduce the amount of radiation of doctor and patient.In complicated limbs fracture, document " Applicationof computer-generated stereolithographyand inter-positioning template in acetabular fractures:a Report of eight cases " using the accurate merging of 3 D-printing guide plate additional screws and internal fixation material, it can shorten Operating time, reduces complication, and surgical effect is satisfactory.Using the surgical guide of 3 D-printing, operation behaviour is being improved While making convenience, it can reduce and set nail punching rate and anisotropy rate, set nail accuracy rate much higher than conventional method.However, mesh The personalized designs of preceding surgical guide still lack professional software, for complicated operation, surgical guide construct difficulty it is big, at This height.Complicated injuries often results in the defect and surrounding comminuted fracture of local sclerotin, and ideal therapeutic scheme is according to patient bone It splits type and bone loss situation carries out the design and treatment of individuation implantation material, while reaching best stability maintenance Repair bony defect.[" design and application of area of computer aided individuation artificial semi-pelvis " utilizes the patient of 3 D-printing to document Individuation pelvis prosthesis has carried out the first half pelvis replacement operation in the world." Xijing hospital orthopedics complete Asia the first 3D to document Printing titanium alloy pelvis prosthesis value enters art " complete Asia the first titanium alloy 3 D-printing pelvic tumor Using prosthesis art.Document It is small that " short term efficacy of 3D printing titanium alloy bone trabecula metal acetabular cup replacement of total hip " has studied 3 D-printing titanium alloy bone Beam metal acetabular cup, the short application use in first replacement of total hip, short term efficacy are good.However and traditional diamond-making technique It compares, 3 D-printing implantation material mechanical strength is lower, fatigue resistance is poor, it is more difficult to postoperative high-intensitive long-time service is adapted to, This has become limitation 3 D-printing orthopaedics implant and is applied to clinical key link.

(2) towards the Graphics and Image Processing of skeleton model

The acquisition of three-dimensional skeleton model is generally required by CT Image Acquisition, image preprocessing, image segmentation, Three-dimensional Gravity Build four steps.For the image that imaging device obtains, generally there are distortion and noises, it is necessary first to carry out to CT image pre- Processing enhances picture quality.Image denoising generallys use filtering operation, and there are commonly mean filter, median filtering, low pass filtereds Wave etc.；Image enhancement generallys use the methods of histogram equalization, laplacian spectral radius.Human body CT image includes bone and soft group Two parts are knitted, and the gray value of bone is generally below soft tissue, therefore can use image segmentation algorithmTake out bony areas. CT image partition method can be divided into four classes by its nature: the dividing method based on region, is based on the dividing method based on boundary The dividing method of model and dividing method based on map.Segmentation based on grayscale information is bone the most commonly used point Segmentation method, and Threshold segmentation is the representative of such method.In addition, the partitioning algorithm based on shape prior knowledge also obtains in recent years Extensive concern is arrived.It is available using image segmentation as a result, passing through isosurface extraction or based on the algorithm of contour line The surface model of three-dimensional bone.

Three-dimensional skeleton model method for reconstructing based on ct images, there are still model the problems such as difficult, interworking amount is big. Main cause is that the particularity of medical image causes algorithm to be difficult to automatically process, such as: the gap between bone is too small, causes phase Obscurity boundary between adjacent bone；The gray value of cancellous bone is distinguished difficult between Bone and soft tissue；Lesion bone lacks Damage collapses, and causes bone boundaries interspersed.

In addition, the three-dimensional skeleton model that current method obtains, is generally used for doctor's interaction observation, often there is number of vertex Excessively, include cavity, isolated face, multilayered structure, contain situations such as much noise, 3 D-printing can not be carried out.To geometrical model Optimization processing, obtained extensive research in field of Computer Graphics.For example, in order to reduce the data volume of geometrical model, Grid model can be simplified, in the case where keeping curved surface features as far as possible, reduce the quantity on vertex, dough sheet and side.Needle The geometric positions missings such as cavity, self intersection, dough sheet coincidence are contained to model surface or are overlapped, geometrical error can be carried out It repairs.For extra ring, isolated island and the cavity contained on model, the reparation and removal of Topology Error can be carried out, generates topology Specification, easy-to-handle high quality grid.Further, can inhibit on model under the premise of keeping geometric detail as far as possible Noise.On skeleton model under anatomy semanteme three-dimensional grid segmentation, for doctor determine fracture parting, realize fracture, The quantitative measurments such as direction, displacement degree have great importance.Different bone block threedimensional models are spliced, carry out personalization The design of implantation material and guide plate, it is necessary first to which skeleton model is registrated.Rigid Registration between threedimensional model is general to utilize Iteration closest approach or the consistent scheduling algorithm of random sampling.For deformable bodies, non-rigid body model can be carried out；By multiple Global registration between model, it is possible to reduce deviation accumulation caused by part is registrated two-by-two.

The geometric manipulations of three-dimensional skeleton model have its particularity.For example, bone block not only has position in comminuted fracture It moves, rotation, there are also the irregular deformation such as interspersed, extrusion stretching mutually；The processing of three-dimensional skeleton model not only needs to consider several What attribute also needs the constraint in terms of consideration biomethanics, anatomical structure.Image processing algorithm general at present, it is three-dimensional in processing The reparation of skeleton model, segmentation, there are also certain difficulties with punctual.It is a large amount of that relevant treatment software relies on professional at present Man-machine interactively, the degree of automation are lower.The priori knowledge of quasi-step matrix skeleton of the present invention is examined for 3 D-printing in orthopaedics Corresponding model treatment algorithm is researched and developed in application in treatment, and it is excellent to improve algorithm process efficiency, promotion the degree of automation, improved model Change result.

(3) the digitizing technique linguistic term towards 3 D-printing

For the application demand in orthopedic treatment, there is also some common problems for current three-dimensional printing technology, such as print Speed is relatively slow, printed material is more expensive, can print dimension of object is smaller, printing objects mechanical properties are poor etc..These problems It solves, be unable to do without the development of electric mechanical, material science.In addition to this, under the conditions of existing hardware, researcher also considers Using digitizing technique and pattern algorithm, processing is optimized to 3-D geometric model and print data, to improve 3 D-printing Effect.3 D-printing need to be sliced successively printing to threedimensional model, when the thickness such as tradition slice can generate model accuracy and printing Between between contradiction: lift height is small, and model accuracy is guaranteed, but the print time is long；Conversely, the print time shortens, but easily lead Cause model ladder error big.For this problem, document " Saliency-Preserving Slicing Optimization For Effective 3D Printing " a kind of grid model self-adapting slicing method based on geometry conspicuousness is proposed, Different slice thickness is set by the part to visual saliencies different in model, is guaranteeing printer model visual effect Under the premise of, save the 3 D-printing time.What slice calculated is printing path planning in next step, and by reducing idle stroke, reduction is swept Path is retouched in the number of hops of different zones, reduces the sweep spacing between each layer cross section, can be further improved printing speed Degree.By model optimization, the support construction of overhanging portion less as far as possible, it is possible to reduce the print time, and can avoid later period removal The operating time of backing material.3 D-printing cost is directly proportional to material consumption, therefore consider how can be not sacrificial by researcher Under the premise of domestic animal print quality, printed material consumption is reduced by Optimized model.Document " Cost-effective Printing of 3D objects with skin-frame structures " by model tormulation at a very thin covering And internal rigid-framed structure, so that meeting required physical strength, force stability, self-regulation and printability Under requiring, printed material used in the object after expression is minimum.Document " Build-to-last:Strength to Weight 3D printed objects " internal structure of the honeycomb as model is used, while reducing material loss It ensure that the intensity of model.For the limitation of 3 D-printing dimension of object, a feasible solution is to be divided into The printable small object of muti-piece, then assembles them into the big object of entirety again.Document " Chopper:partitioning Models into 3D-printable parts " divided using plane, process object is divided into two every time, gradually carefully Change, ultimately forms a tree-like hierarchy segmentation result.However, the 3 D-printing of skeleton model and artificial prosthesis optimizes, not only need Consider its geometric attribute, it is also necessary to consider anatomical structure and biomechanical characterization, corresponding algorithm has not been reported at present.

For the strength problem of 3 D-printing object, document " Stress relief:improving structural Strength of 3D printable objects " it is detected automatically by carrying out stress structure analysis to threedimensional model, And using increasing pillar, thicken, hollow out three kinds of operations and be modified to the structural strength of model.Document " Worst-case Structural analysis " the case where finding a kind of least favorable load, and most destructible or most is identified on model accordingly Large deformation region, to remind user to modify corresponding region.Document " Physical reproduction of materials With specified subsurface scattering " by optimizing the combination that level is superimposed between different materials, Deformation effects when printer model being enabled to reach given external force.Using graphics-optimized algorithm, there are also researchers to beat The work such as the optimization of stamp type center of gravity, mechanism design, the design of self-supporting mechanism.However, power of the orthopaedics therapy to 3 D-printing model Learning intensity and fatigue resistance has this kind of weight bearing area of higher requirement, especially hip and knee, lower limb skeletons, even if using upper Optimization algorithm is stated, three-dimensional printing technology can not still fully meet the demand of orthopedic treatment at present.

With the raising of social standard of living, vehicles number surge causes traffic accident to increase and aging of population Process accelerates, and orthopedic treatment demand is more and more, it is also higher and higher to require, and China is often only bone defect patient and is as high as 3,000,000 Example, the sales volume of orthopaedics implant is every year with 20% speed increase.3 D-printing is related particularly suitable for printing skeleton Tool and this kind of object with complex surface and space structure of orthopaedics implant, including wound bone plate, joint prosthesis are false Body, backbone implants and tumour bone defect implants etc. provide new for orthopedics diagnosis treatment, medical apparatus industry development Opportunity.Critical issue urgently to be resolved in orthopedic treatment based on 3 D-printing provides new machine for number orthopaedic technique It meets.

In conclusion problem of the existing technology is:

(1) three-dimensional skeleton model based on ct images is rebuild, and there are still modeling difficulty, interactive quantity are big.

(2) it for the design of personalized orthopaedics implant and surgical guide, needs skillfully to grasp relevant medicine and CAD Design software, and certain surgical experience is needed, it is higher to personnel requirement.

(3) mechanical strength of 3 D-printing orthopaedics implant mechanical property is lower, fatigue resistance is poor, it is more difficult to adapt to art It is high-intensitive afterwards to be used for a long time.

Solve the difficulty of above-mentioned technical problem:

Three-dimensional skeleton model method for reconstructing based on ct images, there are still model the problems such as difficult, interworking amount is big. Main cause is that the particularity of medical image causes algorithm to be difficult to automatically process, such as: the gap between bone is too small, causes phase Obscurity boundary between adjacent bone；The gray value of cancellous bone is distinguished difficult between Bone and soft tissue；Lesion bone lacks Damage collapses, and causes bone boundaries interspersed.

The optimization of the 3 D-printing of skeleton model and artificial prosthesis, not only needs to consider its geometric attribute, it is also necessary to consider solution Structure and biomechanical characterization are cutd open, corresponding algorithm has not been reported at present.

Orthopaedics therapy has higher requirement, especially hip knee to close the mechanical strength and fatigue resistance of 3 D-printing model Section, this kind of weight bearing area of lower limb skeletons.

Solve the meaning of above-mentioned technical problem:

3 D-printing carries out discrete dynamics models by successively increasing material, simplifies product according to the three-dimensional digital model of object Fabrication schedule, shorten the lead time, improve efficiency and reduce cost, be considered as the third time industrial revolution important symbol it One.With the development of three-dimensional printing technology, the reduction of equipment cost, aerospace, industry manufacture, biology it have been applied at present The fields such as medicine.Surface and space structure of the 3 D-printing particularly suitable for this kind of complexity of skeleton are orthopedics diagnosis Treatment, medical apparatus industry development bring new opportunity.Application of the three-dimensional printing technology in orthopedic treatment is mainly reflected in Three aspects below, as shown in Fig. 3.

Summary of the invention

In view of the problems of the existing technology, the present invention provides a kind of 3D printing personalization orthopedic implant building and Biomethanics optimized treatment method.

The invention is realized in this way a kind of 3D printing personalization orthopedic implant building and biomethanics optimization processing Method, 3D printing personalization orthopedic implant building and biomethanics optimized treatment method the following steps are included:

Step 1 pre-processes CT image；Then the segmentation of CT image is carried out；It rebuilds later good typical three-dimensional Skeleton model, using typical model as template, the reconstruction for carrying out three-dimensional skeleton model based on template to other bones is handled；

Step 2, normal bone more for bone defect and registration bone application entity boolean's difference operation, find out correspondence The shape of personalized orthopaedics implant；

Step 3 optimizes geometric shape matching and the mechanical property of personalized artificial articular prosthesis；

Step 4 carries out three-dimensional segmentation, three-dimensional vanning, structure optimization, self-adapting slicing behaviour to threedimensional model to be printed Make；

Step 5 prints threedimensional model, carries out the orthopaedics implant treatment based on 3 D-printing.

Further, in the segmentation of CT image, by by CT faultage image with divide template faultage image foundation pair It should be related to, it may be difficult to which the fringe region of segmentation is split referring to template；Specific implementation includes: first to do the CT image of the two Non-rigid body model is iterated using the cut-off rule in template image as initial value using the methods of Snake model or level set Optimization；By isosurface extraction or based on the algorithm of contour line, the surface model of three-dimensional bone is obtained；Shape is fitted most to connect Close bone template, the skeleton model for rebuilding template to CT further according to Curvature varying, extreme point, CT image grayscale value tag Deformation alignment, realizes the reparation of skeleton model.

Further, the reference model for constructing normal bone by the registration and bone block between optimization bone block and refers to mould Registration between type realizes preferable alignment；Pass through mirror image healthy bone or the template net of parametric deformation with reference to skeleton model Lattice obtain.

Further, the anatomical reduction of bone is carried out, considers the successively iteration optimization of geometric match and mechanics functional rehabilitation, Building includes the constrained energy equation of institute, carries out the Optimization Solution of overall model.

Further, the geometric shape matching of the personalized artificial articular prosthesis optimizes with mechanical property, passes through a group distribution type With two kinds of personalized artificial joint prostheses implants design schemes of integrated type, the standardization of traditional diamond-making technique production is planted The personalized implantation material for entering object and 3 D-printing is implemented in combination with.

Further, the orthopaedics implant treatment based on 3 D-printing includes: surgery planning and simulated maneuver, establishes Surgical guide, personalized bone plate, four part of personalized articular prosthesis.

In conclusion advantages of the present invention and good effect are as follows:

(1) present invention makes full use of the priori knowledge of skeleton two-dimensional CT image and 3 dimensional coil geometry, realizes three-dimensional Skeleton model quickly generate and Automatic Optimal, solve the problems, such as that conventional method interactive quantity is big, the degree of automation is low.

(2) towards skeleton dissection reset digitlization mesh registration and set nail scheme optimization, while consider geometry with The reset of mechanics function reduces the difficulty that doctor carries out complicated operation planning and operation.

(3) the personalized Using prosthesis for the standardization implantation material and 3 D-printing that the present invention makes traditional diamond-making technique Object combines, and has complementary advantages, and has preferable biomechanical property while realizing good geometric match, extends three-dimensional The application range being printed upon in orthopaedics.

(4) link closely practical application request.With social development, vehicles number increases sharply, aging of population accelerates, orthopaedics Diagnosis and treatment demand is more and more, it is higher and higher to require.On the other hand, the appearance of 3 D-printing and universal, to promote orthopedic treatment effect Fruit, reduction diagnosis and treatment cost bring new opportunity.The present invention is around 3 D-printing urgently to be resolved three in orthopedic treatment application It ties up skeleton model and generates difficult, implantation material and surgical guide design cumbersome, 3 D-printing low efficiency, printer model mechanical property The practical problems such as difference have carried out the research of key graphic algorithm.

(5) multi-crossed disciplines are strong.Present invention combination computer graphics, CAD, 3 D-printing, number The application development trend in the fields such as word orthopaedics, biomethanics, introduced image segmentation based on template, three-dimensional modeling data storehouse, Distortion of the mesh, geometry describe operator, global registration, solid Boolean, random search algorithm, stress analysis, grid point It cuts, three-dimensional vanning, self-adapting slicing, curved surface extraction, collision detection, Important Thoughts and the tool such as finite element simulation, passes through these The further intersection of subject seeks the effective way for solving application problem.

(6) complete system framework.Application of the 3 D-printing in orthopedic treatment is mainly reflected in surgery planning and mould Intend, establish three surgical guide, personalized orthopaedics implant aspects.The present invention is to the three-dimensional bone based on CT image being related to Model generates, skeleton model optimization, skeleton dissection reset, surgical guide generates, personalized implantation material design, efficiently three-dimensional is beaten The entire flows such as print, experimental verification have carried out systematic research.

Detailed description of the invention

Fig. 1 is 3D printing personalization orthopedic implant building provided in an embodiment of the present invention and biomethanics optimization processing Method flow diagram.

Fig. 2 is 3D printing personalization orthopedic implant building provided in an embodiment of the present invention and biomethanics optimization processing The overall framework and flow chart of method.

Fig. 3 is application schematic diagram of the 3 D-printing provided in an embodiment of the present invention in orthopedic treatment；

In figure: being (a) surgery planning and simulation；It (b) is to establish surgical guide；It (c) is personalized orthopaedics implant.

Fig. 4 is the three-dimensional skeleton model schematic diagram that CT image reconstruction provided in an embodiment of the present invention obtains.

Fig. 5 is the mesh registration schematic diagram provided in an embodiment of the present invention resetted towards skeleton dissection；

In figure: being (a) broken bone block model；It (b) is normal bone reference model；It (c) is bone registration effect.

Fig. 6 is bone fracture screw fixation provided in an embodiment of the present invention and surgical guide schematic diagram.

Fig. 7 is traditional prosthesis implantation provided in an embodiment of the present invention and assembly type personalization Using prosthesis effect picture；

In figure: being (a) conventional femoral handle Using prosthesis effect；It (b) is femur outer surface, the extraction of pulp cavity inner surface curved surface； It (c) is that standardization femoral stem and personalized oversleeve assemble effect；It (d) is (EBM RP) metal 3D printing personalization femoral prosthesis Oversleeve+tradition forging standardization shank body (group distribution type).

Fig. 8 is integrated type personalization femoral prosthesis model schematic provided in an embodiment of the present invention.

Specific embodiment

In view of the problems of the existing technology, the present invention provides a kind of 3D printing personalization orthopedic implant building and Biomethanics optimized treatment method, is with reference to the accompanying drawing explained in detail the present invention.

In view of the problems of the existing technology, the present invention provides a kind of 3D printing personalization orthopedic implant building and Biomethanics optimized treatment method, is with reference to the accompanying drawing explained in detail the present invention.

As shown in Figure 1,3D printing personalization orthopedic implant building provided in an embodiment of the present invention and biomethanics optimization Processing method the following steps are included:

S101 pre-processes CT image；Then the segmentation of CT image is carried out；Good typical three-dimensional bone is rebuild later Bone model, using typical model as template, the reconstruction for carrying out three-dimensional skeleton model based on template to other bones is handled.

S102, to normal bone and registration bone application entity boolean's difference operation, is asked in the case of bone defect is more The shape of corresponding personalized orthopaedics implant out, carries out the anatomical reduction of bone.

S103 optimizes geometric shape matching and the mechanical property of personalized artificial articular prosthesis.

S104 carries out three-dimensional segmentation, three-dimensional vanning, structure optimization, self-adapting slicing behaviour to threedimensional model to be printed Make.

S105 prints threedimensional model, carries out the orthopaedics implant treatment based on 3 D-printing.

In step S101, typical three-dimensional skeleton model is rebuild in the segmentation of CT image provided in an embodiment of the present invention, with Typical model is template, and the reconstruction processing for carrying out three-dimensional skeleton model based on template to other bones specifically includes:

By the way that CT faultage image is established corresponding relationship with the template faultage image divided, it may be difficult to the edge of segmentation Region is split referring to template；

Specific implementation includes:

The CT image of the two is first done into non-rigid body model, using the cut-off rule in template image as initial value, utilizes Snake The methods of model or level set are iterated optimization；By isosurface extraction or based on the algorithm of contour line, three-dimensional bone is obtained Surface model；The immediate bone template of shape is fitted, further according to Curvature varying, extreme point, CT image grayscale value tag The skeleton model deformation alignment that template is rebuild to CT, realizes the reparation of skeleton model.

Skeleton model deformation alignment provided in an embodiment of the present invention specifically includes:

The reference model for constructing normal bone passes through matching between the registration and bone block and reference model between optimization bone block Standard realizes preferable alignment；It is obtained with reference to skeleton model by the template mesh of mirror image healthy bone or parametric deformation.

It is provided in an embodiment of the present invention to find out corresponding personalized orthopaedics plant using entity boolean difference operation in step S102 The shape for entering object specifically includes:

(1) the most value of each apex coordinate in normal bone is calculated；

(2) the most value of each apex coordinate in registration bone is calculated；

(3) based on being most worth obtained in step (1) and step (2), each vertex in normal bone and registration bone is found out The maximum value and minimum value of coordinate establish normal bone and the bounding box for being registrated bone；Eight vertex are formed as packet by being most worth Respective vertices, are then combined into face by the vertex for enclosing box, are formed a supplementary set from face and are mentioned；

(4) vertex of supplementary set body and face are separately added into the vertex table and face table of registration bone, using supplementary set body as matching The shell of quasi- bone, adjustment are used as inner casing after being registrated each vertex of surface sequence of bone, the benefit of registration bone are made of inner casing and shell Collective；The supplementary set body of the registration bone is the shape of personalized orthopaedics implant.

In step S102, the anatomical reduction of bone provided in an embodiment of the present invention is specifically included:

By the successively iteration optimization of geometric match and mechanics functional rehabilitation, building includes the constrained energy equation of institute, Carry out the Optimization Solution of overall model.

It is provided in an embodiment of the present invention to personalized artificial articular prosthesis (group distribution type/integration type) in step S103 Geometric shape matching is optimized with mechanical property to be specifically included:

Geometric shape matching and the mechanical property of the personalized artificial articular prosthesis optimize, and pass through group distribution type and one Two kinds of personalized artificial joint prostheses implants design schemes of change type, by traditional diamond-making technique production standardization implantation material with The personalized implantation material of 3 D-printing is implemented in combination with.

In step S103, the three-dimensional dividing method of threedimensional model provided in an embodiment of the present invention is specifically included:

Threedimensional model surface is split using clustering bottom-uply, then finds out suitable cut surface to entirety It is divided；

It specifically includes:

(1) m Print direction d has been taken at random_iAs sample orientation, expended to reduce search, in segmentation quality and fortune Reach a good tradeoff state on the row time；Then in the sample orientation set D of m size_initIn select candidate direction, have Gymnastics is made as follows:

If the surface mesh of threedimensional model S is indicated with set F, triangle gridding f_i(f_i∈ F) it indicates；For each direction d_i, count all normals and d_iAngulation θ is located at the triangle gridding f of section [60 °, 120 °]_i, use f^*Expression is met the requirements Grid set, then find out f^*In all grids area and, be defined as direction d_iCovering score, it is specific as follows:

Then according to each Print direction d_iThe height for covering score, from D_initCandidate Print direction set D is selected, mould is worked as Until when type is completely capped, i.e., to guarantee each grid corresponding Print direction；

(2) for D_initIn each candidate Print direction d_i, allow grid f^*To the direction d for being suitble to it to print_iBallot；It is right All voting results and m triangle gridding and n Print direction are unified to a two values matrix M=(m_ik)_m*nIn, That is m_ij=0 or 1；

Work as m_ijWhen=1, indicate with direction d_iWhen printing, grid f_iWith d_iAngle meet preset range, otherwise m_ij= 0；

Obviously, matrix M has recorded the relationship of each triangle gridding and Print direction, if sample point is beaten identical India side is to d_iBallot, then they are possible to adjacent and belong to identical unit；

Therefore triangle gridding is clustered simply by traversing a matrix M, the grid mutually gone together will be possessed and be divided into one Class forms unit；

(3) similarity matrix S is set up, indicates the similarity between each unit；

Matrix size is n*n, and n is the quantity of unit；In order to the tightness between higher surface quality and piecemeal it Between make balance, matrix items are defined as follows:

u_i∩u_j≠ 0 shows unit C_iWith C_jBe it is adjacent, furthermore:

The compactness between surface quality and piecemeal is assessed respectively with above-mentioned two formula, wherein l (u_i) indicate unit u_iBoundary Line length；

After obtaining matrix A, matrix A is based on using Ncut algorithm and is clustered, the high unit of similarity is clustered to obtain most Whole piecemeal；After unit merges component block, each piecemeal has corresponding candidate direction vector set, this set It is that the union that the Print direction corresponding to the unit of group component block tries is constituted, it is then true according to surface quality evaluation function Fixed optimal Print direction；

Surface quality evaluation function is as follows:

M is whole surface grid in above formula, and f indicates each triangle gridding, in which:

E (f)=C*area (f).

In step S103, the three-dimensional bin packing algorithm of threedimensional model provided in an embodiment of the present invention is specifically included:

The threedimensional model for treating vanning carries out voxelization processing, generates initial vanning sequence, is found and filled using TABU search Case sequence, output vanning sequence and corresponding vanning result；

The TABU search specifically includes:

Initialization vanning sequence, cases to piecemeal according to sequence order, selects optimal mobile scheme and records, comments Valence vanning result simultaneously judges whether vanning result meets termination condition, output sequence and vanning result if meeting；If discontented Foot, then generate candidate sequence.

In step S105, the orthopaedics implant treatment provided in an embodiment of the present invention based on 3 D-printing is specifically included:

The orthopaedics implant treatment based on 3 D-printing includes: that surgery planning is led with simulated maneuver, foundation operation Plate, personalized bone plate, four part of personalized articular prosthesis.

Technical scheme of the present invention will be further described combined with specific embodiments below.