CT 和整形美容影像手术导航

本文探讨电子束和螺旋CT机可实现全方位扫描和精密三维重建技术在颅颌面外科和减肥的适应症的应用价值。采用美国Imatron公司的电子束CT（以下简称EBCT），已对76例严重颅颌面畸形患者实行薄层CT容积扫描。将所获CT图象经数字接口传至加拿大ISG公司生产的Allegro工作站进行三维重建。EBCT成像技术能立体的、精细地显示机体组织三维解剖结构，包括骨骼、软组织、脂肪、动脉、静脉及其相互关系，引导主刀切割的路径，提高手术治疗效果。EBCT和螺旋CT作三维重建技术是现代颅颌面外科和减肥外科最主要的诊断方法之一，并具有重要的临床应用价值。预期改装微焦点CT机后，再现畸形或病体模型的程度可以达到亚微米极解剖学的精度，为准确了解和掌握畸形程度并制定合理的手术治疗计划提供了极为重要的依据。近年来工业微焦点CT机其空间分辨率已达5-15微米陈椎昌教授等已发展了用于生物医学的研究，今后可对皮下组织作精细的CT成像，对皮肤作粗糙度（或光滑度）的定量分级，以了解整形美容、针炙磁疗减肥与CT影像的微观效果。

3D CT and Plastic Surgery Navigation and Making Beauty Image

Successful execution of a surgical treatment necessitates knowledge of the relevant anatomy, physiology, and pathology, as well as the technical specifics of the operation. At this time, the Cranio-maxillo-facial 3D reconstruction can display bone change and relationship with adjacent structure, which is very useful for clinical assistance examination and more favorable and more accurate for establishing surgical operation planning. Since 1996, many people have undergone this technique at the Service of Plastic and Cranio-maxillo-facial surgery in Beijing. They adapted clinical results to four main indications: 1. Congenitally deformity; 2. Trauma or post-traumatic reconstructive Surgery; 3. Cranio-maxillo-facial tumors surgery and 4. Esthetic surgery. The indication of using the 3D EBCT reconstruction technique in surgery with these managments is discussed and some cases of clinic are demonstrated. 　　The industrial computed tomography (ICT) has been developed rapidly on the non-destructive testing fields and its spatial resolution has already reached 5~ 15μm in magnitude. Prof. Chen Weichang have already applied the micro ICT to examine the tissues of rats and obtained the distinct microscopic CT images of tissues and cells. Micro CT images of the pyramidal neurons of the cerebral cortex, and the structure of the hepatic lobules were first reported in ref.10], results were very exciting，it means that the advanced technologies of ICT can be available to improve the spatial resolution of the medical CT and that the micro CT is feasible. We suggested that the medical micro CT should composed of the following properties: a small diameter focus spot (1~10μm ) of X- ray source, high speed electronic beam scanning (1~10ms per frame), hyper thin tomo section (5~50μmm thick), super computer with vast storage volume, rapid imaging technique of the region of interest (ROI), special μ- CT technique, etc. It is obvious that the micro CT will give a great impact on the clinical medicine and ＂Ｍaking beauty imaging＂in the 21 century.