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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/16934完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 呂東武 | |
| dc.contributor.author | Chien-Chung Kuo | en |
| dc.contributor.author | 郭建忠 | zh_TW |
| dc.date.accessioned | 2021-06-07T23:50:14Z | - |
| dc.date.copyright | 2014-03-08 | |
| dc.date.issued | 2014 | |
| dc.date.submitted | 2014-02-10 | |
| dc.identifier.citation | [1] Allard P, Thiry P, Duhaime M. Estimation of the ligaments' role in maintaining foot stability using a kinematic model. Medical and Biological Engineering and Computing. 1985;23:237-42.
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/16934 | - |
| dc.description.abstract | 足踝複雜的骨頭形態，對於解剖學、踝關節生物力學和全踝人工關節的設計非常重要。然而，只有少數研究分析足踝骨頭三維的形態，特別極少針對華人分析。以往的研究大多以二維平面的X光片來測量足踝的形態。然而，二維平面X光片的資料會受到人為判讀的誤差，以及X光片成像準確度會受其足踝在空間位置擺位不同造成投影上的誤差。 本研究主要目的，藉由取得華人足踝三維骨頭的形態資料，探討二維平面X光片的人為判讀誤差以及空間位置擺位所造成投影上的誤差。進而提供完整足踝關節的形態資料以助於全踝人工關節的設計及足踝相關疾病之預防。
本研究以華人足踝大體為樣本，以夾具固定於標準解剖位置，以三維電腦斷層收集資料並重建足踝三維影像模型，包含遠端脛骨、腓骨以及距骨之三維形態模型。透過重建足踝模型，取得足踝骨頭相關的尺寸、面積、體積等31個重要參數。測量出的數據，以統計方法分析在性別之間的不同以及比較以往以高加索人為主的文獻資料之差異。藉由足踝三維影像模型，以數位影像重建二維平面X光片。所重建的二維平面X光片用來評估觀察者本身以及觀察者之間，不同時間點，其足踝參數的人為判讀可靠性(信度)和有效性(效度)。另一方面由足踝三維影像模型模擬足踝骨頭關節空間中擺位不同之影響，得出二維平面X光片成像之敏感程度，測量及量化隨機誤差。根據上述技術，進一步研究前足骨頭形態，以前足骨頭形態參數來比較正常人與拇趾外翻病人之差異，預測其危險因子。 結果可以歸納出下列四點：(1)以三維電腦斷層收集以及重建華人足踝形態的資料，和以往文獻中高加索人的資料大部分相似，但存在距骨長寬比以及其截面積等參數之不同，這些重要參數對於全踝人工關節的設計以及植入技術，有其重要參考價值。(2)藉由三維足踝模型，以數位方式來重建X光片，觀察受試者對於其所產生X光片，判讀上有非常好的信度，至於效度上，可藉由其相關性來修正。(3) 二維X光片成像受到足踝骨頭在空間中擺位位置不同產生誤差，然而在3維與二維之間測量數據的誤差，可以以線性回歸方程式來修正其誤差，以利於臨床上二維平面X光片之判讀。(4)拇趾外翻病人與正常人前足骨頭形態之比較，其大拇趾、第二腳趾的長度與前腳、第一個蹼狀部寬度的比率相對於正常人小，存在某些比率以上為其危險因子。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2021-06-07T23:50:14Z (GMT). No. of bitstreams: 1 ntu-103-D94548013-1.pdf: 2991191 bytes, checksum: 808795fb8e32b5f72ca10be8be4c1616 (MD5) Previous issue date: 2014 | en |
| dc.description.tableofcontents | Acknowledgements i
中文摘要 ii Abstract iv Table of Contents vi List of Figures xi List of Tables xvi Chapter 1 Introduction 1 1.1 Anatomy of the Foot and Ankle 1 1.2 Diseases of the Ankle 5 1.3 Diseases of the Forefoot 9 1.4 Evaluation Ankle and Forefoot Diseases 12 1.4.1 Imaging 12 1.4.2 Bone model reconstruction by Image Registration Methods 14 1.5 Purpose of the Study 15 Chapter 2 Materials and Methods 17 2.1 Three-Dimensional Computer Graphics-Based Ankle Morphometry with Computerized Tomography for Total Ankle Replacement Design and Positioning 17 2.2 Intra-Rater, Inter-Rater and Inter-Session Reliability of Ankle Morphological Measurements on Planar Radiographs Digitally Reconstructed from Computerized Tomography 26 2.3 Effects of Positioning on Radiographic Measurements of Ankle Morphology: A Computerized Tomography-Based Simulation Study 28 2.4 Forefoot Morphological Parameters as Risk Factors for Hallux Valgus 29 Chapter 3 Three-Dimensional Computer Graphics-Based Ankle Morphometry with Computerized Tomography for Total Ankle Replacement Design and Positioning 31 3.1 Overview 31 3.2 Materials and Methods 34 3.3 Results 36 3.4 Discussion 42 3.5 Conclusion 51 Chapter 4 Intra-Rater, Inter-Rater and Inter-Session Reliability of Ankle Morphological Measurements on Planar Radiographs Digitally Reconstructed from Computerized Tomography 52 4.1 Overview 52 4.2 Materials and Methods 58 4.3 Results 67 4.4 Discussion 71 4.5 Conclusion 73 Chapter 5 Effects of Positioning on Radiographic Measurements of Ankle Morphology: A Computerized Tomography-Based Simulation Study 74 5.1 Overview 74 5.2 Materials and Methods 78 5.2.1 Overview 78 5.2.2 Specimen preparation and CT scan 80 5.2.3 Bone model reconstruction and morphological parameters 81 5.2.4 Generation of digitally reconstructed radiograph (DRR) 82 5.2.5 2D Measurements in standard pose 83 5.2.6 Sensitivity analysis of 2D measurements to Mal-positioning 86 5.2.7 Repeatability analysis of 2D measurements 88 5.2.8 Prediction of 3D measurements using 2D measurements via linear regression equations 89 5.3 Results 89 5.4 Discussion 97 5.5 Conclusion 102 Chapter 6 Forefoot Morphological Parameters as Risk Factors for Hallux Valgus 103 6.1 Overview 103 6.2 Materials and Methods 106 6.2.1 Subjects 106 6.2.2 Calculation of the Forefoot Parameters 107 6.2.3 Statistical analysis 111 6.3 Results 112 6.4 Discussion 122 6.5 Conclusion 125 Chapter 7 Conclusions, Recommendations and General Summary 128 7.1 Conclusions 128 7.1.1 Three-Dimensional Computer Graphics-Based Ankle Morphometry with Computerized Tomography for Total Ankle Replacement Design and Positioning 128 7.1.2 Intra-Rater, Inter-Rater and Inter-Session Reliability of Ankle Morphological Measurements on Planar Radiographs Digitally Reconstructed from Computerized Tomography 128 7.1.3 Effects of Positioning on Radiographic Measurements of Ankle Morphology: A Computerized Tomography-Based Simulation Study 129 7.1.4 Forefoot Morphological Parameters as Risk Factors for Hallux Valgus 130 7.2 Recommendations for Future Work 130 7.2.1 TAR design recommendation 130 7.2.2 Risk Factors for Hallux Valgus 132 7.3 General Summary 133 References 135 | |
| dc.language.iso | en | |
| dc.subject | 拇趾外翻 | zh_TW |
| dc.subject | 踝關節 | zh_TW |
| dc.subject | 前足 | zh_TW |
| dc.subject | 形態測量學 | zh_TW |
| dc.subject | 信度 | zh_TW |
| dc.subject | 效度 | zh_TW |
| dc.subject | 全人工踝關節置換 | zh_TW |
| dc.subject | Reliability | en |
| dc.subject | Hallux valgus | en |
| dc.subject | Total Ankle Arthroplasty | en |
| dc.subject | Ankle Joint | en |
| dc.subject | Forefoot | en |
| dc.subject | Morphometry | en |
| dc.subject | Validity | en |
| dc.title | 電腦輔助足踝骨關節形態之三維影像學研究 | zh_TW |
| dc.title | Computer-aided three-dimensional image-based morphological study of the foot and ankle complex | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 102-1 | |
| dc.description.degree | 博士 | |
| dc.contributor.oralexamcommittee | 黃世傑,許弘昌,陳文斌,陳祥和 | |
| dc.subject.keyword | 踝關節,前足,形態測量學,信度,效度,全人工踝關節置換,拇趾外翻, | zh_TW |
| dc.subject.keyword | Ankle Joint,Forefoot,Morphometry,Reliability,Validity,Total Ankle Arthroplasty,Hallux valgus, | en |
| dc.relation.page | 142 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2014-02-10 | |
| dc.contributor.author-college | 工學院 | zh_TW |
| dc.contributor.author-dept | 醫學工程學研究所 | zh_TW |
| 顯示於系所單位： | 醫學工程學研究所 | |
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| ntu-103-1.pdf 未授權公開取用 | 2.92 MB | Adobe PDF |
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