Estabishment Of3D Diagnosis And Treatment Database System For Cranio-maxillo-facial Surgery

Background:Congenital or acquired cranial jaws malformation and tissue destruction or defect bring patients great negative impact on looks and psychology. Paul Tessier. a famous French plastic surgery professor, found "cranial and maxillofacial surgery".in1960s.using the special cutting-bone and planting-bone method to block mobile cranial-maxillo-facial bone and to re-fix cranial-maxillo-facial bone according to principle of plastic to fundamentally correct deformity or get better beauty. The main treatment objects of cranial-maxillo-facial surgery are all sorts of serious deformities of skull, facial bone and corresponding soft tissue. Anatomy structure of Cranial-maxillo-facial is complex and has deformity of diversity, thus comprehensive, objective, qualitative and quantitative diagnosis analysis is the important prerequisite for scientific diagnosis and treatment of cranial-maxillo-facial deformities. Since1931Bordabnet has used X thrum cephalometric measures in the oral orthodontic research and clinical practice, head positive, lateral radiographs and facial photographs are generally used in studies on cranial-maxillo-facial deformities at present. Following cranial-maxillo-facial plastic technology development progress, the traditional plane measurement and diagnosis methods can’t meet the clinical application, because it is difficult to know their regional fine anatomy and morphological characteristics, lack of visual and accuracy, especially for complex cranial-maxillo-facial deformity, appear more limited. Head X-radiographs is plane projection of3D head, and headed structure complexity makes image happen overlapped. Head positive radiographs can only reflect on a left-right, vertical side to the skull, not on the direction of anterior-posterior. Head lateral radiographs probably reflects anterior-posterior, vertical side, not craniofacial transverse and asymmetric deformity, and especially can not extract the feature points deformity.With the development of medical imaging technology, medical imaging become diversified and digitized, and emerge in various new technologies such as:CT, MRI, DSA, PET, FMRI etc. Since invented by Hounsfield in the nineteen seventies, CT scanner has gradually become the most conventional examination method of medical imaging. CT technology and CT image3D reconstruction technology are widely applied in medical field, so that the craniofacial surgery developed to a new height. The three-dimensional reconstruction can get different tissue types in each image, observe the hidden deep tissue structure, and understand details of the spatial anatomical structure relations. Three dimensional image is visual and convenient to measure, providing diagnostic basis and direct guidance for clinical surgery operation. Following the rapid development of medical imaging technology and computer technology,3D reconstruction technology, based on the data in the DICOM,owing to its significant advantages, has been widely used. As an important clinical data,3D reconstruction image data of craniofacial surgery’can provide a basis for diagnosis, following-up and analysis of craniofacial disease.PACS (Picture Archiving Communication Systems) was born, and developed rapidly to solve such problem of medical image acquisition, display, store, transport and management. PACS storaged image data DICOM. DICOM (Digital Imaging and Communications in Medicine), it is a group of universal standard agreement, namely medical Digital images and communication standards. Most DICOM images browse to specialized medical image based on workstations, and in clinical application, most images were converted to JPG or other Windows platform that can be identified by converting tool software. So, medical images can be called conveniently. But,this operation bring a lot of inconvenience to clinical, scientific research and teaching. And for the storage of data, optical storage and magnetic storage carrier are the main medium, At present medical image data is stored by copy CD.Along with the development of computer hardware and software technology and computed tomography (CT),3D reconstruction technology, based on the data in the DICOM,owing to its significant advantages, has been widely used.3D image is visual and convenient to measure, providing the basis for diagnosis and instruction for clinical operation, but clinical database system, lack of the function of the integration management for3d images, limits the3d images clinical application.Database is a storage which is used to organize, store and manage data according to the data structure, the medical databases are mainly classified as medical medical information database, biological information databases and clinical databases and so on. Now in the medical,the databases technology are mainly applicated for managing of the medical literature retrieval; hospital information management. Such as patient,s informations system, ward management systems, electronic medical records system, administration system and medical image management system; medical specialist data management and so on. On the specialist databases establishment.WangZhigang and others estabished orthopedic clinical research database with ACCESS; Chen Lei and others estabished the construction of the medical image database with Delphi programming;Zhou kun estabished poisoned information database with ACCESS. Hou Fengzhen estabished cases of lung cancer information database with Visual C programming. The database created in craniomaxillofacial surgery:the Chinese people trauma database, graphic information cosmetic database and so on. At present.existed database is used to collect and manage clinical patients for the basic information, the two-dimensional photographs, imaging data and so on. But,that can not directly show its complex three-dimensional structure of the database, the visualization of three-dimensional image is still a problem, now we lack a database system for the information of three-dimensional management.With the rapid development of computer aided technology in medicine and3d reconstruction,3d measurement has become a important way to make a intuitive and accurate understanding at complex maxillofacial, provides the basis for learning and grasping condition and setting up reasonable treatment plan well and has certain significance on guidance and surgery choose. In this technology promotion, cranial and maxillofacial surgery disease diagnosis and treatment patterns are occurring in big change, and at the same time they also become cranial and maxillofacial surgery and orthopaedic research hot spot. Therefore, we establish such a database which can store and manage cranial and maxillofacial surgery patients of basic medical history material, and also has the functions of3d data access, retrieval, view, contrast and so on. Besides, with the development of the computer aided3d automatic measurement and diagnosis function, diagnosis reports can be printed automatically, which is convenient for clinical doctors.Purpose and Significancepurpose1Set up the database of3D Diagnosis and treatment for Cranio-maxillo-facial Surgery. Preserve and manage the3D data, quantitative measurement and diagnosis and so on.Complete reading3D data STL, quantitative measurement and generating a diagnostic report and other functions.Significance1Estabishment of3D Diagnosis and treatment database system for Cranio-maxillo-facial Surgery save and management cranial and maxillofacial surgery patients basic material,3Dimages, the three dimensional measurement and diagnosis material.2Establish cranial and maxillofacial surgery three dimensional diagnosis and treatment and more complete and accurate database to maintain and management cranial and maxillofacial surgery three dimensional material, at the same time by measuring the more delicate and precise understanding of cranial and maxillofacial complex structure and lesions characteristic, also for us to understand and grasp condition and formulate the surgical treatment scheme is for a very important basis.3These make the doctor in the clinical work for3d image data more convenient, assist doctors to cranial and maxillofacial deformity makes a comprehensive and objective, qualitative and quantitative diagnosis analysis, improve their work efficiency, while back to clinical, teaching, experiment to bring convenience, enhance the communication between the patient. In addition through the database and summarizes the related law facial deformity, data mining.4Through the database and summarizes the related law facial deformity, data mining. Therefore, the operation has certain academic value and broad application prospect.Materials and Methods:1, development environment for database systemComputer:PC computer, Intel core i5processor430M,4G memory,1G video memory,640G hard disk space. Operating system:Windows7Development platform:Microsoft Visual C++2010, Microsoft Visual Fox Pro8, Open Graphics Library (OpenGL)2, research methods(1) complete database development through Microsoft Visual Fox Pro8.(2) using Open Graphics Library (OpenGL), Microsoft Visual studio2010VC++language to compose the read, measurement and diagnosis function of3d image STL files.(3) Microsoft Visual Fox Pro8integration to Microsoft Word function, automatically generating Word diagnosis report.Content1,establishment of the3d database of cranial and maxillofacial surgery(1) management data set and collectionAccording to the cranial and maxillofacial surgery diagnosis and treatment needs, making the management of data collected data for:patients basic material, STL format of the3d image, the measurement data, diagnostic data.(2) database table and determination of the fieldThe establishment of database table including:patients basic information, medical records,3d measurement table, diagnosis standard table, diagnosis report form, public dictionary tables (some). In table setting field, each table with ID correlation between. Public dictionary tables include:gender, nationality, diagnosis, treatment measures, medicine, surgery name, departments, and the doctor, etc.(3) database programmingUsing Microsoft Visual Fox Pro8system to program realizes the function of data entry, edit, inquiring, summarizing and so on.2, the realization of the function of the three dimensional diagnosis and treatment of the computer aided database system(1)3d visualization realized STL files In vc++environment, OpenGL application as a method of realizing visual STL, realizing the reading and storage function of the database of3d STL file:directly read STL format and display3d images, save3d image data links.(2) three dimensional function realization of diagnosis and treatmentDatabase of3d diagnosis and treatment and the realization of the function of the key lies in the following steps:According to two dimensional diagnosis standard setting up new three dimensional diagnosis standard:creating a new point and measuring plane.According to the cranial and maxillofacial deformity measurement in the skull to click on the surface.Using computer identification is realized.Programmed to be automatic measured, according to diagnosis standard, completes automatic diagnosis.Results1. Establishing Visual Fox Pro8database system, using Microsoft Visual studio2010VC++language to edit the3d image STL files to read, measurement and diagnosis.2. Establishment of the three dimensional cranial-maxillo-facial surgery clinic database, save and management of the basic information of cranial-maxillofacial surgery patients,3D images,3D measurement data and diagnosis materials.3. The three dimensional cranial-maxillo-facial surgery clinic database has the following features:storage and management of the medical history data of cranial-maxillo-facial surgery patients, reading and saving of3D images, increasing automatic3D measurement and diagnosis function, and automatic printing diagnosis report. ConclusionsEstablish the3d diagnosis and treatment surgery database of cranial and maxillofacial to maintain and manage the cranial and maxillofacial surgery three dimensional material more completed and accurate. At the same time understanding the complex structure and lesions characteristic of cranial and maxillofacial more delicately and precisely by measuring offers a very important basis for understanding and mastering the illness and formulating the surgical treatment scheme. It assists doctors to get3d image data in the clinical work and make a comprehensive, objective andqualitative and quantitative diagnosis analysis of the cranial-maxillo-facial deformity, which improves work efficiency, brings convenience to the clinical, teaching, experiment and enhances the communication between doctors and the patients.