Formulation of a reference coordinate system of threedimensional head & neck images : Part Ⅱ. Reproducibitity Ⅱ부 수평기준면과 정중사상면의 재현성 = 3차원 두부영상의 기준좌표계 설정을 위한 연구

다국어 초록 (Multilingual Abstract)

This study was performed to investigate the reproducibility of the horizontal and midsagittal planes, and to suggest a stable coordinate system for three-dimensional (3D) cephalometric analysis. Eighteen CT scans were taken and the coordinate system was established using 7 reference points marked by a volume model, with no more than 4 points on the same plane. The 3D landmarks were selected on V works (Cybermed Inc., Seoul, Korea), then exported to V surgery (Cybermed Inc., Seoul, Korea) to calculate the coordinate values. All the landmarks were taken twice with a lapse of 2 weeks. The horizontal and midsagittal planes were constructed and its reproducibility was evaluated. There was no significant difference in the reproducibility of the horizontal reference planes. But, FH planes were more reproducible than other horizontal planes. FH planes showed no difference between the planes constructed with 3 out of 4 points. The angle of infersection made by 2 FH planes, composed of both Po and one Or showed less than 1° difference. This was identical when 2 FH planes were composed of both Or and one Po. But, the latter cases showed a significantly smaller error. The reproducibility of the midsagittal plane was reliable with an error range of 0.61 to 1.93° except for 5 establishments (FMS-Nc, Na-Rh, Na-ANS, Rh-ANS, and FR-PNS). The 3D coordinate system may be constructed with 3 planes; the horizontal plane constructed by both Po and right Or; the midsagittal plane perpendicular to the horizontal plane, including the midpoint of the Foramen Spinosum and Nc; and coronal plane perpendicular to the horizontal and midsagittal planes, including point clinodale, or sella, or PNS.

국문 초록 (Abstract)

본연구는 삼차원 두부 영상을 위치시키기 위한 좌표계를 구성하는 방법에 대한 제안하기 위해, CT data에서 기존의 두부방사선 계측사진에서 쓰이는 점들을 선정하고, 이를 바탕으로 수평, 수직평면의 안정성을 조사하였다. 서울대학교 치과병원에 내원한 환자 18명의 CT자료를 채득하였으며, 모든 환자는 서울대학교 병원 진단방사선과에서 촬영하였다. (Somatom Plus 4: Siemens, Eriange, Germany). V works for surgery 4.0 (Cybermed Inc., Seoul, Korea)을 이용하여 3차원 좌측표를 선정하고, 계측점을 선택하였다. 좌표축을 동일하게 설정하기 위해 7개의 점(reference point)을 4·4·2 pixel size의 voxel로 따로 표시하였다. 계측점을 선정한 후 V surgery (Cybermed Inc., Seoul, Korea)에서 각 점의 좌표값을 추출하였다. 각각의 점들은 2회 반복 선정한 후 점들을 조합하여 수평, 수직평면의 재현성을 평가한 결과 다음과 같은 결론을 얻었다 수평 기준면의 재현도는 S-CI평면을 제외하고는 통계적으로 유의한 차이를 보이지 않았으나, 사잇각은 FH평면이 가장 작게 나타났다. FH평면은 Po과 Or중 어느 3점을 선택하더라도, 통계적으로 유사한 재현도를 보였다. FH1과 FH2의 사잇각과 FH3과 FH4의 사잇각은 1° 이하의 적은 오차를 보이며, FH3과 FH4의 사잇각이 통계적으로 더 작은 차이를 보였다. 정중시상면의 재현도는 FMS-Nc, Na-Rh, Na-ANS, Rh-ANS, FR-PNS를 기준으로 설정한 경우를 제외하면, 0.61~1.93° 의 양호한 값을 보였다. 이상의 결과에 의하면 공간에서 정의되는 평면의 재현도는 평면을 정의하는 점 자체의 식별오차뿐 아니라, 각 점의 위치관게에도 영향을 받는 것을 알 수 있었다. 따라서, 안정적인 3차원 기준좌표계를 구성하려면 양측 Po과 편측 Or으로 구성되는 평면을 수평기준면으로, 수평면에 수직이고, Foramen Spinosum의 중점과 Nc를 포함하는 평면을 수직기준면으로, 수평면과 수직면에 수직이고, clinoidale나 sella, PNS를 지나는 평면을 전두면으로 설정하는 것이 바람직할 것으로 생각된다.

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