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面部三維運(yùn)動(dòng)定量分析系統(tǒng)的研制及面部三維測(cè)量指標(biāo)研究

發(fā)布時(shí)間:2018-08-10 21:35
【摘要】:第一部分面部三維運(yùn)動(dòng)定量分析系統(tǒng)的研制和精度測(cè)量面部三維運(yùn)動(dòng)定量分析系統(tǒng)由三部分組成:數(shù)據(jù)采集部分、數(shù)據(jù)處理和結(jié)果輸出部分、固定系統(tǒng)。數(shù)據(jù)采集部分主要由六臺(tái)運(yùn)動(dòng)捕捉紅外矩陣攝像機(jī)(采集頻率60幀/秒)呈對(duì)稱(chēng)“品”字形排列,通過(guò)多路同步控制器保證采集的一致性。數(shù)據(jù)處理部分的核心為定制的面部運(yùn)動(dòng)捕捉軟件。固定系統(tǒng)包括一個(gè)固定頭架和一個(gè)綜合固定椅,兩者均可固定于雙側(cè)乳突及枕骨突隆。固定系統(tǒng)既能保證與頭顱相對(duì)靜止,又不影響受試者的面部活動(dòng)。固定系統(tǒng)前端有三個(gè)固定標(biāo)記點(diǎn),為面部分析的參考坐標(biāo)系。面部運(yùn)動(dòng)測(cè)量時(shí),攝像機(jī)捕捉面部的反射光線,系統(tǒng)根據(jù)標(biāo)定結(jié)果進(jìn)行坐標(biāo)轉(zhuǎn)換,軟件進(jìn)行在線計(jì)算和離線重建。應(yīng)用加速度儀進(jìn)行加速度試驗(yàn),該面部三維運(yùn)動(dòng)定量分析系統(tǒng)的速度測(cè)量最大誤差為0.0058m/s,平均誤差為0.003026m/s,加速測(cè)量誤差為0.000135m/s2。第二部分面部三維測(cè)量指標(biāo)的影響因素目的:評(píng)估面部三維運(yùn)動(dòng)定量分析系統(tǒng)在面癱患者的應(yīng)用,探討測(cè)量指標(biāo)的影響因素。方法:連續(xù)收集76例單側(cè)面癱患者。應(yīng)用三維運(yùn)動(dòng)定量分析系統(tǒng)進(jìn)行靜態(tài)和動(dòng)態(tài)測(cè)量。測(cè)量過(guò)程:清潔面部→黏貼標(biāo)記點(diǎn)→受試者動(dòng)作訓(xùn)練→系統(tǒng)設(shè)置和安置。測(cè)量結(jié)果與年齡作偏相關(guān)分析;比較男女間指標(biāo)的差異;與正常值作析因方差分析。結(jié)果:1.健側(cè)靜態(tài)指標(biāo):鼻唇溝長(zhǎng)(產(chǎn)0.517)與年齡呈正相關(guān),眥角與年齡呈負(fù)相關(guān)(γ=-0.424)。除笑角外,余指標(biāo)在男女間均有統(tǒng)計(jì)學(xué)差異(P<0.05),且男性測(cè)量值多大于女性。與正常值比較,除笑角外均有統(tǒng)計(jì)學(xué)差異(P<0.05)。2.健側(cè)動(dòng)態(tài)指標(biāo):眉弓中點(diǎn)(r=-0.428)、上瞼中點(diǎn)(=r=-0.495)和鼻旁點(diǎn)(r=-0.471)的最大移動(dòng)速度與年齡呈負(fù)相關(guān),余指標(biāo)未見(jiàn)明顯相關(guān)性。男性眉弓中點(diǎn)最大移動(dòng)距離和速度、用力閉眼上瞼中點(diǎn)最大移動(dòng)速度、輕閉眼上瞼中點(diǎn)加速度均大于女性(P<0.05)。與正常值相比:上瞼中點(diǎn)的最大移動(dòng)速度,眉弓中點(diǎn)最大移動(dòng)速度,鼻旁點(diǎn)的最大移動(dòng)速度和加速度,口角的最大移動(dòng)距離、速度和加速度,眥角變化,均為面癱組大于正常組(P<0.05)。3.患側(cè)靜態(tài)指標(biāo):以神經(jīng)電圖(ENoG)作為控制變量作偏相關(guān)分析,鼻唇溝長(zhǎng)(r=0.538)、左右口角間距(r=0.353)與年齡呈正相關(guān)(r=0.538),眥角(r=-0.349)與年齡呈負(fù)相關(guān)。男女間除瞼裂高度外均有統(tǒng)計(jì)學(xué)差異(P<0.05)。4.患側(cè)動(dòng)態(tài)指標(biāo):眉弓中點(diǎn)(r=-0.332)、用力閉眼上瞼中點(diǎn)(r=-0.349)的最大移動(dòng)速度與年齡呈負(fù)相關(guān),余指標(biāo)與年齡間均無(wú)明顯相關(guān)性。眉弓中點(diǎn)最大移動(dòng)速度,撅嘴時(shí)口角最大移動(dòng)距離、速度和加速度為男性大于女性(P<0.05)。結(jié)論:(1)面部三維運(yùn)動(dòng)定量分析系統(tǒng)可快速評(píng)估面癱情況,評(píng)估過(guò)程患者無(wú)痛苦和創(chuàng)傷。(2)面部靜態(tài)結(jié)構(gòu)和肌肉運(yùn)動(dòng)可隨著年齡增長(zhǎng)而變化,但在面癱時(shí)未見(jiàn)額外影響。(3)大部分動(dòng)態(tài)和靜態(tài)指標(biāo)均為男性大于女性,而面癱時(shí)這種差異可能會(huì)減小。(4)面癱患者的健側(cè)面部運(yùn)動(dòng)功能可能會(huì)代償性增加。第三部分各面癱評(píng)價(jià)系統(tǒng)相關(guān)性及預(yù)后評(píng)估研究目的:比較面部三維運(yùn)動(dòng)定量分析系統(tǒng)與其它面癱評(píng)價(jià)系統(tǒng)間的相關(guān)性及各系統(tǒng)的預(yù)后評(píng)估價(jià)值。方法:(1)納入50例單側(cè)面癱患者。應(yīng)用House-Brackmann (H-B)分級(jí)系統(tǒng)等進(jìn)行主觀評(píng)價(jià);應(yīng)用肌電/誘發(fā)電位儀進(jìn)行瞬目反射和面神經(jīng)電圖檢查;應(yīng)用中文版FaCE量表進(jìn)行患者自我評(píng)價(jià);應(yīng)用面部三維運(yùn)動(dòng)定量分析系統(tǒng)進(jìn)行三維客觀測(cè)量,計(jì)算患側(cè)與健側(cè)的對(duì)稱(chēng)比。三維測(cè)量指標(biāo)綜合評(píng)分=0.7×D+0.3×V-A,公式中,D為雙側(cè)各標(biāo)記點(diǎn)的最大移動(dòng)距離百分比平均得分,V為雙側(cè)各個(gè)標(biāo)記點(diǎn)的最大移動(dòng)速度百分比平均得分,A為靜態(tài)得分。最后比較不同評(píng)價(jià)系統(tǒng)結(jié)果與三維測(cè)量指標(biāo)間的相關(guān)性。(2)納入發(fā)病1月以?xún)?nèi)的急性面癱患者,對(duì)其進(jìn)行電生理測(cè)量、主觀評(píng)價(jià)、三維運(yùn)動(dòng)定量分析及患者自我評(píng)價(jià)(FaCE).對(duì)所有患者進(jìn)行跟蹤隨訪,一月后和半年后復(fù)查。根據(jù)發(fā)病后半年面癱的恢復(fù)情況比較各評(píng)價(jià)系統(tǒng)對(duì)面癱預(yù)后的評(píng)估價(jià)值。結(jié)果:1.動(dòng)態(tài)指標(biāo)中,各標(biāo)記點(diǎn)的最大移動(dòng)距離與主觀評(píng)價(jià)系統(tǒng)間相關(guān)性強(qiáng),最大移動(dòng)速度次之,而最大移動(dòng)加速度相關(guān)性最差,且部分無(wú)統(tǒng)計(jì)學(xué)意義。三維測(cè)量綜合評(píng)分與各主觀評(píng)價(jià)系統(tǒng)得分之間相關(guān)系數(shù)分別為-0.630(HB分級(jí))、-0.728(面神經(jīng)分級(jí)量表2.0)、0.697(Sunnybrook評(píng)分)和0.617(Fisch評(píng)分),P值均<0.05。FaCE量表僅反映患者面部運(yùn)動(dòng)的評(píng)價(jià)條目與部分指標(biāo)有相關(guān)性。三維動(dòng)態(tài)測(cè)量結(jié)果與瞬目反射結(jié)果的相關(guān)性強(qiáng)于同ENoG的相關(guān)性。面部三維測(cè)量指標(biāo)與瞬目反射振幅的相關(guān)性明顯強(qiáng)于潛伏期。與ENoG進(jìn)行相關(guān)性比較,各標(biāo)記點(diǎn)的最大移動(dòng)距離指標(biāo)相關(guān)性差異較大。2.共納入37例單側(cè)面癱患者,隨訪期間共有6例(16%)刪失。多元回歸分析篩選最佳預(yù)后評(píng)價(jià)指標(biāo):(1)面癱發(fā)病30內(nèi)ENoG為最佳預(yù)后指標(biāo),其預(yù)測(cè)公式y(tǒng)=113.527-60.558x,公式中y為半年后SFGS評(píng)分,x為ENoG估算的面神經(jīng)變性比例;(2)面癱31至60天,SFGS得分和三維測(cè)量結(jié)果為最佳預(yù)后指標(biāo),其預(yù)測(cè)公式為y=19.202+0.557x1+0.531x2,x1為SFGS得分,x2為三維測(cè)量指標(biāo)得分。結(jié)論:(1)面部三維運(yùn)動(dòng)定量分析結(jié)果與傳統(tǒng)的主觀評(píng)價(jià)結(jié)果及電生理檢查結(jié)果間有較好的相關(guān)性,且可以提供更為細(xì)致的量化指標(biāo)。(2)面癱急性期,電生理檢查仍然是預(yù)測(cè)面癱預(yù)后的最佳指標(biāo);面癱超過(guò)1月,聯(lián)合主觀評(píng)價(jià)和三維運(yùn)動(dòng)定量分析可提供最佳的預(yù)后評(píng)估。
[Abstract]:The first part is the development of the quantitative analysis system for facial 3D motion and its precision measurement. The quantitative analysis system for facial 3D motion consists of three parts: data acquisition, data processing and output, and fixed system. The key part of the data processing section is a customized facial motion capture software. The fixing system includes a fixed headframe and a comprehensive fixed chair, both of which can be fixed to the bilateral mastoid and occipital protuberances. The fixing system ensures relative stillness with the skull without shadow. The front end of the fixing system has three fixed markers for the reference coordinate system of facial analysis. In facial motion measurement, the camera captures the reflected light of the face, the system carries out coordinate transformation according to the calibration results, the software carries out on-line calculation and off-line reconstruction. The maximum error of velocity measurement is 0.0058m/s, the average error is 0.003026m/s, and the acceleration error is 0.000135m/s 2. Part 2: The influencing factors of facial three-dimensional measurement indicators Objective: To evaluate the application of facial three-dimensional motion quantitative analysis system in facial paralysis patients and explore the influencing factors of measurement indicators. Seventy-six patients with unilateral paralysis were collected in succession.Static and dynamic measurements were performed using a three-dimensional motion quantitative analysis system.The measurement process was as follows:clean face_sticking markers_subject movement training_system setting and placement.Partial correlation analysis was made between the measurement results and age.Differences between male and female indicators were compared.Factorial variance scores were calculated with normal values. Results: 1. Static indices of healthy side: length of nasolabial sulcus (0.517) was positively correlated with age, and canthus angle was negatively correlated with age (gamma = - 0.424). Except for laughing angle, the remaining indices were statistically different between men and women (P < 0.05), and the measured values of men were more than those of women. There were statistical differences between healthy side and normal value except laughing angle (P < 0.05). The maximum velocity of eyebrow arch midpoint (r = - 0.428), upper eyelid midpoint (= r = - 0.495) and paranasal point (r = - 0.471) was negatively correlated with age, but no significant correlation was found with other parameters. Constant comparison: the maximum moving speed of the middle point of the upper eyelid, the maximum moving speed and acceleration of the midpoint of the eyebrow arch, the maximum moving speed and acceleration of the paranasal point, the maximum moving distance of the mouth angle, the speed and acceleration, and the change of the canthus angle were all greater in the group of facial paralysis than in the normal group (P < 0.05). 3. Static index of the affected side: EEG was used as the control variable for partial correlation. The results showed that the length of nasolabial sulcus (r = 0.538), the distance between the left and right corners of mouth (r = 0.353) were positively correlated with age (r = 0.538), and the canthus angle (r = - 0.349) was negatively correlated with age. Conclusion: (1) The quantitative analysis system of facial three-dimensional movement can quickly evaluate the situation of facial paralysis, and can evaluate the process of patients without pain and trauma. (2) Facial static knot. (3) Most of the dynamic and static indexes were higher in males than in females, but this difference may be reduced in facial paralysis. (4) The motor function of healthy side of patients with facial paralysis may increase compensatively. Objective: To compare the correlation between facial three-dimensional motion quantitative analysis system and other facial paralysis evaluation systems and the prognostic value of each system.Methods: (1) 50 patients with unilateral paralysis were included. The patients were assessed by electrogram, the Chinese version of FaCE scale was used for self-evaluation, and the facial three-dimensional motion quantitative analysis system was used for three-dimensional objective measurement to calculate the symmetry between the affected side and the healthy side. At last, the correlation between the results of different evaluation systems and three-dimensional measurements was compared. (2) Patients with acute facial paralysis within 1 month of onset were included in the study, and their electrophysiological measurements, subjective evaluation, three-dimensional motion quantitative analysis and patient self-evaluation (FaCE) were performed. All patients were followed up for 1 month and 6 months. The evaluation value of each evaluation system was compared according to the recovery of facial paralysis after the onset of the disease. The correlation coefficients between the three-dimensional measurement score and the subjective evaluation system scores were - 0.630 (HB grade), - 0.728 (Facial Nerve Scale 2.0), 0.697 (Sunnybrook score) and 0.617 (Fisch score). The P values were < 0.05. The correlation between 3-D dynamic measurements and blink reflex was stronger than that of ENoG. The correlation between 3-D facial measurements and blink reflex amplitude was stronger than that of incubation period. Compared with ENoG, the correlation between the maximum moving distance of each marker was different. 2. 37 patients with unilateral paralysis were included. Multivariate regression analysis screened the best prognostic indicators: (1) ENoG was the best prognostic indicator within 30 days of facial paralysis, and its predictive formula y = 113.527-60.558x, in which y was the SFGS score after six months, and X was the ratio of facial nerve degeneration estimated by ENoG; (2) SFGS score and three-dimensional measurement were the best prognostic indicators within 31 to 60 days of facial paralysis. The predictive formula was y = 19.202 + 0.557x1 + 0.531x2, X1 was SFGS score, and X2 was three-dimensional measurement index score. Conclusion: (1) There was a good correlation between quantitative analysis of facial three-dimensional motion and traditional subjective evaluation and electrophysiological examination results, and it could provide more detailed quantitative indicators. (2) In acute facial paralysis, electrical measurements were performed. Physiological examination is still the best index for predicting the prognosis of facial paralysis. If facial paralysis lasts for more than one month, the combination of subjective evaluation and three-dimensional quantitative exercise analysis can provide the best prognostic evaluation.
【學(xué)位授予單位】:北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】:博士
【學(xué)位授予年份】:2016
【分類(lèi)號(hào)】:R745.12

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