影像導引的微創手術中，醫生須透過即時的醫學影像來提供手術部位的解剖結構才能使手術更順暢的進行。而執行微創手術的醫生須具有豐富的經驗，因此虛擬手術訓練系統就變得更重要。在手術的訓練系統中所使用到之假體並不具有其醫學影像，因此，重建假體之醫學影像為影像導引手術訓練系統中最重要的議題之ㄧ。然而，在可即時顯示之醫學影像中，超音波影像由於其拍攝出之解剖影像較模糊，因此重建其三維影像的技術上仍相當具有挑戰性。在本論文中，我們提出了一個新穎的重建假體超音波影像的方法，使假手能具有其醫學影像，並將結果應用到板機指手術訓練系統上。
我們提出的重建假體超音波影像的方法主要分為兩部分，分別為重建三維超音波影像，以及假手電腦斷層影像與三維超音波影像之對位。在重建三維超音波影像的部分，藉由將兩個垂直的超音波影像切面對位，結合兩垂直切面的影像建立出三維的超音波影像。接著，利用非剛體對位的技術將重建出來的超音波影像與假手電腦斷層影像進行對位，建構出符合假手結構的醫學影像資訊。透過上述的方法，我們可以利用具有超音波影像資訊的假手模擬板機指手術訓練系統中的手術環境。並藉由結合光學追蹤系統來整合影像、假手以及手術工具之座標系，建構出讓手術者熟練手術流程的訓練系統。如同實驗結果顯示，利用我們提出的方法，可以克服因取像頻率及方向所造成的影像資訊不足，建構出解剖結構清晰的三維超音波影像。而建構出之假手超音波影像也相當符合假手結構。

In image-guided minimally invasive surgery, real-time medical image is the essence to assist the operation. Since surgeons need adequate experience in performing the minimally invasive surgery, a virtual surgical training system is proposed and implemented in this thesis. Since the phantom used in the training system does not have its medical image, medical image reconstruction of hand phantom becomes one of the most important issues for developing the image-guided training system. In real-time medical imaging, reconstructing 3D volume of ultrasound (US) images is still challenging due to its speckle noise and ambiguous anatomic structure. In this thesis, a novel reconstruction procedure of US images for constructing the anatomical image of hand phantom is proposed and applied to the trigger finger surgical training system.
The proposed method consists of two main steps, the 3D US volume reconstruction of hand phantom and the registration of US volume to computed tomography (CT) volume. In the first step, we reconstruct the 3D US volume by aligning and combining the two orthogonal views of US images. In the second step, non-rigid registration is employed to construct the medical image of phantom by aligning the reconstructed 3D US volume to CT volume. Following the proposed procedure, the phantom with US images is applied to the training system to simulate the surgical environment. The medical image, phantom and the surgical instruments can be integrated by adopting the optical tracker to acquiring the 3D spatial correspondence and construct the virtual surgical training system. A surgical training system is built to improve the clinician proficiency for US -guided percutaneous trigger finger release (UGPR). As shown in experimental results, the proposed method can effectively overcome the shortcoming in single-view reconstruction to reconstruct the US image volume with clarity of tissues in 3D view. And the reconstructed US image is shown to be consistent with phantom during the process of image-guided surgical training.

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