腰椎間盤突出症會造成椎管狹窄，是成年人神經根損傷最常見的原因。目前治療椎間盤突出症的方式主要分為手術治療及保守治療，然而是否需要進行手術治療並沒有一定的標準，文獻指出進行保守治療六週後病患症狀沒有明顯好轉，臨床醫師將建議病患進行手術治療。為了避免評估療效造成病患時間以及醫療資源的浪費，本研究提出一套自動偵測突出椎間盤病計算狹窄程度的系統，運用於腰部T2加權以及脂肪訊號抑制之核磁共振影像上，過程分別是影像前處理、椎間盤提取、突出判斷、椎管區域提取、重建與檢視。因為椎間盤的灰階值與肌肉、軟骨等組織非常相近，在椎間盤提取的部分提出了區域型主動輪廓法，運用限制圈選邊界的方式以得到更加精準的椎間盤輪廓。為了快速判斷出突出椎間盤，本研究使用支持向量機對椎間盤紋理與平均灰度值特徵進行分類。因為脂肪訊號抑制核磁共振影像中水分呈現白色，利用此特性迅速的將椎管提取出來，圈選突出的區域，得到椎管與椎間盤突出部位後進行三維重建。
本研究採用532位椎間盤突出病患的核磁共振影像進行實驗與評估，所提出的系統能自動計算狹窄程度並進行三維重建，每個樣本經過影像濾波、椎間盤圈選、突出辨識、椎管提取以及三維重建後，平均需要55秒進行計算，系統的準確率為96.42%。本研究之系統能夠輸出腰椎間盤突出部位三維重建模型以及椎管狹窄程度的量化數值，有助於臨床醫師的診斷與後續療程規劃。

Lumbar disc herniation will causes spinal stenosis, and it’s also the most common cause of nerve root injury in adults. At present, the methods for treating disc herniation are mainly divided into surgical treatment, and conservative treatment. However, there are no definite criteria for assessing whether or not it is necessary to perform surgery, in general, there is no obvious improvement after six weeks of conservative treatment. The medical staff will recommend the patient for surgical treatment. In order to avoid wasting patient’s time and medical resources while evaluation the efficacy of conservative treatment, this research proposes a set of image processing methods applied to spinal canal and intervertebral disc herniation in lumbar MRI image for calculating the degree of spinal and three-dimensional reconstruction. The process are image preprocessing, disc extraction, herniated disc judgment, spinal region extraction and three-dimensional reconstruction. Because the gray value of the disc is very similar to the surrounding tissue, an improved active contour method is proposed in the disc extraction part to obtain a more accurate disc contour. In order to quickly determine the herniated intervertebral discs, the support vector machine was used to classify the features of intervertebral discs such as texture features and average gray values. Because the moisture in the MR image of fat signal suppression is white, this feature can be used to quickly extract the spinal canal and find out the prominent areas to obtain the position of the spinal canal and disc herniation and commencing three-dimensional reconstruction.
In this study, 532 MR images of patients with disc herniation were examined and evaluated. The proposed system can automatically calculate the degree of stenosis and perform three-dimensional reconstruction, each sample takes 55 seconds to calculate, the accuracy of the system is 96.42%. The system of the this study can output three-dimensional reconstruction models and quantified values of spinal stenosis degree, which is helpful for the diagnosis of clinicians.

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