CN100493471C - Puncture guiding system of computer aided PCNL - Google Patents
Puncture guiding system of computer aided PCNL Download PDFInfo
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- CN100493471C CN100493471C CNB2006100334629A CN200610033462A CN100493471C CN 100493471 C CN100493471 C CN 100493471C CN B2006100334629 A CNB2006100334629 A CN B2006100334629A CN 200610033462 A CN200610033462 A CN 200610033462A CN 100493471 C CN100493471 C CN 100493471C
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Abstract
A computer assistant piercing leading system for dermal nephrocentesis, comprising: a brachial in C shape and its mating image taking device, a positioning system and its mating tracker, a target cover, an image working station, and a mating software treating image leading. The invention employs tracking for space target and image treating technology with computer to track the position and direction of puncture needle in real time, which helps doctor choose proper position for puncture needle and make detail operation plan. The choice of needle position can be decided by taking only one or two images, which can reduce the X exposition time for doctor and patient.
Description
Technical field
The present invention relates to the medical operation airmanship, particularly relate to and utilize C shape arm X-ray machine to finish area of computer aided kidney puncture Position Fixing Navigation System and method.
Background technology
The PCN art is crucial ingredient in the operation of intracavity Urology Surgery, become the main modern treatment method of urinary system calculus jointly with ureteroscope art, extracorporeal shock-wave lithotripsy, change and replaced gradually the therapeutic modality of traditional open surgery, (minimallyinvasive percutaneous nepharolithotomy MPCNL) is this technical development and perfect result to lithotomy and micro-wound percutaneous kidney punctures.PCN (percutaneous renal puncture lithotomy) is the most basic technology of intracavity Urology Surgery, also is the basis of PCN art.The application puncture needle successfully punctures and enters in the kidney collection urinary system, sets up percutaneous kidney passage through expansion, is the successful assurance of PCN operation.Suitable puncture approach and as far as possible little puncture channel are that the wisdom of avoiding the kidney wound hemorrhage, reducing complication is selected, so the selection that puncture needle is gone into the pin position is a step of most critical in the operation.The micro-wound percutaneous kidney puncture of carrying out is at present got in the stone operation, puncture needle is inserted in the renal calices normally under the image guiding of C shape arm, finishes, go into the pin position in order to determine puncture needle, the X-ray that usually needs the doctor to carry out repeatedly shines, and is especially big to the patient especially damage to doctor's raying like this.Also have at present by mechanical scale indicating means, but machinery uses in operation not too easily.
Summary of the invention
Technical problem to be solved by this invention is: puncture navigation system and method in a kind of computer aided percutaneous kidney puncture lithotomy are provided, it is by the method for navigation system, C shape arm Image Acquisition and Computer Image Processing, help the doctor to finish micro-wound percutaneous kidney puncture and get in the stone operation, be inserted into the selection that puncture needle in the renal pelvis is gone into the pin initial position.
Puncture navigation system in the computer aided percutaneous kidney puncture of the present invention lithotomy comprises:
One C shape arm and supporting image collecting device thereof are used for taking the x-ray image of kidney focus and as the image acquisition hands section of guided puncture before operation;
One location system and supporting tracker thereof are used to follow the tracks of and the position of definite puncture needle needle point and the direction of puncture needle;
One target cover, be installed on image collecting device one end of C shape arm, comprise at least 3 index points and some plumbous points on it, some plumbous points are used for the x-ray image distortion correction that C shape arm is clapped and are used to obtain projective transformation matrix between earth coordinates and the x-ray image coordinate system, and index point is as the registration point of setting up the transformation relation between positioning-system coordinate system and the earth coordinates;
One image workstation is connected with navigation system with the image collecting device of C shape arm, is used to finish the operation of application softwaries such as image acquisition, storage, processing;
One supporting image-guidance process software, be installed in the described image workstation, be used to finish the x-ray image that shows that C shape arm is clapped, image rectification, the transformation matrix of finishing between x-ray image coordinate system and the earth coordinates calculates, set up the transformation relation between positioning-system coordinate system and the earth coordinates, and finish functions such as puncture needle and x-ray image fusion demonstration.
Puncture air navigation aid in a kind of computer aided percutaneous kidney puncture lithotomy may further comprise the steps:
A, image workstation pass through the x-ray image that C shape arm is taken the patient renal position, sketch the contours of the profile diagram of kidney on x-ray image;
B, according to the 3 d space coordinate of the lead point on the target cover and this lead point corresponding coordinate in described x-ray image, calculate the central projection matrix of C shape arm, determine the projection relation of spatial point in described x-ray image;
C, according to the 3 d space coordinate of index point on the target shroud rim, and the location three-dimensional coordinate of this index point that measures by navigation system is set up the transformation matrix between earth coordinates and the positioning-system coordinate system;
D, navigation system are followed the tracks of the tracker that is fixed on the puncture needle, finish the track and localization to puncture needle, and are transferred to the result in the image workstation in real time; The transformation matrix that image workstation is set up according to step c is converted to three-dimensional coordinate in the earth coordinates with the positioning-system coordinate of puncture needle, and this three-dimensional coordinate is projected on the described x-ray image by the determined projection relation of step b;
E, detect puncture needle whether go into the pin position suitable, if suitable, inserting needle then, if improper, mobile puncture needle changes steps d.
Puncture air navigation aid in the another kind of computer aided percutaneous kidney puncture lithotomy may further comprise the steps:
1), image workstation takes the x-ray image of patient renal normotopia and side position by C shape arm, rebuilds the line drawing of kidney according to two width of cloth x-ray images, be presented on the display screen;
2), according to the 3 d space coordinate of index point on the target shroud rim, and the three-dimensional coordinate of this index point that measures by navigation system is set up the transformation matrix between earth coordinates and the positioning-system coordinate system;
3), navigation system follows the tracks of the tracker be fixed on the puncture needle, finish track and localization, and be transferred to the result in the image workstation in real time puncture needle; Image workstation is according to step 2) transformation matrix set up is converted to three-dimensional coordinate in the earth coordinates with the positioning-system coordinate of puncture needle, is attached in the kidney 3-D view that reconstructs;
4), detect puncture needle whether go into the pin position suitable, if suitable, inserting needle then, if improper, mobile puncture needle changes step 3).
The present invention utilizes extraterrestrial target tracking technique and computer image processing technology, and the position and the direction of puncture needle are carried out real-time tracking, helps the doctor to select proper puncture needle on position, and can do detailed surgical planning.Only need to take a width of cloth or two width of cloth images, can finish the selection of going into the pin position of puncture needle, can reduce doctor and patient's X-ray exposure frequency, and space orientation is accurate.
Description of drawings
Fig. 1 is the puncture system construction drawing of navigation system of the present invention;
Fig. 2 is the puncture fundamental diagram of navigation system of the present invention;
Fig. 3 is the structural representation that is fixed with the puncture needle of tracker;
Fig. 4 is the register method sketch map of puncture needle needle point locus;
Fig. 5 is the sketch map of C shape arm and target cover thereof;
Fig. 6 adopts the flow chart of two dimensional image to the puncture needle location navigation for the present invention;
Fig. 7 adopts the flow chart of 3-D view to the puncture needle location navigation for the present invention.
The specific embodiment
The present invention goes into the optimum of pin position and determines in order to finish puncture needle in the percutaneous renal puncture lithotomy, and goes into the comparison of pin by diverse location, thereby determines operation pathway, and puncture needle is penetrated in the focus.
It obtains a width of cloth or two width of cloth projections at patient renal position by C shape arm, by Computer Processing, rebuilds the two dimension or the 3-D view of kidney, is used for the doctor and selects puncture needle to go into the object that a result shows;
On C shape arm, fix a target cover, by three-dimensional coordinate and its image coordinate in the C shape arm captured x-ray image that go out of plumbous point in the target cover in the earth system, set up the projection relation transformation matrix of space coordinates and image coordinate, this transformation matrix is to be used for puncture needle tip position and the direction projection projection matrix to C shape arm image;
The index point of the fixing system identification that can be positioned on the outward flange of target cover by navigation system recognition marks point, measures the coordinate of these index points in positioning-system coordinate system.Simultaneously, the three-dimensional coordinate of these index points in earth coordinates that is fixed on the target shroud rim also is known.Therefore, by these index points, can obtain the transformation matrix of coordinates between positioning-system coordinate system and the earth coordinates, this transformation matrix of coordinates is used for positioning-system coordinate is transformed to the coordinate of earth coordinates;
The tracker that the stationary positioned system can discern on puncture needle, by this step of apparatus registration, the space coordinates that navigation system can real-time tracking puncture needle syringe needle summit;
Projection relation transformation matrix through space coordinates and image coordinate, puncture needle is projected in the two dimensional image of C shape arm shooting, perhaps puncture needle is attached in the kidney 3-D view that reconstructs, real-time tracking by navigation system, thereby can point out puncture needle current position to the doctor, provide auxiliary for the doctor selects the optimum pin position of going into.
It has two kinds of mode of operations, and first kind of mode of operation is to adopt a width of cloth X-ray sheet to finish puncture needle to go into the pin choice of location, and second kind of mode of operation is to adopt two width of cloth X-ray sheets to finish puncture needle to go into the pin choice of location.First kind of mode of operation, what C shape arm was taken is the normotopia projection image, and navigation software only need be finished the demonstration of two dimensional image, and second kind of mode of operation both can have been finished the demonstration of two dimensional image, also can finish the demonstration of three-D profile image, what C shape arm was taken is normotopia and lateral projection's picture.
Present invention includes the function of puncture needle locus and image co-registration, under first kind of mode of operation, the locus of puncture needle finally will be projected on the two-dimentional x-ray image.Under second kind of mode of operation, the locus of puncture needle and direction both can also can show with 3 D stereo with the display mode of first kind of mode of operation.The present invention can also finish the measurement functions such as distance calculating, needle angle of puncture needle needle point to focus.
Below in conjunction with accompanying drawing the present invention is elaborated:
With reference to Fig. 1 and Fig. 5, the puncture navigation system in this computer aided percutaneous kidney puncture lithotomy mainly is made up of C shape arm 2, target cover 6, navigation system 3, tracker 4, image workstation 1, puncture needle 5 and relevant assistive device.C shape arm 2 is finished obtaining patient image.
1 of image workstation is to finish C shape arm 2 treatment of picture of clapping (to extract processing such as the kidney profile, processing such as kidney 3D image reconstruction), and the locus of puncture needle 5 is projected on the image that C shape arm obtains, projected image shows on display 11 the most at last, is used for auxiliary doctor and finishes the selection that puncture needle 5 is initially gone into the position.
As shown in Figure 1.Patient 10 lies on the operating-table 9, and target cover 6 is installed on the imaging head of C shape arm 2.The position of C shape arm 2 is placed in the place that can photograph kidney.The position that navigation system 3 is put will make its measuring range cover operative region as far as possible, and tracker 4 is fixed on the puncture needle 5 by custom-designed fixture 42 (clip), and the range of activity of tracker 4 will be within the measuring range of navigation system 3.The image of C shape arm 2 is transferred in the image workstation 1 by image data line 8, navigation system 3 measures the 3 d space coordinate of index point 61 on the space coordinates of the index point 41 on the tracker 4 and the target cover 6, is transferred in the image workstation 1 by navigation system data wire 7.The doctor can finish the corresponding software function operations by means such as keyboard 12, mouse or touch screens.Image workstation 1 finishes mainly that the image distortion correction of C shape arm 2 is handled, the profile of kidney extracts, the tip position of the foundation of the projection relation formula of the plumbous some identification of target cover, C shape arm and puncture needle and direction be in the functions such as projection of image.Final process result shows on display 11.
The transmission of data is followed successively by: the data image that C shape arm 2 collects is transferred in the image workstation 1 according to the storage format of the C shape arm image picture format with DICOM.Navigation system 3 is obtained the 3 d space coordinate of the index point on the tracker 4, and the result is input in the image workstation 1 by string line in real time.Tracker 4 is fixed on the puncture needle 5 by clip, and is locked then, makes the index point coordinate on the tracker 4 and the position relative fixed of puncture needle 5 needle points.The 3 d space coordinate of puncture needle 5 needle points obtains by the registration of aligner.Plumbous space of points coordinate on the target cover 6 is fixed with distributing, and preserves model, the lead of target cover with the form of file and counts out and each plumbous 3 d space coordinate of putting with respect to lead point target cover initial point.This document is read in the application program when image workstation 1 starts navigation software.
Fig. 2 is the system works schematic diagram.C shape arm obtains the x-ray image that a width of cloth comprises the plumbous point of target cover image-forming information by the shooting to focus.By the plumbous point of target cover identification software, finish the plumbous dot image location recognition of target cover in the x-ray image.By these plumbous some positions, finish the distortion in images calibration and alignment.By being installed in the index point information on the target cover, finish the coordinate transform between 3 d space coordinate and the positioning-system coordinate system.Follow the tracks of the tracker be fixed on the puncture needle by navigation system and finish track and localization puncture needle, and the position of puncture needle is projected on the x-ray image, by being installed in the visual software on the image workstation, finish the demonstration of puncture needle and x-ray image relative position again.
Provide tracker 4 among Fig. 3 and be fixed on sketch map on the puncture needle 5, fix four index points 41 on the tracker 4, navigation system 3 is measured in order, measures the space coordinates of these index points 41 respectively, and, obtain the 3 d space coordinate of puncture needle 5 needle points by registration process.Tracker 4 is fixed on the afterbody of puncture needle 5 by custom-designed fixture 42.
With reference to Fig. 4, the logon mode that puncture needle 5 needle point three-dimensional coordinates are determined is: the needle point that will be fixed with the puncture needle 5 of tracker 4 is put on the point 50 ' of known spatial three-dimensional coordinate of base 50, relation according to the 3 d space coordinate of the 3 d space coordinate of 4 index points 41 on this moment tracker and known point 50 ', obtain on the tracker 4 geometrical relationship of four index points 41 and puncture needle 5 needle points, thereby obtain determining the expression formula of puncture needle 5 needle point three-dimensional coordinates with the space coordinates of four index points 41, therefore, as long as obtain the 3 d space coordinate of index point on the tracker 4, just can obtain the 3 d space coordinate of puncture needle 5 needle points.
This navigation system can be operated in two kinds of patterns, and first kind is to adopt a width of cloth X-ray sheet to finish puncture needle to go into the pin choice of location, and second kind is to adopt two width of cloth X-ray sheets to finish puncture needle to go into the pin choice of location.Explanation respectively below:
First kind of mode of operation: be in operation process, to adopt a width of cloth C shape arm X-ray sheet to determine that the puncture needle in the percutaneous renal puncture lithotomy goes into the method for pin position as shown in Figure 6.Its workflow is as follows:
[1] picture of collection patient's normotopia C shape arm;
[2] by the plumbous point of target cover identification software the picture of C shape arm is carried out distortion correction;
[3] by clicking the mouse, sketch the contours of the profile diagram of kidney, and the edge of calculus, and put on different colors respectively, treated image is used for the doctor and selects puncture needle to go into the object that a result shows;
[4] utilize the 3 d space coordinate of the lead point on the target cover and in x-ray image corresponding coordinate, calculate the central projection matrix of C shape arm, determine the projection relation of spatial point three-dimensional coordinate and image coordinate;
[5] measure the 3 d space coordinate of index point on the target shroud rim, and measure the three-dimensional coordinate of these index points, set up the transformation matrix between earth coordinates and the positioning-system coordinate system by navigation system;
[6] positioning-system coordinate of the puncture needle that tracker is determined is converted to the coordinate in the earth coordinates, and this three-dimensional coordinate is projected on the picture of C shape arm by the projection relation of determining in [4];
[7] detect puncture needle whether go into the pin position suitable, if improper, mobile puncture needle changes [6] again, if suitable, inserting needle then.
Second kind of mode of operation: accompanying drawing 7 provides is to take two width of cloth X-ray sheets to finish puncture needle and go into the regioselective workflow diagram of pin in operation.Its workflow is described below:
[1] gather patient just, the picture of side position C shape arm;
[2] by the plumbous point of target cover identification software the picture of C shape arm is carried out distortion correction;
[3] utilize the 3 d space coordinate of the lead point on the target cover and in image corresponding coordinate, calculate the central projection matrix of C shape arm, determine the projection relation of spatial point three-dimensional coordinate and image coordinate, and reconstruct the three-dimensional coordinate of the key position in the kidney profile, thereby can obtain to reflect the 3-D view of true kidney profile by two width of cloth X-ray sheets;
[4] measure the 3 d space coordinate of index point on the target shroud rim, and measure the three-dimensional coordinate of these index points, set up the transformation matrix between earth coordinates and the positioning-system coordinate system by navigation system;
[5] positioning-system coordinate of the puncture needle that tracker is determined is converted to the coordinate in the earth coordinates;
[6] with the 3 d space coordinate that obtains in [5], be attached in the kidney 3-D view that reconstructs, provide position relation more than you know to the doctor;
[7] detect puncture needle whether go into the pin position suitable, if improper, mobile puncture needle changes [5] again, if suitable, inserting needle then.
Patent of the present invention is used multi-door subject technologies such as high-accuracy position system, computer Medical Image Processing, has solved the key technology of utilizing single image or two width of cloth images to realize the method and system of the puncture navigation in the computer aided percutaneous kidney puncture lithotomy.Utilize the function of navigation system and pictorial display, can help the frequent shooting X-ray sheet of doctor in operation process, the doctor only need be once or under the situation of twice shooting X-ray sheet, by the position of conversion puncture needle constantly realizing selecting best renal puncture route.System is reliable, advanced, can provide high-precision location and direction again, can satisfy the requirement in the medical treatment.Its supporting image-guidance process software also has the case history archive managerial function.
Be understandable that, for those of ordinary skills, can be equal to replacement or change according to technical scheme of the present invention and inventive concept thereof, and all these changes or replacement all should belong to the protection domain of the appended claim of the present invention.
Claims (5)
1, the puncture navigation system in a kind of computer aided percutaneous kidney puncture lithotomy is characterized in that comprising:
One C shape arm and supporting image collecting device thereof are used for taking the x-ray image of kidney focus before operation;
One location system and supporting tracker thereof are used to follow the tracks of and the position of definite puncture needle needle point and the direction of puncture needle;
One target cover, be installed on image collecting device one end of C shape arm, comprise at least 3 index points and some plumbous points on it, some plumbous points be used for the x-ray image distortion correction that C shape arm is clapped and obtain earth coordinates and the x-ray image coordinate system between projective transformation matrix, index point is as the registration point of setting up the transformation relation between positioning-system coordinate system and the earth coordinates;
One image workstation is connected with navigation system with the image collecting device of C shape arm, is used to finish the operation of image acquisition, storage, processing application software;
One supporting image-guidance process software, be installed in the described image workstation, be used to finish the x-ray image that shows that C shape arm is clapped, image rectification, the transformation matrix of finishing between x-ray image coordinate system and the earth coordinates calculates, set up the transformation relation between positioning-system coordinate system and the earth coordinates, and finish puncture needle and x-ray image fusion Presentation Function.
2, puncture navigation system as claimed in claim 1 is characterized in that: described target cover comprises flat board, and dull and stereotyped above and below all is provided with some plumbous points, and a dull and stereotyped side is provided with index point, and this flat board is substantially parallel with the imaging plane of C shape arm.
3, puncture navigation system as claimed in claim 2, it is characterized in that: the size of the lead point of described target cover above and below is different with the interval that distributes, the lead point that guarantees the above and below is not overlapping in vertical direction, the x-ray image distortion correction that the quantity of plumbous point should enough be clapped C shape arm, also enough obtains projective transformation matrix between earth coordinates and the x-ray image coordinate system.
4, as the described puncture navigation system of the arbitrary claim of claim 1-3, it is characterized in that: the supporting tracker of described and navigation system is fixed on the puncture needle, and some index points are set on the tracker; Navigation system can provide the 3 d space coordinate of puncture needle in real time, and the three-dimensional coordinate computational accuracy of navigation system can satisfy clinical needed scope.
5, puncture navigation system as claimed in claim 4 is characterized in that: described navigation system is machinery or optics or electromagnetic positioning system.
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| CNB2006100334629A CN100493471C (en) | 2006-01-26 | 2006-01-26 | Puncture guiding system of computer aided PCNL |
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| CNB2006100334629A CN100493471C (en) | 2006-01-26 | 2006-01-26 | Puncture guiding system of computer aided PCNL |
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-
2006
- 2006-01-26 CN CNB2006100334629A patent/CN100493471C/en not_active Expired - Fee Related
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20170193160A1 (en) * | 2016-01-06 | 2017-07-06 | Boston Scientific Scimed, Inc. | Systems and methods for planning medical procedures |
| US11302435B2 (en) | 2016-01-06 | 2022-04-12 | Boston Scientific Scimed, Inc. | Systems and methods for planning medical procedures |
| US11830604B2 (en) | 2016-01-06 | 2023-11-28 | Boston Scientific Scimed, Inc. | Systems and methods for planning medical procedures |
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| CN1806771A (en) | 2006-07-26 |
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