CN115619750B - Calculation method of contrast projection angle in TAVR (total automated video computing) operation based on coronary sinus - Google Patents
Calculation method of contrast projection angle in TAVR (total automated video computing) operation based on coronary sinus Download PDFInfo
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Abstract
The invention discloses a method for calculating a contrast projection angle in a TAVR operation by taking a coronary sinus as a reference, which comprises the following steps: acquiring three-dimensional medical image data of an aortic valve; extracting an aortic root annulus plane: three sinus bottom coordinates of the aortic root are extracted; extracting a tile-type sinus region plane parallel to the annulus plane, wherein the tile-type sinus region plane can clearly see the connection points between the sinus regions; identifying a coronary sinus within the tile sinus region plane; identifying left and right connection points of the coronary sinus; obtaining a projection vector, wherein the projection vector is a vector in the connecting line direction of a connecting point at the left side and a connecting point at the right side of the coronary sinus; based on the projection vector, automatically calculating a left/right front-facing angleAnd a head/foot position angle θ. The method can effectively reduce the operation difficulty of doctors, shorten the operation time, improve the accuracy of the projection angle and improve the contrast effect, thereby helping the doctors to better develop the transcatheter aortic valve replacement.
Description
Technical Field
The invention belongs to the technical field of medical image processing, and relates to a method for calculating a contrast projection angle in a TAVR (total internal volume) operation by taking a coronary sinus as a reference.
Background
Transcatheter aortic valve replacement (Transcatheter Aortic Valve Replacement, TAVR) is a minimally invasive valve replacement procedure that delivers a prosthetic heart valve to the aortic valve site via interventional catheter techniques, thereby completing prosthetic valve implantation and restoring valve function.
In transcatheter aortic valve replacement, a physician uses a catheter to deliver a prosthetic valve through a blood vessel to the site of the diseased valve. Accurate release of the prosthetic valve in place has a significant impact on the outcome of the procedure, and poor release can lead to complications such as valve migration, paravalvular leakage, regurgitation in the center of the valve, and coronary occlusion. Thus, in transcatheter aortic valve replacement, it is necessary to ensure that the valve is released at the proper location and depth.
In order to implant the valve at the proper location and depth, positioning by angiography is required during surgery. For accurate positioning, it is important that the contrast device adopts a proper projection angle. Currently, there are two general types of projection positions used in TAVR surgery: right coronary sinus centering and left-right coronary sinus overlapping (Cusp overlay). The right coronary sinus centering method projects the coronary sinus to the centers of the left coronary sinus and the non-coronary sinus, and the three sinuses Dou De are in a straight line, and under the projection position, three sinus bottoms and surrounding structures are clear, but under the position, the delivery system and the plane of the valve annulus are not parallel, so that the implantation depth of the valve is difficult to accurately control. The left and right coronary sinus overlapping method refers to overlapping the right crown Dou Doude with the left crown Dou Doude, and the annulus is parallel to the delivery system under the body position, so that positioning can be accurately released, but because the method relies on accurate positioning of the bottoms of the left and right crowns Dou Dou, when severe calcification exists on the bottoms of sinuses, the prediction result can be affected, and the left and right coronary sinuses are different in size, different analysts judge whether overlapping is deviated, and therefore, the prediction angle also has deviation.
Considering that there are certain limitations in the two methods of determining the angle of illumination commonly used in TAVR at present. It has been found that the angle of the projection intersection of the tangential line passing through the two coronary sinus coaptation edges (i.e. the coronary sinus coaptation edge and the left coronary sinus coaptation edge) and the plane of the annulus can in most cases be obtained as a double parallel angle of the plane of the delivery system and the plane of the annulus itself, so that a new optimal release projection angle prediction method is proposed by the scholars: a calculation method based on the coronary sinus.
Currently, in the usual case, the positioning of the valve requires the projection angle of the contrast device to be determined by the interventional physician by means of 3D medical image software through complex manual interactions. This requires a high software operation experience for the doctor and also takes a lot of time for the doctor. At the same time, manual interaction is also difficult to guarantee and accurate, which also results in the fact that in practice it may be necessary to adjust the projection angle of the contrast device several times. Therefore, a method capable of automatically calculating the projection angle is needed, and a doctor only needs to directly set parameters in the contrast device according to the calculated angle, so that the time of operation in the operation is greatly reduced, the precision of the projection angle is ensured, and the contrast effect is ensured.
Disclosure of Invention
The invention aims at overcoming the defects in the prior art, and provides a method for calculating a contrast projection angle in a TAVR operation by taking a coronary sinus as a reference, which comprises the following steps:
step 1: acquiring three-dimensional medical image data of an aortic valve;
step 2: extracting an aortic root annulus plane: three sinus bottom coordinates of the aortic root are extracted and are respectively P1 (x,y,z) 、P2 (x,y,z) And P3 (x,y,z) An annulus plane is formed based on the three sinus bottoms, and an annulus plane normal vector annu is obtained through a calculation or manual extraction methodlusNormal (x,y,z) ；
Step 3: along vector annulus normal (x,y,z) Extracting a tile-type sinus region plane parallel to the plane of the annulus, wherein the tile-type sinus region plane can clearly see the connection points among the sinus regions;
step 4: identifying a coronary sinus within the tile sinus region plane in step 3;
step 5: identifying the left connecting point and the right connecting point of the coronary sinus in the step 4 respectively, and expressing the coordinates of the connecting points as: left connection point coordinate LHinge (x,y,z) And right connection point coordinate rhine (x,y,z) ；
Step 6, obtaining a projection vector which is a line direction vector ProDirection of a connecting point at the left side and a connecting point at the right side of the coronary sinus (x,y,z) ；
Step 7: based on the projection vector obtained in step 6, the left/right front bevel angle is automatically calculatedAnd a head/foot position angle θ.
Further, the three-dimensional medical image data is medical image data containing aortic valve information of a human body.
Further, the aortic root annulus plane extracted in the step 2 may be obtained by an automatic extraction algorithm, or manually extracted, and the method for calculating the normal vector of the aortic root annulus plane is as follows: let the plane equation be ax+by+cz+d=0, then, three sinus floor coordinates are substituted into the equation, respectively, to find parameters a, B, C and D, thereby obtaining the plane normal vector annuius normal (x,y,z) Is (A, B, C).
Further, the plane of the area of the tile-shaped sinus in the step 3, which is parallel to the plane of the valve annulus, can be identified by an automatic identification algorithm, can also be identified by a manual positioning mode,
further, the non-coronary sinus in the identification plane in the step 4 may be identified by an automatic identification algorithm, or may be identified by a manual positioning method.
Further, the left and right connection points of the coronary sinus in the plane are extracted in the step 5, and can be identified by an automatic identification algorithm.
Further, the projection vector ProDirection in the step 6 (x,y,z) The calculation method of (1) is as follows:
ProDirection＝RHinge-LHinge
ProDirection x ＝RHinge z -LHinge z
ProDirection y ＝RHinge y -LHinge y
ProDirection z ＝RHinge z -LHinge z
further, in the step 7, a left/right front bevel angle is calculatedAnd the head/foot position angle theta is as follows:
a. calculating the left/right front oblique angle of the proposed projection angle
When (when)In the case of right front incline, when +.>In the time, the left front slope is adopted,
b. calculate the head/foot position angle θ of the proposed projection angle:
θ＝arctan2(ProDirection z ,ProDirection y )
when θ >0, it is the head bit, and when θ <0, it is the foot bit.
The invention has the technical effects that:
by applying the technical scheme of the invention, the operation difficulty of doctors can be effectively reduced, the operation time can be shortened, the accuracy of the projection angle can be improved, and the radiography effect can be improved, thereby helping the doctors to better develop the transcatheter aortic valve replacement.
Drawings
FIG. 1 is a flow chart of a method for calculating a contrast projection angle in a TAVR procedure based on the coronary sinus in accordance with the present invention;
FIG. 2 is a schematic representation of three sinus floor locations at the aortic root of step 2 of the method of the present invention;
FIG. 3 is a schematic representation of the plane of the area of the tile sinus parallel to the plane of the annulus and the corresponding non-coronary sinus region and left and right connection points of the non-coronary sinus in steps 3, 4 and 5 of the method of the present invention;
fig. 4 is a schematic view of the projection directions in step 6 of the method of the present invention.
Detailed Description
The invention will be further illustrated with reference to specific examples. It should be understood that the examples are only for illustrating the present invention and are not intended to limit the scope of the present invention. Further, it is understood that various changes and modifications of the present invention may be made by those skilled in the art after reading the disclosure of the present invention, and such equivalents are intended to fall within the scope of the present invention as defined by the appended claims.
As shown in fig. 1, the method for calculating the contrast projection angle in TAVR operation based on the coronary sinus comprises the following 7 steps:
step 1: three-dimensional medical image data of the aortic valve is acquired. In particular, the three-dimensional medical image data should contain aortic valve information of human body, and can be any medical image data type, such as CT/MRI/US.
Step 2: three sinus bottom coordinates of the aortic root are extracted, respectively P1 (x,y,z) 、P2 (x,y,z) And P3 (x,y,z) Forming an annulus plane based on the three sinus bottoms to obtain an annulus plane normal vector annuiusnormal (x,y,z) . Specifically, the three sinus bottom coordinates of the aortic root can be obtained by an automatic extraction algorithm or manually. The automatic extraction algorithm may be machine learningThe method can also be a traditional image processing algorithm; the manual extraction method can select three sinus bottom coordinates by using a three-dimensional image browsing tool and utilizing a multi-plane reconstruction (MPR) function.
Step 3: along vector annulus normal (x,y,z) The direction, the plane of the sinus region of the tile parallel to the plane of the annulus is extracted, where the connection points between the individual sinus regions can be clearly seen. Specifically, the above-mentioned extraction of the plane of the valvular sinus region parallel to the plane of the annulus may be obtained by an automatic extraction algorithm or by manual selection of the positioning. The automatic extraction algorithm can be a machine learning method or a traditional image processing algorithm, for example, after the plane of the valve annulus is determined, the automatic extraction algorithm translates along the normal vector of the plane of the valve annulus towards the ascending aorta, the sinus structural characteristics are obtained through polar coordinate expansion in the translation process, and one layer of each sinus connecting point can be clearly seen. The manual extraction method can be realized by using a three-dimensional image browsing tool and utilizing a multi-plane reconstruction (MPR) function, selecting a parallel movement layer after the plane of the annulus is determined, and selecting a layer which can clearly see the connecting points of the sinuses.
Step 4: identifying a coronary sinus in the tile sinus region plane in step 3; specifically, the coronary sinus can be obtained by an automatic extraction algorithm or manually. The automatic extraction algorithm can be a machine learning method, and can also be a traditional image processing algorithm based on sinus and coronary artery structures; the manual extraction method may determine the coronary sinus using a multi-planar reconstruction (MPR) function through a three-dimensional image browsing tool.
Step 5: identifying the left-side connecting point and the right-side connecting point of the coronary sinus in the step 4, and expressing the coordinates of the connecting points as: left connection point coordinate LHinge (x,y,z) And right connection point coordinate rhine (x,y,z) And obtains the line direction vector LRHingeDirection of the left and right connection points (x,y,z) Specifically, the left and right connection points of the coronary sinus in the identification step 4 can be obtained by an automatic extraction algorithm or manually. The automatic extraction algorithm can be a machine learning method or a traditional image processing algorithm, such as attachment to the region of the coronary sinus through polar coordinate expansionSearching extreme points to find out left and right connection points; the manual extraction method can determine the left and right connection points of the coronary sinus by using a multi-plane reconstruction (MPR) function through a three-dimensional image browsing tool.
Step 6, obtaining projection vector, namely ProDirection of connecting line direction vector of left and right connecting points of the coronary sinus (x,y,z) 。
Specifically, the above-described acquisition of ProDirection (x,y,z) The method is as follows:
ProDirection＝RHinge-LHinge
ProDirection x ＝RHinge z -LHinge z
ProDirection y ＝RHinge y -LHinge y
ProDirection z ＝RHinge z -LHinge z
step 7: based on the projection vector obtained in step 6, the left/right front bevel angle is automatically calculatedAnd a head/foot position angle θ; specifically, the solving method is as follows:
a. calculating the left/right front oblique angle of the proposed projection angle
When (when)In the case of right front incline, when +.>In the time, the left front slope is adopted,
b. calculate the head/foot position angle θ of the proposed projection angle:
θ＝arctan2(ProDirection z ,ProDirection y )
when θ >0, it is the head bit, and when θ <0, it is the foot bit.
Claims (10)
1. A method for calculating a contrast projection angle in a TAVR operation based on a coronary sinus, comprising the steps of:
step 1: acquiring three-dimensional medical image data of an aortic valve;
step 2: extracting an aortic root annulus plane: three sinus bottom coordinates of the aortic root are extracted and are respectively P1 (x，y，z) 、P2 (x，y，z) And P3 (x，y，z) An annulus plane is formed based on the three sinus bottoms, and an annulus plane normal vector annuius normal is obtained through a calculation method (x,y,z) ；
Step 3: along vector annulus normal (x,y,z) Extracting a tile-type sinus region plane parallel to the plane of the annulus, wherein the tile-type sinus region plane can clearly see the connection points among the sinus regions;
step 4: identifying a coronary sinus within the tile sinus region plane in step 3;
step 5: identifying the left connecting point and the right connecting point of the coronary sinus in the step 4 respectively, and expressing the coordinates of the connecting points as: left connection point coordinate LHinge (x,y,z) And right connection point coordinate rhine (x,y,z) ；
Step 6: obtaining a projection vector, wherein the projection vector is a vector ProDirection of a connecting line direction from a left connecting point to a right connecting point of the coronary sinus (x,y,z) ；
Step 7: based on the projection vector obtained in step 6, the left/right front bevel angle is automatically calculatedAnd a head/foot position angle θ.
2. The method according to claim 1, wherein the specific method for obtaining the normal vector of the plane of the annulus in the step 2 by the calculation methodThe method comprises the following steps: let the plane equation be ax+by+cz+d=0, then, three sinus floor coordinates are substituted into the equation, respectively, to obtain parameters A, B, C and D, thereby obtaining the plane normal vector annuius normal (x,y,z) Is (A, B, C).
3. The method according to claim 2, wherein the projection vector ProDirection in step 6 (x,y,z) The calculation method of (1) is as follows:
ProDirection＝RHinge-LHinge
ProDirection x ＝RHinge z -LHinge z
ProDirection y ＝RHinge y -LHinge y
ProDirection z ＝RHinge z -LHinge z 。
4. the method according to claim 3, wherein in the step 7, a left/right front bevel angle is calculatedAnd the head/foot position angle theta is as follows:
a. calculating the left/right front oblique angle of the projection angle
When (when)In the case of right front incline, when +.>In the time, the left front slope is adopted,
b. calculating the head/foot position angle theta of the projection angle:
θ＝arctan2(ProDirection z ,ProDirection y )
when theta is greater than 0, the head position is the foot position, and when theta is less than 0.
5. The method of claim 4, wherein the three-dimensional medical image data is medical image data containing aortic valve information of a human body.
6. The method according to claim 5, wherein the tile-shaped sinus region plane parallel to the plane of the annulus in the step 3 is identified by an automatic identification algorithm.
7. The method according to claim 5, wherein the tile-shaped sinus region plane parallel to the plane of the annulus in step 3 is identified by manual positioning.
8. The method according to claim 6, wherein the non-coronary sinus in the identification plane in the step 4 is identified by an automatic identification algorithm.
9. The method according to claim 6, wherein the non-coronary sinus in the identification plane in the step 4 is identified by manual positioning.
10. The method according to claim 8 or 9, wherein the left and right connection points of the coronary sinus are extracted from the plane in step 5, and are identified by an automatic identification algorithm.
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