WO2020107165A1

WO2020107165A1 - Auxiliary lung diagnosis method and device

Info

Publication number: WO2020107165A1
Application number: PCT/CN2018/117472
Authority: WO
Inventors: 易新; 庄凌峰; 刘鑫; 郑伟; 田文; 戴政国
Original assignee: 苏州朗开医疗技术有限公司
Priority date: 2018-11-26
Filing date: 2018-11-26
Publication date: 2020-06-04

Abstract

The present disclosure provides an auxiliary lung diagnosis method and device. The method comprises: obtaining a registration matrix of an electromagnetic navigation bronchoscope according to a preoperative CT image; obtaining a lesion image using a peripheral ultrasound probe; in the case that the lesion image is obtained, performing on-site cytological evaluation; importing a puncture path and registration information to a transthoracic electromagnetic navigation system; directing a puncture needle at a target puncture point on a person to be tested; adjusting the spatial angle of the puncture needle; obtaining a respiration curve of said person; and after the puncture needle reaches a predetermined position, performing needle aspiration biopsy. Thus, transthoracic needle aspiration biopsy guided by electromagnetic navigation is performed, thereby reducing the diagnosis transit time and puncture risk of a patient to the maximum extent.

Description

Lung auxiliary diagnosis method and device

Technical field

The present disclosure relates to the field of medical technology, and in particular, to a lung assisted diagnosis method and device.

Background technique

Computer tomography (computed tomography, CT) guided transthoracic wall biopsy (TTNA) is an effective method for diagnosing lung lesions, but due to the fact that the technology cannot be guided in real time, it is difficult to accurately diagnose some small lesions Need to puncture the lungs repeatedly, and repeated puncture of the lungs will cause pneumothorax, bleeding and other complications.

At present, TTNA guided by electromagnetic navigation is commonly used. Compared with relying solely on CT positioning, accurate preoperative positioning and intraoperative real-time navigation can shorten the puncture time, reduce the radiation dose and needle adjustment times received by patients, and reduce the occurrence of complications. .

However, the traditional electromagnetic navigation still needs the assistance of CT equipment. The reason is that the registration module of the navigation system needs to identify the marked points of the CT three-dimensional reconstruction, so the patient needs to carry out a CT scan with the markers before puncture. The electromagnetic navigation bronchoscopy system (ie ENB system) is a new diagnostic method for lung lesions. Through electromagnetic navigation guidance, the lung lesions can be biopsied through the bronchus (natural cavity), that is, transbronchial lung biopsy biopsy (TBLB for short), when the ENB system is not in place, if TBLB is immediately converted to TTNA, biopsy of lung lesions can be continued. But TBLB operation is generally in the bronchoscope room, while TTNA operation is generally in the CT room. Therefore, the existing electromagnetic navigation system cannot satisfy this situation.

Summary of the invention

The embodiments of the present disclosure provide a method and device for assisting diagnosis of lungs, to solve the technical problem that the current electromagnetic navigation bronchoscopy technology cannot immediately convert TBLB to TTNA during biopsy of lung lesions.

In order to achieve the above object, the present disclosure provides a lung assisted diagnosis method, including:

Obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;

According to the registration matrix, use peripheral ultrasound probes to obtain lesion images;

In the case of acquiring the image of the lesion, perform a bronchoscopy brush test and perform on-site cytological assessment;

If the on-site cytology is negative, perform bronchoalveolar lavage and bronchoscopy biopsy;

Import pre-acquired puncture path and registration information to the transthoracic electromagnetic navigation system;

According to the puncture path and registration registration information, aim the puncture at the target puncture point on the prospective examinee;

Adjust the spatial angle of the puncture needle;

Obtain the breathing curve of the person to be tested;

When the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time, the puncture operation is started;

When the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed.

Preferably, before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, the method further includes:

Import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture on the tail of the puncture needle;

Align the needle of the puncture needle to the primary puncture point on the subject;

According to the position and direction indicator of the puncture needle displayed on the CT image, adjust the spatial angle of the puncture needle aimed at the examinee;

When the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject, the target puncture point is marked on the skin of the subject.

Preferably, the step of acquiring the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image includes:

If there are markers in the pre-operative CT image, use the markers for point registration registration;

If there is no marker in the preoperative CT image, use the positioning wire to collect the main bronchus for registration of point cloud registration;

Record the registration matrix of the electromagnetic navigation bronchoscope.

Preferably, the step of acquiring a lesion image using a peripheral ultrasound probe according to the registration matrix includes:

According to the registration matrix, the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe;

Use peripheral ultrasound probes to obtain lesion images.

Preferably, the step of withdrawing the puncture needle and performing needle biopsy after the puncture needle reaches a predetermined position includes:

When the puncture needle reaches the predetermined position, if the sheath in the bronchoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and the needle Aspiration biopsy;

If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.

Preferably, after the puncture needle reaches a predetermined position, the step of withdrawing the puncture needle and performing needle biopsy further includes:

When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;

If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;

If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient.

Another aspect of the present disclosure provides a lung biopsy device, including:

The registration matrix acquisition module is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;

A lesion image acquisition module, configured to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix;

On-site cytology evaluation module, used to perform bronchoscopy and parallel on-site cytology evaluation when the lesion image is acquired;

The first biopsy module is used for bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;

The first information import module is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system;

Target puncture point alignment module, which is used to target the puncture point to the target puncture point on the subject to be detected according to the puncture path and registered registration information;

The first adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle;

The breathing curve acquisition module is used to acquire the breathing curve of the person to be detected;

The puncture module is used to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path and the breathing time of the subject to be detected is consistent with the CT time;

The second biopsy module is used to withdraw the puncture needle after the puncture needle reaches a predetermined position and perform a needle biopsy.

Preferably, the above device further includes:

The second information import module is used to import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;

The primary puncture point alignment module is used to align the needle of the puncture needle with the primary puncture point on the subject;

The second adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle aimed at the examinee according to the position and direction indicator of the puncture needle displayed on the CT image;

The target puncture point determination module is used to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.

Preferably, the registration matrix acquisition module includes:

A first registration matrix acquisition sub-module, which is used for registration of point registration using the marker if the pre-operative CT image has a marker;

A second registration matrix acquisition sub-module, which is used to acquire the main bronchus by using a positioning wire for point cloud registration if the pre-operative CT image has no markers;

The registration matrix acquisition submodule is used to record the registration matrix of the electromagnetic navigation bronchoscope.

Preferably, the lesion image acquisition module includes:

The first lesion image acquisition sub-module is used for navigating the positioning wire carrying the sheath to the lesion according to the registration matrix, withdrawing the positioning wire, and inserting a peripheral ultrasound probe;

The second lesion image acquisition submodule uses peripheral ultrasound probes to acquire lesion images.

Preferably, the second biopsy module is used to: when the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, then the electromagnet When the navigation of the navigation system ends, the puncture needle is withdrawn and a needle biopsy is performed;

Preferably, the second biopsy module is also used to:

If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient. The method and device for assisted diagnosis of the lungs provided by the embodiments of the present disclosure combine transthoracic lung biopsy with transthoracic electromagnetic navigation system puncture navigation, and use electromagnetic navigation bronchoscopy preoperative planning and intraoperative navigation information to guide transthoracic wall biopsy , So that there is no need for CT equipment for intraoperative information collection and registration registration, which can guide doctors to perform electromagnetic navigation-guided transthoracic biopsy immediately when TBLB is not in place or when electromagnetic navigation bronchoscopy biopsy is not ideal. , Minimize patient diagnosis transfer time and puncture risk, without the need for CT equipment assistance and guidance during operation, transthoracic puncture biopsy without registration and registration during the operation, directly use electromagnetic navigation bronchoscope registration information.

BRIEF DESCRIPTION

FIG. 1 is one of the flowcharts of a lung assisted diagnosis method provided by an embodiment of the present disclosure;

2 is a second flowchart of a method for assisting diagnosis of lungs provided by an embodiment of the present disclosure;

3 is a third flowchart of a method for assisting diagnosis of lungs provided by an embodiment of the present disclosure;

4 is a fourth flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure;

FIG. 5 is a fifth flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure;

6 is one of the structural diagrams of a lung biopsy device provided by an embodiment of the present disclosure.

detailed description

To make the technical problems, technical solutions, and advantages to be solved by the present disclosure clearer, the following will describe in detail with reference to the accompanying drawings and specific embodiments.

Please refer to FIG. 1. FIG. 1 is a flowchart of a lung assisted diagnosis method provided by an embodiment of the present disclosure. As shown in FIG. 1, an embodiment of the present disclosure provides a lung assisted diagnosis method, including the following steps:

Step 101: Acquire the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image.

Before this step, it is necessary to perform preoperative CT planning, such as planning the path of the electromagnetic navigation bronchoscopy system (ENB-TBLB) and the puncture needle path of the transthoracic electromagnetic navigation system (EMN-TTNA), and planning and marking the patient's skin Puncture point on the target. Then the electromagnetic navigation bronchoscope device is in place, and the positioning wire is inserted into the working channel of the bronchoscope together with the guide sheath. After the above steps are completed, the registration matrix is obtained according to the preoperative CT image.

Step 102: Navigate according to the registration matrix, and use peripheral ultrasound probes to obtain lesion images. Specifically, the positioning wire carries the sheath to navigate to the vicinity of the lesion, the positioning wire is withdrawn, a peripheral ultrasound probe is inserted for confirmation, and the lesion image is acquired through the peripheral ultrasound probe.

Step 103: Under the condition that the image of the lesion is acquired, perform a bronchoscopy test and perform on-site cytological assessment. Preferably, the peripheral ultrasound probe does not display the lesion image, that is, if the lesion image is not acquired, the sheath and bronchoscope are withdrawn, and step 105 is executed.

Step 104: If the on-site cytology is negative, perform bronchoalveolar lavage and bronchoscopy biopsy. Preferably, if the on-site cytology is positive, a bronchoscopy biopsy is performed and the operation is ended.

Step 105: Import the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system;

Step 106: According to the puncture path and the registration registration information, aim the puncture at the target puncture point on the prospective examinee. The target puncture point is preset.

Step 107: Adjust the spatial angle of the puncture needle. According to the position and direction indicator of the puncture needle displayed on the CT image before surgery, adjust the spatial angle of the puncture needle aligned with the body of the patient to be detected.

Step 108: Obtain the breathing curve of the person to be detected. A body position sensor is provided on the person to be detected, and the breathing curve of the person to be detected can be obtained through the body position sensor.

Step 109: When the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time, the puncture operation is started. That is, the electromagnetic navigation puncture needle is used to guide the intraoperative puncture, and the respiratory gating technique is used to guide the intraoperative puncture time, which can effectively ensure the puncture effect.

Step 110: After the puncture needle reaches a predetermined position, withdraw the puncture needle and perform needle biopsy.

The lung assisted diagnosis method in this embodiment obtains the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image; according to the registration matrix, the peripheral ultrasound probe is used to obtain the lesion image; when the lesion image is obtained Next, perform a bronchoscopy test and perform on-site cytology assessment; if the on-site cytology is negative, perform bronchoalveolar lavage and transbronchoscope biopsy; import the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system According to the puncture path and registration registration information, aim the puncture at the target puncture point on the subject to be tested; adjust the spatial angle of the puncture needle; obtain the breathing curve of the subject to be tested; when the puncture path of the puncture needle and the introduced puncture path When the breathing time of the person to be detected coincides with the CT time, the puncture operation starts; when the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed. In this way, transbronchial lung biopsy combined with transthoracic electromagnetic navigation system puncture navigation, using electromagnetic navigation bronchoscopy preoperative planning and intraoperative navigation information to guide transthoracic wall biopsy, without CT equipment for intraoperative information collection and registration Registration can guide doctors to perform electromagnetic navigation-guided transthoracic puncture biopsy immediately when TBLB is not in place or when electromagnetic navigation bronchoscopy biopsy is not ideal, to minimize patient transfer time and puncture risk, and There is no need for CT equipment assistance and guidance. Transthoracic needle biopsy does not require registration and registration during the operation, and directly uses electromagnetic navigation bronchoscope registration information.

Preferably, as shown in FIG. 2, in step 105, before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, the method further includes:

Step 112: Import the puncture needle calibration database to the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture on the tail of the puncture needle;

Step 113: Align the needle of the puncture needle to the primary puncture point on the subject to be tested;

Step 114: Adjust the spatial angle of the puncture needle aligned with the person to be detected according to the position and direction indicator of the puncture needle displayed on the CT image;

Step 115: When the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject, mark the target puncture point on the skin of the subject.

In this embodiment, the spatial angle of the puncture needle aimed at the subject to be inspected is adjusted according to the position and direction indicator of the puncture needle displayed on the CT image. When the puncture path of the puncture needle displayed on the CT image is aligned with the puncture aimed at the subject to be inspected When the puncture paths of the needles coincide, determining the target puncture point can effectively ensure the accuracy of the target puncture point.

Preferably, as shown in FIG. 3, step 101 includes:

Step 1011, if there are markers in the preoperative CT image, use the markers for point registration registration; otherwise, use positioning wires to collect the main bronchus for point cloud registration registration;

Step 1012: Record the registration matrix of the electromagnetic navigation bronchoscope.

Preferably, as shown in FIG. 3, step 102 includes:

Step 1021: According to the registration matrix, the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe.

Step 1022: Use a peripheral ultrasound probe to acquire the lesion image.

In this embodiment, the focus image is obtained according to the registration matrix, and the position of the focus can be obtained, so as to perform on-site cytological evaluation of the position.

Preferably, as shown in FIG. 3, step 110 includes:

Step 1101, after the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, the navigation through the chest wall electromagnetic navigation system ends and the puncture needle is withdrawn , Needle biopsy;

Step 1102, if the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and a needle biopsy is performed.

In this embodiment, when the TBLB is not in place or the electromagnetic navigation bronchoscope biopsy is not ideal, the electromagnetic navigation-guided transthoracic puncture biopsy is performed immediately to minimize the patient's transit time and puncture risk.

Preferably, step 110 further includes: after the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or airway optical coherence from the sheath through the chest wall Small imaging probe;

In this step, the peripheral ultrasound probe or the airway optical coherent imaging small probe is used to confirm the image of the lesion, and X-ray assistance is not required at all, which can reduce the damage of the X-ray to the patient's body.

Please refer to FIG. 4. FIG. 4 is a structural diagram of a lung biopsy device according to an embodiment of the present disclosure. As shown in FIG. 4, an embodiment of the present disclosure provides a lung biopsy device 200, including:

The registration matrix obtaining module 201 is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;

The lesion image acquisition module 202 is used to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix;

The on-site cytology evaluation module 203 is used to perform a bronchoscopy test and parallel on-site cytology evaluation when the lesion image is acquired;

The first biopsy module 204 is used to perform bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;

The first information import module 205 is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system;

The target puncture point alignment module 206 is used to target the puncture to the target puncture point on the subject to be detected according to the puncture path and the registered registration information;

The first puncture needle adjustment module 207 is used to adjust the spatial angle of the puncture needle;

The breathing curve obtaining module 208 is used to obtain the breathing curve of the person to be detected;

The puncture module 209 is configured to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time;

The second biopsy module 210 is configured to withdraw the puncture needle and perform a needle biopsy after the puncture needle reaches a predetermined position.

Preferably, as shown in FIG. 5, the lung biopsy device 200 further includes:

The second information import module 211 is used to import a puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;

The primary puncture point alignment module 212 is used to align the needle of the puncture needle with the primary puncture point on the subject to be tested;

The puncture needle second adjustment module 213 is used to adjust the spatial angle of the puncture needle aligned with the subject according to the position and direction indicator of the puncture needle displayed on the CT image;

The target puncture point determination module 214 is configured to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.

Preferably, as shown in FIG. 6, the registration matrix acquisition module 201 includes:

The first registration matrix acquisition sub-module 2011 is used to register the points using the markers if the pre-operative CT image has markers;

The second registration matrix acquisition sub-module 2012 is used to acquire the main bronchus using the positioning wire for point cloud registration if the preoperative CT image has no markers;

The registration matrix acquisition submodule 2013 is used to record the registration matrix of the electromagnetic navigation bronchoscope.

Preferably, as shown in FIG. 6, the lesion image acquisition module 202 includes:

The first lesion image acquisition sub-module 2021 is used for navigating the positioning wire and carrying the sheath to the lesion according to the registration matrix, withdrawing the positioning wire, and inserting a peripheral ultrasound probe;

The second lesion image acquisition submodule 2022 uses peripheral ultrasound probes to acquire the lesion image.

Preferably, the second biopsy module is also used to:

The lung biopsy device 200 is a passage established from a lung parenchyma puncture to a lung lesion. The lung biopsy device 200 can also be used in interventional treatment, such as radiofrequency ablation, freezing, and other interventional treatment methods.

It should be noted that the lung biopsy device in the above embodiment can implement any of the implementation methods in the method embodiments shown in FIGS. The corresponding content will not be repeated here.

The above is the preferred embodiment of the present disclosure. It should be noted that for those of ordinary skill in the art, without departing from the principles of the present disclosure, several improvements and retouches can be made. It should be regarded as the scope of protection of this disclosure.

Claims

A method for assisting diagnosis of the lungs, including:

Obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;

Navigate according to the registration matrix and use peripheral ultrasound probes to obtain lesion images;

In the case of acquiring the image of the lesion, perform a bronchoscopy brush test and perform on-site cytological assessment;

If the on-site cytology is negative, perform bronchoalveolar lavage and bronchoscopy biopsy;

Import pre-acquired puncture path and registration information to the transthoracic electromagnetic navigation system;

According to the puncture path and registration registration information, aim the puncture at the target puncture point on the prospective examinee;

Adjust the spatial angle of the puncture needle;

Obtain the breathing curve of the person to be tested;

When the puncture path of the puncture needle coincides with the introduced puncture path, and the breathing time of the subject to be detected coincides with the CT time, the puncture operation is started;

When the puncture needle reaches a predetermined position, the puncture needle is withdrawn and a needle biopsy is performed.
The lung assisted diagnosis method according to claim 1, wherein before the step of importing the pre-acquired puncture path and registration registration information into the transthoracic electromagnetic navigation system, further comprising:

Import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture on the tail of the puncture needle;

Align the needle of the puncture needle to the primary puncture point on the subject;

According to the position and direction indicator of the puncture needle displayed on the CT image, adjust the spatial angle of the puncture needle aimed at the examinee;

When the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject, the target puncture point is marked on the skin of the subject.
The lung-assisted diagnosis method according to claim 1, wherein the step of acquiring the registration matrix of the electromagnetic navigation bronchoscope based on the preoperative CT image includes:

If there are markers in the pre-operative CT image, use the markers for point registration registration;

If there is no marker in the preoperative CT image, use the positioning wire to collect the main bronchus for point cloud registration;

Record the registration matrix of the electromagnetic navigation bronchoscope.
The lung-assisted diagnosis method according to claim 1, wherein the step of acquiring a lesion image using a peripheral ultrasound probe according to the registration matrix includes:

According to the registration matrix, the positioning wire carries the sheath to navigate to the lesion, withdraw the positioning wire, and insert a peripheral ultrasound probe;

Use peripheral ultrasound probes to obtain lesion images.
The method for assisting diagnosis of a lung according to any one of claims 1 to 4, wherein the step of withdrawing the puncture needle and performing a needle biopsy after the puncture needle reaches a predetermined position includes:

When the puncture needle reaches the predetermined position, if the sheath in the bronchoscope and the peripheral ultrasound probe are withdrawn, and the puncture needle can be seen through X-ray fluoroscopy, the navigation through the chest wall electromagnetic navigation system ends, the puncture needle is withdrawn, and the needle Aspiration biopsy;

If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
The lung auxiliary diagnosis method according to claim 5, wherein the step of withdrawing the puncture needle and performing needle aspiration biopsy after the puncture needle reaches a predetermined position, further comprising:

When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;

If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;

If no lesion image is obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient.
A lung biopsy device, including:

The registration matrix acquisition module is used to obtain the registration matrix of the electromagnetic navigation bronchoscope according to the preoperative CT image;

A lesion image acquisition module, configured to acquire a lesion image using a peripheral ultrasound probe according to the registration matrix;

On-site cytology evaluation module, used to perform bronchoscopy and parallel on-site cytology evaluation when the lesion image is acquired;

The first biopsy module is used for bronchoalveolar lavage and transbronchoscope biopsy if the on-site cytology is negative;

The first information import module is used to import the pre-acquired puncture path and registration registration information to the transthoracic electromagnetic navigation system;

Target puncture point alignment module, which is used to target the puncture point to the target puncture point on the subject to be detected according to the puncture path and registered registration information;

The first adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle;

The breathing curve acquisition module is used to acquire the breathing curve of the person to be detected;

The puncture module is used to start the puncture operation when the puncture path of the puncture needle coincides with the introduced puncture path and the breathing time of the subject to be detected is consistent with the CT time;

The second biopsy module is used to withdraw the puncture needle after the puncture needle reaches a predetermined position and perform a needle biopsy.
The device according to claim 7, further comprising:

The second information import module is used to import the puncture needle calibration database into the transthoracic electromagnetic navigation system, enter the puncture needle model, and install the electromagnetic navigation fixture at the tail of the puncture needle;

The primary puncture point alignment module is used to align the needle of the puncture needle with the primary puncture point on the subject;

The second adjustment module of the puncture needle is used to adjust the spatial angle of the puncture needle aimed at the examinee according to the position and direction indicator of the puncture needle displayed on the CT image;

The target puncture point determination module is used to mark the target puncture point on the skin of the subject when the puncture path of the puncture needle displayed on the CT image coincides with the puncture path of the puncture needle aimed at the subject.
The apparatus according to claim 7, wherein the registration matrix acquisition module includes:

A first registration matrix acquisition sub-module, which is used for registration of point registration using the marker if the pre-operative CT image has a marker;

A second registration matrix acquisition sub-module, which is used to acquire the main bronchus by using a positioning wire for point cloud registration if the pre-operative CT image has no markers;

The registration matrix acquisition submodule is used to record the registration matrix of the electromagnetic navigation bronchoscope.
The device according to claim 7, wherein the lesion image acquisition module includes:

The first lesion image acquisition sub-module is used for navigating the positioning lead and carrying the sheath to the lesion according to the registration matrix, withdrawing the positioning lead, and inserting a peripheral ultrasound probe;

The second lesion image acquisition submodule uses peripheral ultrasound probes to acquire lesion images.
The device according to any one of claims 7-10, wherein the second biopsy module is used for, when the puncture needle reaches a predetermined position, if the sheath in the bronchoscope and the peripheral ultrasound probe are withdrawn, and X-ray fluoroscopy can see the puncture needle, then the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and the needle biopsy is performed;

If the sheath and the peripheral ultrasound probe in the bronchoscope are not withdrawn, and the puncture needle can be seen through the peripheral ultrasound probe, the navigation through the chest wall electromagnetic navigation system is ended, the puncture needle is withdrawn, and a needle biopsy is performed.
The device according to claim 11, wherein the second biopsy module is further used to:

When the puncture needle reaches a predetermined position, if the sheath in the tracheoscope and the peripheral ultrasound probe are withdrawn, withdraw the puncture needle, and insert the peripheral ultrasound probe or small airway optical coherent imaging probe from the sheath through the chest wall;

If the image of the lesion is obtained by the peripheral ultrasound probe or the small airway optical coherent imaging probe, the navigation through the chest wall electromagnetic navigation system ends, and the peripheral ultrasound probe or the small airway optical coherent imaging probe is withdrawn and the needle is moved. Aspiration biopsy;

If the image of the lesion is not obtained through the airway optical coherent imaging small probe, align the needle of the puncture needle with the puncture point marked on the patient