CN100473355C - System for guiding a medical instrument in a patient body - Google Patents

System for guiding a medical instrument in a patient body Download PDF

Info

Publication number
CN100473355C
CN100473355C CN 200480038283 CN200480038283A CN100473355C CN 100473355 C CN100473355 C CN 100473355C CN 200480038283 CN200480038283 CN 200480038283 CN 200480038283 A CN200480038283 A CN 200480038283A CN 100473355 C CN100473355 C CN 100473355C
Authority
CN
Grant status
Grant
Patent type
Prior art keywords
means
ray
region
system
interest
Prior art date
Application number
CN 200480038283
Other languages
Chinese (zh)
Other versions
CN1897878A (en )
Inventor
G·吉斯伯斯
O·格拉德
R·弗洛伦特
Original Assignee
皇家飞利浦电子股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Grant date

Links

Abstract

本发明涉及一种医疗系统,包括要被导入到病人体内的医疗仪器;用于采集所述医疗仪器的二维X射线图像的装置;用于通过使用超声探头采集所述医疗仪器的三维超声数据组的装置;用于在所述X射线采集装置的参考范围内定位所述超声探头的装置;用于选择在三维超声数据组内在所述医疗仪器周围的感兴趣的区域的装置,它规定在超声采集装置的参考范围内所述感兴趣的区域的第一位置;用于把第一位置变换成在X射线采集装置的所述参考范围内的第二位置;以及用于通过组合所述二维X射线图像和被包括在所述感兴趣区域中的三维超声数据而生成所述医疗仪器检测的双模表示的装置。 The present invention relates to a medical system, including to be introduced into a patient a medical instrument; means a two-dimensional X-ray image acquisition of the medical instrument; means for collecting said medical instrument 3D ultrasound data by using an ultrasonic probe It means the group; means within a reference range of the X-ray acquisition means for positioning the ultrasound probe; means a region of interest around the internal three-dimensional ultrasound data set for selecting the medical instrument, in which a predetermined a first reference position of the region within the range of interest the ultrasound acquisition means; means for converting the first position to a second position within the reference range X-ray acquisition means; and means for by combining the two dimensional X-ray image and the 3D ultrasound data are included in the region of interest to generate a representation of the dual-mode device detecting medical equipment.

Description

仪器导入到病人体内的系统发明领域本发明涉及医疗系统,包括要被导入到病人体内的医疗仪器以及用于使得所述医疗仪器可看见的装置。 Introduced into the field instrument system of a patient The present invention relates to a medical system, including to be introduced into a patient's medical instruments and means for the medical instrument such that visible. 本发明还涉及在所述系统中使L 用的方法。 The present invention further relates to a method L using the manipulation system. 本发明例如找到它的应用,用于在电生理学介入手术期间把导管导入到病人的心脏。 The present invention finds its application, for example, during a surgical intervention electrophysiology catheter introduced into the patient's heart. 发明背景医疗仪器必须被导入到病人体内的临床应用正变得非常普遍。 BACKGROUND OF THE INVENTION Medical instruments have to be introduced into the patient's clinical applications are becoming very popular. 值得注意地,对于用于治疗心脏疾病的最小侵入方法的越来越大的兴趣迫使开发允许医生把医疗仪器导入到心脏内部或外部的预定的位置的方法和设备。 Notably, for the increasing interest in minimally invasive method for the treatment of heart disease has forced doctors to allow the development of medical devices into the heart of an internal or external method and apparatus prescribed position. 在电生理学,例如必须把导管导入到心室或动脉壁上的特定的位置,以便测量电脉冲或烧蚀壁組织。 In Electrophysiology, for example, a catheter must be introduced into the ventricle particular location or arterial wall, in order to measure the electrical pulses or ablating tissue wall. 美国专利6,587,709公开一种用于把医疗仪器导入到病人体内的系统。 U.S. Patent No. 6,587,709 discloses a method for introducing a medical instrument into the patient's system. 这样的系统通过使用超声探头采集实时3D困像数据组。 Such systems acquire real 3D image data set is trapped by using an ultrasonic probe. 采集实时3D图像数据组的优点是得到深度信息,使用实时3D超声图像模式的优点在于,周围的解剖组织是可见的,这使得医生易于导引医疗仪器。 Advantage acquired real-time 3D image data set is obtained depth information, the advantages of using real-time 3D ultrasound image mode is that the surrounding anatomy are visible, which makes it easy to guide doctors medical instruments. 系统还包括定位装置,用于定位在3D超声数据组内的医疗仪器,它相对于所述超声探头定位在医疗仪器上要装的三个超声接收机,这样的定位允许自动选择要被成像的平面,它包括医疗仪器的至少一个部分。 The system further comprises a positioning means for positioning a medical instrument within the 3D ultrasound data set, which the ultrasound probe is positioned with respect to the medical instrument to be installed on the three ultrasonic receivers, such positioning allowing automatic selection to be imaged plane, which comprises at least a portion of a medical instrument. 所以,不必重新调节超声探头位置。 Therefore, the need to re-adjust the position of the ultrasound probe. 这样的3D超声数据组的第一个缺点在于,它具有窄的视域,它不覆盖由导管引入和放置所涉及的病人身体的整个部分。 A first drawback of such a 3D ultrasound data set that it has a narrow field of view, it does not cover the entire portion of the catheter is introduced and involved placing the patient's body. 所以为了在整个手术期间导入导管,超声探头必须移动几次。 Therefore, in order to introduce the catheter during the whole operation, the ultrasonic probe must be moved several times. 在每次位移时,需要在介入空间的参考范围中定位超声探头的预操作步骤,因为导管的位置是相对于超声探头的位置测量的。 At each displacement, the pre-positioning procedure requires an ultrasound probe in the intervening space reference range, since the position of the catheter relative to the position of the ultrasound probe is measured. 这样的预先操作步骤可使得介入手术延迟和复杂化。 Such pre-surgical interventional procedures may cause delay and complexity. 超声成像模式的第二个缺点在于,它具有低分辨率。 A second disadvantage is that ultrasonic imaging mode, it has a low resolution. 所以,采集的3D数据组不能给出导管和它的周围物体的可接受的质量的图像。 Therefore, the acquired 3D data set can not give an acceptable quality of the image of the catheter and its surrounding objects. 超声成像模式的第三个缺点在于,病人身体有其中胸部骨架掛挡超声扫描的某些区域,以及不能输出可利用的图像。 A third disadvantage is that the ultrasound imaging modes, there are certain areas in which the patient's body in gear thoracic skeleton ultrasound scanning, and image output is not available.

发明内容所以,本发明的目的是提供用于把医疗仪器导入到病人体内的医疗系统,这在整个手术期间给出医疗仪器和它的周围的解剖组织的改进的可视性。 SUMMARY OF THE INVENTION Therefore, an object of the present invention is to provide a medical instrument into the patient's medical system, which gives an improved medical instruments anatomy and its surroundings visibility during the entire procedure. 这是通过包括以下装置的医疗系统达到的: -要被导入到病人体内的医疗仪器;-X射线采集装置,用于采集所述医疗仪器的二维X射线闺像; -超声采集装置,用于使用超声探头采集所述医疗仪器的三维超声数据组;-定位装置,用于提供所述超声探头在所述X射线采集装置的参考范围内的位置;-选择装置,用于选择在3D超声数据组中在所述医疗仪器周围感兴趣的区域,它规定在所述超声采集装置的参考范围内所述感兴趣区域的第一位置;-转换装置,用于通过使用超声探头的所述位置把在超声采集装置的所述参考范围内所述感兴趣区域的第一位置变换成在所述X射线采集装置的所述参考范围内所述感兴趣区域的第二位置;-生成装置,用于生成和显示所述医疗仪器的双模表示,其中所述二维X射线围像和被包括在所述感兴趣区域中的三维超声数据通过使用所 This is achieved by a medical system comprising means to achieve: - to be introduced into a patient a medical instrument; the -X-ray acquisition means for acquiring the two-dimensional X-ray medical equipment like Gui; - ultrasound acquisition means for acquired using an ultrasound probe to a three-dimensional ultrasound data set of said medical instrument; - positioning means for supplying the ultrasound probe location within the reference range of the X-ray acquisition means; - a selecting means for selecting in the 3D ultrasound data set in the region of interest around said medical instrument, which predetermined region of interest in a first position within the reference range of the ultrasound acquisition means; - conversion means for converting said position by using an ultrasonic probe the first position of the region of interest within the reference range of the ultrasound acquisition means into a second position within the reference range of the X-ray acquisition means in the region of interest; - generating means for generating and displaying on the representation of the dual mode medical device, wherein said two-dimensional X-ray image and the surrounding three-dimensional ultrasound data is included in the region of interest by using the 述第二位置被组合。 Said second position are combined. 通过本发明,提供了其中二维(2D) X射线数据和三维(3D) 超声数据被组合的双模表示。 By the present invention, there is provided a dual mode wherein a two-dimensional (2D) X-ray data and three-dimensional (3D) ultrasound data representation are combined. 二维X射线数据提供医疗仪器和骨结构的良好的可视性和高分辨率.2D X射线数据也从大的视场获益, 这允许可看见由电生理学手术所关心的病人身体的整个区域,3D超声数据提供在医疗仪器周围的软组织和有时血管的良好的可视度。 Two-dimensional X-ray data provide medical instruments and bone structure of good visibility and high-resolution .2D X-ray data also benefit from the large field of view, which allows the patient's body can be seen by the entire electrophysiology procedures are concerned area, 3D ultrasound data provided in the soft tissue around the blood vessels of medical instruments and sometimes good visibility. 另外,3D超声数据给出深度的指示,这是2DX射线闺像不能提供的,因为所述X射线图像只按照X射线采集装置的几何关系提供所述医疗仪器的投影。 Further, 3D ultrasound data gives an indication of the depth, which is the Inner 2DX ray image can not provide, since only the X-ray projection image of the medical instrument according to the geometry of the X-ray acquisition means. 这样的几何关系规定投影的线,沿该线积累由病人的暴露的组织对X射线的吸收。 Such predetermined geometric relationship projected line, the accumulation by the X-ray absorption of the exposed tissue along the patient line. 所以,医疗仪器的周围部分的可视度通过2DX射线和3D超声数据的组合被改进。 Therefore, the visibility of the peripheral portion of the medical instrument is improved by a combination of radiation and 2DX 3D ultrasound data. 为了提供这样的组合,系统首先定位超声探头和在X射线采集装置的参考范围内的3D超声数据组。 To provide such a combination, the system first ultrasound probe positioning and 3D ultrasound data groups within the reference range of the X-ray acquisition means. X射线采集装里的这样的参考范假设是固定的。 X-ray acquisition means in such a reference range is assumed fixed. 所以,假设超声探头不运动,可以导出在x射线采集装置的参考范围内的3D超声数据组的任何点的位置。 Therefore, assuming that an ultrasound probe is not moved, the position can be derived at any point of the 3D ultrasound data set in the reference range of an x-ray acquisition device. 由于在X射线采集装置的参考范围内X射线检测器上2D X射线图像的位置通过X射线采集装置的几何关系给出,在X射线采集装置的参考范围内的3D超声数据组的定位允许利用2 DX射线图像来映射3D超声数据组,即利用2D X射线图像的点按照X射线采集装置的几何关系来映射3D超声数据组的任何点的投影。 Since the position of the X-ray in the reference range of the X-ray detector collecting apparatus 2D X-ray image is given by the geometric relationship between the X-ray acquisition means, the positioning of the 3D ultrasound data set in the reference range of the X-ray acquisition device allows the use of 2 DX-ray image mapped 3D ultrasound data set, namely the use of 2D X-ray image point in a geometric relationship between the X-ray acquisition device to map projection at any point of the 3D ultrasound data set. 按照本发明的系统还选择在3D超声数据组中在医疗仪器周围的感兴趣区域以及提供在超声采集装置的参考范围内所述感兴趣区域的第一位置。 System according to the present invention is further selected in the 3D ultrasound data set in a first position of the region of interest surrounding the medical instruments and a region of interest provided in the reference range of the ultrasound acquisition means. 人工地或自动地作出的这样的选择目标是抑制阻挡医疗仪器的可视度的任何超声数据.用3D超声采集装置的参考范闺的坐标表示的笫一位置然后通过使用超声探头的定位被变换成X射线采臬装置的参考范围内医疗仪器的第二位置。 Such manually or automatically select the target is made to suppress any ultrasound data block visibility of the medical instrument. Zi a position indicated by the coordinates of the reference range Gui 3D ultrasound acquisition device is then converted by using the ultrasound probe positioning reference range to the X-ray collection apparatus Nie second position of the medical instrument. 按照本发明的系统最后生成双模表示,其中被包括在所述感兴趣区域中的3D超声数据通过使用在X射线采集装置的麥考范围内感兴趣区域的所述第二位置被组合到2DX射线数据。 Represents the last generation dual-mode system according to the present invention, which is included in a region of interest in the 3D ultrasound data of interest by using the range of the X-ray acquisition means McCaw the region of the second position are combined to 2DX ray data. 优选地,根据2DX射线困像生成双模表示.在这个2DX射线图像上,具有在3D超声数据组的选择的感兴趣区域中的相应点的点的所有的X射线强度值与超声强度值相组合。 All X-ray intensity values ​​of the ultrasound intensity values ​​Preferably, the trapped rays represented 2DX dual-mode image generated in this 2DX ray image, points with corresponding points in the selected region of interest of the 3D ultrasound data group of relative combination. 所述用于选择感兴趣区域的装置预定规定其中包括所述医疗仪器的一部分的参考面。 Said means for selecting a predetermined region of interest, wherein the predetermined reference surface comprises a portion of the medical instrument. 在本发明的第一实施例中,感兴趣区域被包括在所述参考面,它例如包括与壁组织接触并垂直于X射线采集装置的取向的医疗仪器的末端。 In a first embodiment of the present invention, the region of interest is included in the reference plane, which includes, for example, tissue contacting wall and perpendicular to the alignment of the end of the X-ray acquisition device is a medical instrument. 所以,用于生成双模表示的装置预定把2DX射线图像与通过采样在X射线采集装置的参考范围内参考面坐标上的3D 超声数据组而得到的2D超声困像相组合。 Therefore, the dual-mode means for generating a predetermined represents 2DX ray image and the 2D ultrasound image by sampling the trapped 3D ultrasound data set of coordinates on the reference plane within the reference range of the X-ray acquisition means to obtain combined. 本发明的第一实施例的第一个优点是,它是非常简单的。 A first advantage of the first embodiment of the present invention is that it is very simple. 第二个优点是阻挡医疗仪器和它的周围部分的任何超声数据被去除。 A second advantage is that any barrier medical instruments and its surrounding portion of the ultrasound data is removed. 在替换例中,选择装置包括用于检测3D超声数据组的感兴趣区域中医疗仪器的检测装置。 In an alternative embodiment, the selection means comprises detection means for detecting a region of interest of the 3D ultrasound data set of medical instruments. 这样的检测例如是通过使用困像处理技术, 例如用于增强和定阈值拉长的形状的滤波器而自动得到的。 Such detection, for example, by using storm image processing techniques, such as thresholding and enhancement filters elongated shape for automatically obtained. 在双模表示中,属于检测到医疗仪器的2DX射线图像的点的X射线强度有利地 X-ray intensity represented in dual mode, the detected point belongs 2DX-ray image of a medical instrument is advantageously

保持不变。 constant. 第一个优点是双模表示从由x射线采集装置提供的医疗仪器的高分辨率获益。 A first advantage is represented benefit from dual-mode provided by high resolution x-ray acquisition device is a medical instrument. 这种检测的第二个优点在于,它是基于图像处理技术以及不需要任何特定的医疗仪器,如配备有有源定位器的医疗仪器。 This second advantage is that detection, which is based on image processing technology and does not require any particular medical instruments, such as the active locator provided with a medical instrument. 考虑到医疗仪器对于每个新的病人必须改变,按照本发明的系统的另一个优点是允许不可忽略的花费节省。 Taking into account the medical instrument must be changed for each new patient, according to another advantage of the system of the present invention is to allow non-negligible cost savings. 这种检测的第三个优点在于,它给出医疗仪器的末端的位置。 A third advantage of this detector is that it gives the position of the end of the medical instrument. 这个位置,与双模表示相组合,可有助于生成心脏壁的电驱动图,亊实上,在这样的手术中,医疗仪器是其末端配备有用于测量在心脏壁上的电脉冲的传感器的导管。 This position, in combination with the dual-mode indicates, can contribute to generate an electrical drive of FIG heart wall, the Shi Indeed, in such a procedure, the medical instrument which is equipped with a sensor for measuring the end electrical pulse to the heart wall the catheter. 当导管接触到心脏壁时,用户驱动传感器。 When the catheter is in contact with the wall of the heart, the user drives the sensor. 在导管的当前的位置处进行电脉冲的测量。 Electrical pulse measured at the current location of the catheter. 由按照本发明的系统提供的导管的位置提供在电驱动困上相应于所述当前的位置和所述电测量的点的位置。 Provided by the position of the catheter system according to the present invention is provided in the trapped electric drive corresponding to the position of the current point position and the electrical measurements. 通过使得双模表示成为可视的,用户有可能估计在当前的测量点与以前的测量点之间的距离,所以,按照本发明的系统易于实行心脏壁的快速、均匀和完全的映射。 Represented by such dual mode becomes visible, the user is possible to estimate the distance between the measuring point and the previous measuring point in the current, the system according to the present invention is easy to implement rapid, uniform and complete mapping of the heart wall. 在本发明的第二实施例中,按照本发明的系统还包括用于分段3D 超声数据组中壁组织区域。 In a second embodiment of the present invention, the system according to the present invention further comprises a wall segment tissue region 3D ultrasound data set. 所以,在2DX射线困像中,仅仅属于所述壁组织区域的点的X射线强度值与相应的超声强度值相组合。 Therefore, difficulties in 2DX ray image, only the X-ray intensity value belonging to a corresponding ultrasound intensity values ​​of the points of the wall tissue region in combination. 所以, 双模表示超过在心脏壁内的X射线强度值和在心脏壁里面和外面的超声强度值。 Therefore, the dual-mode than in the wall of the heart represents the X-ray intensity values ​​and intensity values ​​of the ultrasound in the heart wall inside and outside. 一个优点在于,双模表示从可得到的最好信息局部获益。 One advantage is that the dual-mode represents the best available information from the local benefit. 在本发明的第三实施例中,感兴趣区域是3D超声数据组的3D子組,它或者位于沿X射线方向在参考面后面或者在参考面周围形成切片。 In a third embodiment of the present invention, the region of interest is a subset of 3D 3D ultrasound data set, it is formed or positioned behind the reference plane or slice in the reference plane around the X-rays direction. 提供了被包括在所述选择的感兴趣区域中的3D超声数据的体积呈现图通过组合2DX射线投影的点的强度值与在体积呈现图上相应的点的强度值,构建双模表示。 Providing the volume are included in said selected region of interest of the 3D ultrasound data presented by the combination of FIG 2DX ray intensity values ​​of the points projected intensity value of the corresponding point on the presentation in FIG volume, expressed constructing dual mode. 一个优点是提供周围组织的立体图。 One advantage is to provide a perspective view of the surrounding tissue. 按照本发明的系统能够实时采集2D X射线图像和3D超声数据組》所以,可以在每个2D X射线图像和3D超声数据组中跟踪医疗仪悠森。 System according to the present invention can collect real-time 2D X-ray image and the 3D ultrasound data set "it is possible to track the medical instrument Yau Sen each 2D X-ray image and the 3D ultrasound data set. 在本发明的第四实施例中,系统包括用于周期地触发探头定位装置的控制装置。 In a fourth embodiment of the present invention, the system includes control means for periodically triggering the probe positioning apparatus. 事实上,超声探头在X射线采集装置的参考范围内的位置可以通过病人的外部运动,如在临床手术期间的呼吸运动而改变。 Indeed, the ultrasound probe location in the reference range of the X-ray acquisition device can be changed by the external motion of the patient, such as during surgery clinical respiratory motion. 所以,超声探头的位置必须定期更新。 Therefore, the position of the ultrasound probe must be updated regularly.

的当前的3D超声数据组相对于在时间tl采集的以前的3D超声数据组的运动的装置. 一个优点是超声探头的小的位移可被校正而不用触发探头定位装置,所以,不用中断医疗仪器的实时可視度,参照此后描述的实施例阐迷和明白本发明的这些和其它方面.附田简述现在参照附图作为例子更详细地描述本发明,其中: 图l是按照本发明的系统的示意图,图2是当超声探头配备有有源定位器时用于定位超声探头在X射线参考范闺内的位置的装置的示意围,困3,4a,4b是当探头配备有包括射频-不透明的标记的皮带时用于定位超声探头在X射线参考范围内的位置的装置的示意困,图5是按照本发明的用于定位医疗仪器和确定在3D超声数据组内所述医疗仪器的面的装置的示意图,图6是用于把超声采集装置的参考范爾内感兴趣区域的笫一位置变换成X射线采集装置的参考范围 Current 3D ultrasound data set with respect to time tl device moves a 3D ultrasound data set of previously acquired. One advantage is the small displacements ultrasound probe can be corrected without trigger probe positioning apparatus, therefore, without interrupting the medical instrument real-time visibility, with reference to the embodiments described hereinafter fans and explain that the present invention these and other aspects of the present invention is now attached fields dESCRIPTION described in more detail by way of example with reference to the accompanying drawings, wherein: Figure l is a system according to the invention is diagram when FIG. 2 is a schematic ultrasonic probe is equipped with means for confining the position of an ultrasound probe is positioned within the reference range of the X-ray of the inner retainer when active, trapped 3,4a, 4b when the probe is equipped with a radio frequency comprising - an opaque a schematic trapped labeled ultrasound probe position for positioning the belt in the X-ray range when the reference device, in accordance with FIG. 5 is determined for positioning a medical instrument of the present invention and a surface of the medical instrument in the 3D ultrasound data set a schematic view of the apparatus, FIG. 6 is a reference range for the undertaking of a region of interest within the reference Vail ultrasound acquisition means into a position of the X-ray acquisition device 内感兴趣区域的第二位置的装置的示意图,图7是按照本发明笫一实施例的用于生成双模表示的示意困, 图8是按照本发明笫二实施例的用于生成双模表示的示意困, 困9是按照本发明第三实施例的用于生成双棋表示的示意困, 困IO是用于补偿在当前的时间采集的当前的3D超声数据组与在以前的时间采集的以前的3D超声数据組之间的运动的装置的示意图, 图ll是按照本发明的方法的功能图. 发明详细说明本发明涉及用于把医疗仪器导入到病人体内的系统.这样的系统特别适配于把导管导入到心脏,以便诊断和治疗心脏疾病,但它更一般地可被使用于把任何其它医疗仪器—例如针—导入到病人体内.图1的示意困显示被安排在病人台2上的病人1,他的象征性表示的心脏3通过被引入到身体的导管进行治疗.系统包括用于采集病人身体的2DX射线困像的装置5.所述X射 A schematic view of a second device position within the region of interest, FIG. 7 is a schematic trapped for generating a dual-mode embodiment according Zi represents an embodiment of the present invention, FIG 8 is a great undertaking for generating a dual mode in accordance with the second embodiment of the present invention a schematic representation of the trapped, stuck 9 is a schematic showing of a third embodiment of the present invention is generated in accordance with the move double-stranded, trapped IO is the current 3D ultrasound data set to compensate for the current time acquired in the previous time and the acquisition a schematic view of the apparatus of the motion between the previous 3D ultrasound data group, FIG. ll is a functional diagram of a method according to the present invention. dETAILED DESCRIPTION the present invention relates to a system for introducing a medical instrument into a patient. such a system is particularly the catheter introducer adapted to the heart, to the diagnosis and treatment of heart disease, but more generally it may be used for any other medical instruments to - such as a needle - is introduced into the patient of Figure 1 shows a schematic difficulties are arranged in the patient table 1 patient, his heart symbolized by 3 is introduced into the catheter body 2 to be treated. the system comprises means for emitting 2DX 5. X-ray image of the patient's body trapped acquisition 采集装置包括聚焦的X射线源6和检测器7.有利地,这些X射线采集装里5是C臂系统,正如通常在Cathlab室中的情形.这样的C臂系统的优点是能够囀缺病人身体旋转运动,以便产生在已知的取向角度上病人的多个2DX射线图像。 Collecting apparatus comprises a focusing X-ray source 6 and detector 7. Advantageously, in the X-ray acquisition means 5 is a C-arm system, as is often the case in Cathlab chamber. The advantage of such a C-arm system is capable of missing patients warble rotational movement of the body, so as to produce a plurality of radiation images 2DX known orientation angle on the patient. 按照本发明的系统还包括用于从被放置在病人身体上和用闺定装置一例如皮带10或立体排列臂—固定的超声探头9采集3D超声数据組的装置8.应当指出,2DX射线困像和3D超声数据组被实时采集,这使能当医疗仪器被导入到病人体内时实时看见医疗仪器.X射线采集装置5与坐标(0,x,y,z)的参考范围一这里被称为X射线参考范围--有关,其中聚焦的X射线源6和检测器7的几何关系是已知的.应当指出,X射线参考范围(O,x,y,z)被限于X射线采集装置的固定部分而不限于C臂.所以,C臂的取向可以在所迷X射线参考范围中被表示.然而,X射线采集装置的几何关系取决于C臂的特定的位置.按照本发明的系统还包括用于定位超声探头9在X射线参考范闺内(O,x,y,z)的位置的装置11,用于选择在3D超声数据組中医疗仪器周围的感兴趣区城和用于提供在超声采集装置的参考范圃 System according to the present invention further comprises from a patient's body is placed on and fixed by means of one or Gui perspective arm arrangement such as a belt 10 - 9 ultrasound probe immobilized capture device 8. 3D ultrasound data set is to be noted, 2DX trapped rays and 3D ultrasound image data sets are acquired in real time, which enables real-time .X-ray visible medical devices acquisition device 5 and coordinates (0, x, y, z) when the medical device is introduced into a patient reference range is referred to herein X-ray reference range - about geometry, wherein the focusing X-ray source 6 and the detector 7 is known to be noted, with reference to the X-ray range (O, x, y, z) is restricted to the X-ray acquisition device without being limited to the fixed portion C of the arm. Therefore, the orientation of the C-arm may be represented by the X-ray fan reference range. However, the geometric relationship between the X-ray acquisition device depends on the particular position of the C-arm system according to the invention further comprising means for locating the position of the ultrasonic probe 11 in the X-ray 9 inside the inner reference range (O, x, y, z) for selecting in the 3D ultrasound data set regions of interest around the city and for medical instruments Fan po reference in ultrasound acquisition device (O,,x,,y,,z,)的感兴趣区域的笫一位置Locl的装置12,用于把超声采集装置的参考范闺内(O,,x,,y,,z,)的感兴趣区城的第一位置Lod变换成X射线参考范围内(O,x,y,z)的感兴趣区域的第二位置Loc2的装置13,以及用于通过组合来自2DX射线困像的数据与被包括在感兴趣区域中和由第二位置Loc2定位的3D超声数据,而生成双模表示BI的装置.双模表示BI被显示在屏幕15上,参照困2,探头定位装置11在第一方法中U于本领域技术人员熟知的、被安排在超声探头9上的有源定位器16.所述有源定位器16, 例如RF线圃,预定把RF信号发送到被放置在病人身体下、和例如被合并在表中的RF接收单元17. RF接收单元发送接收的信号到测量装置18,用于测量超声探头9在已知的参考范闺,例如X射线采集装置5的参考范围(O,x,y,z)内的位置.应当指出,有源定位器16必须 Locl means a position Zi (O ,, x ,, y ,, z,) of the region of interest 12, the reference range for the ultrasound acquisition device Gui (O ,, x ,, y ,, z,) a second position within the X-ray range of the reference (O, x, y, z) of the region of interest means a first position Loc2 Lod transform 13 into the region of interest of the city, and means for combination of the image from the trapped rays 2DX data is included in the region of interest from the 3D ultrasound data and a second position positioned Loc2, dual mode generating means BI FIG. BI is expressed dual mode displayed on a screen 15, with reference to storm 2, the probe positioning apparatus 11 U in the first method well known to those skilled in the art, is arranged on an ultrasound probe 9 active locator 16. the locator 16 active, such as an RF line Po, the predetermined RF signal to be placed in the patient the body, and are incorporated in a table, for example, an RF receiving unit 17. a received RF signal transmitting and receiving unit 18 to the measuring means for measuring a reference ultrasonic probe 9 in the Inner known reference range, such as X-ray acquisition device 5 position within the range (O, x, y, z) It should be noted that the retainer 16 to be active 是二维的,并且被这样地放置在超声探头9,以使得可以计算超声探头的位置与取向的精确的测量值.应当指出,也可以使用基于引导的光定位器.这种第一方法的第一优点在于它提供超声探头的精确的位置. 笫二优点在于它被实时地执行,所以可以在临床手术期间被触发.在图3所示的探头定位装罝11的笫二方法中,超声探头用配备有至少三个非排成一直线的相互关联的射频不透明的标记MbM2,和M3 Is two-dimensional, and is so placed in an ultrasonic probe 9, so that accurate measurements may be calculated position and orientation of the ultrasound probe should be noted, may be used based on the positioning guide optical Such a first method the first advantage is that it provides precise location of the ultrasound probe. undertaking of two advantages in that it is performed in real time, it may be triggered during the clinical procedure. catching rabbits probe Zi two positioning means 11 shown in FIG. 3, the ultrasound a probe equipped with a radio frequency of at least three non-aligned straight line interrelated opaque markers MbM2, and M3

的皮带IO被固定在病人身体周闺.例如皮带10包括有机玻璃板,其中固定了三个非排成一直线的相互关联的射頻不透明的标记.三个标记MhM2,M3属于同一个平面,所以,需要以C臂系统5 的取向角度0t采集的至少一个2DX射线投影2DX&,以便确定超声探头在X射线参考范围(O,x,y,z)内的位置.然而,由于三个标记是相互关联的,和非排成一直线的,这意味着,它们形成坚固的四元体, 所以本领域技术人员熟知,探头的位置完全由X射线投影2DXR,规定,参照困4a,我们考虑检测器参考范闺(dO,dx,dy).例如,如在第一2D X射线闺像2DXRt中三个标记Mi,M2,和M3的投影Pi,P2,P3的坐标(dx,,dy0,(dx2,dy2),(dx3,dy3)那样的六个参数完全规定超声探头9在X射线参考范围(O,x,y,z)中的位置.使用射频不透明的标记Mi,M2,M3 的第一个优点是,它们以非常高的对比度出现在2DX射线 IO belt is fixed to the Inner circumference of the patient's body, for example a belt 10 comprises a plexiglass plate, wherein the fixed RF interrelated three non-aligned straight line opaque marker. Three marks MhM2, M3 belong to the same plane, , required the orientation angle of the C-arm system 5 0t collecting at least a 2DX ray projection 2DX &, to determine the position of the ultrasound probe in the X-ray reference range (O, x, y, z) However, since the three markers are mutually associated and non-aligned straight line, which means that they form a solid quadruplexes, the present art is well known in the art, by the position of the probe is completely X-ray projection 2DXR, predetermined, reference trapped 4a, we consider the detector reference Fan Gui (dO, dx, dy). For example, as in the first 2D X-ray image coordinates 2DXRt Gui three marks Mi, M2, and M3, projectors Pi, P2, P3 of (dx ,, dy0, (dx2 , dy2), (dx3, dy3) six parameters fully specified as the first ultrasonic probe 9 in the X-ray range of reference (O, x, y, z) in the position of use of radio opaque marks Mi, M2, M3 of advantage is that they are present in very high contrast ray 2DX 影,这易于实行它们的定位.这样的定位可以人工地或自动地得到.在人工的情形下,用户可点击在每个2D X射线困像中的至少两个射頻不透明的标记,在自动的情形下,例如像形态学的滤波器那样的、本领域技术人员熟知的闺像处理技术可被使用于检测在2D X射线投影中以高的对比度的斑点出现的、射频不透明的标记.第二个优点是,这样的定位被实时地执行,所以,没有暗示任何近-介入步骤.然而,应当指出, 在临床手术期间亊先不需要移位超声探头,因为一旦医疗仪器被导入到病人体内要被探查的空腔,就预定使用超声探头.第三个优点是它在X射线和超声采集装置的视场中没有引入金属物体.在第二个方法的替换例中,第二个2DX射线困像2DXR2以C臂系统5的第二取向角度02被采集,如闺4b所示,这个笫二个X射线闺像允许确定三个标记Mi,M2和M3的一组新的 Movies, which tends to carry out their positioning. Such positioning may be manually or automatically obtained. Under artificial circumstances, the user may click least two radio opaque marker in each of the 2D X-ray image of the storm, the automatic case, for example, as a filter such as morphology, well known to those skilled in the Inner image processing techniques may be used for the detection of high contrast spots in 2D X-ray projection, the radio opaque marker. the second advantage is that such positioning is performed in real time, therefore, it does not imply any close - intervention steps, however, it should be noted that, during clinical surgery Shi does not need to shift to an ultrasound probe, because once the medical instruments to be introduced into the patient It probed cavity to a predetermined ultrasound probe used. a third advantage is that it does not introduce metal objects in the field of view of the X-ray and ultrasound acquisition device. in an alternative embodiment of the second method, the second trapped ray 2DX like 2DXR2 a second orientation angle of the C arm 02 is collected system 5, as shown in Gui 4b, the two X-ray Zi Gui image allows determining a new set of three marks Mi, M2 and M3 of 投影P、,P,2,P,3的坐标(dx、,dy,0, (dx,2,dy,2),(dx,3,dy,3).应当指出,定位的点P^P^和P、P,2,P,3遵循外表约束条件:例如这意味着,链接源聚焦点到Pt的线L,作为包括P、的、在笫二X射线闺像2DXR2上的投影线L、出现. 第一个优点是,P、不必在整个图像内被搜索,而只要在投影线L、上搜索.第二个优点是,它给出把点PbP2,P3和P、,P,2,P,3与正确的标记MbM2和M3相联系的方法.牵涉到两个2DX射线困像的、超声探头9的这样的定位不是实时地执行,所以,必须在临床手术的近-介入步騍中被採作.采集两个2D X射线图像的优点是定位的精度大大地提高.一旦超声探头9被放置在X射线参考范闺(O,x,y,z)内,就知道探头的取向,所以可以得到3D超声数据組22的位置,也称为3D超声圃锥.这是通过变換装置13得到的,它从所述超声探头位置计算在X 射线参考范围 Projection P ,, P, 2, P, coordinates 3 (dx ,, dy, 0, (dx, 2, dy, 2), (dx, 3, dy, 3). It should be noted that the positioning of the point P ^ P ^ and P, P, 2, P, 3 follow the outer constraints: this means that for example, the link source to the focus point Pt line L, as comprising P, and the image on the projection line Zi two 2DXR2 L in the X-ray Gui occurs. the first advantage is that, P, does not have to be searched in the entire image, as long as the projection line L, search. a second advantage is that it gives the point PbP2, P3 and P ,, P, 2 ., P, 3 methods associated with the correct markup MbM2 and M3 involves two 2DX-ray image of the storm, the ultrasound probe 9 such positioning is not performed in real time, it must be close to clinical surgery - intervention steps Ke was taken as the advantage of two 2D X-ray image acquisition is greatly improved accuracy of positioning. Once the ultrasound probe 9 is positioned in the X-ray range of the inner reference (O, x, y, z), orientation of the probe will know , the position can be obtained 3D ultrasound data set 22, also referred to as 3D ultrasound garden cone. this is obtained by the conversion means 13, which calculates the X-ray in the range from the reference position of the ultrasound probe 中所述3D超声数据组的一个点的位罝.也可以按照X射线采集装置的几何关系得到所述点在检测器上的投影,参照困5,按照本发明的系统包括用于选择在3D超声数据組21 内医疗仪器4周围的感兴趣区域35的装置12.规定了包括医疗仪器的一部分的参考面.有利地,所述参考面被选择为垂直于X射线采集装置的取向的方向.通过剪取处在所述参考面后面的3D超声数据子組或通过剪取在所述参考面周围形成的切片而得到感兴趣区域,这样,在3D超声数据组中会阻挡医疗仪器的可视度的结构被去除.在第一个方法中,用户互动地选棒在3D超声数据组中的感兴趣区域35.在笫二个方法中,所迷参考面的位置例如可以以等于3D数据組的深度的三分之一的预定的参考深度被预先规定.这个预定的参考面还可以旋转, 用于搜索3D超声数据組内的视角图,从这个视角医疗仪器是更加可见 And the Location of a point in the 3D ultrasound data set may be obtained at the points are projected on the detector in accordance with the geometry of the X-ray acquisition means, reference trapped 5, the system according to the present invention comprises means for selecting in the 3D It means a region of interest around the ultrasound data sets within the medical instrument 435 21 12. predetermined reference plane comprises a portion of a medical instrument advantageously, the reference plane is selected perpendicular to the orientation direction of the X-ray acquisition means. obtained by clipping the region of interest in the slice of the reference surface is formed by clipping at around the 3D ultrasound data subset of the reference plane or behind, so that, in the 3D ultrasound data set may block visible medical devices of the structure is removed. in the first method, the user interaction in the region of interest selected from rods 3D ultrasound data set 35. in undertaking of two methods, the position of the reference plane, for example, fans may be equal to the 3D data set a third of a predetermined depth is predetermined reference depth. the predetermined reference plane can also be rotated within the search for the perspective of FIG. 3D ultrasound data set, from the perspective of the medical instrument is more visible . 得到旋转的参考面33.有利地,所述視角被加到C臂系统,以使得2DX射线困像最佳化.有利地,选择装置12包括用于检测在3D超声数据组21内的医疗仪器4的装置.应当指出,医疗仪器通常以高的对比度出现在3D超声数据组内.它例如是电生理学导管的情形,该导管包括在它的末端处的金属尖端.所述尖端是小的和薄的分段,它是非常易于生成回声的以及在3D超声数据组中留下特定的特征。 33. The rotation of the reference surface obtained Advantageously, the viewing angle is added to the C-arm system, so as to optimize 2DX trapped rays. Advantageously, the selection means 12 comprises means for detecting within the 3D ultrasound data set of medical instruments 21 device 4. it should be noted that the medical instrument is generally a high contrast appears in the 3D ultrasound data set. it is the case, for example, electrophysiology catheters, the catheter comprises a metal tip at its end. the tip is small and thin sections, it is very easy to create an echo and specific features left in the 3D ultrasound data set. 所以,或者尖端末端被看作为点状的界标,或者整个末端被看作为拉长的界标.因此,所述检测装置牵涉到本领域技术人员熟知的闺像处理技术, 用于增强高对比度的斑点或在相对较均匀的背景中的拉长的形状.检测装置允许用点EP,和法线取向及自动规定参考面30,其中点EP,例如相应于医疗仪器的检测的末端,例如尖端31的末端,以及法线取向々相应于X射线源6的已知的取向32,在替换例中,参考面33由通过医疗仪器4的检测给出的至少三个非排成一直线的点EPhEP2,EP3被规定.规定了笫二法线W,它可以有利地用来重新取向X射线源6,以使得X射线采集相对于医疗仪器4 的检测位置最佳化.参照困6,可以从X射线采集装置的几何关系的知识与由变換装置13提供的、在X射线参考范闺(O,x,y,z)内的超声探头9的笫二位置的知识,计算在被包括在参考面30,33中的点与被 Therefore, the end or tip is seen as a point-like landmarks, or the entire elongated tip is regarded as landmarks. Thus, the detecting means involves well known to those skilled in the Inner image processing techniques for enhancing high-contrast spots or an elongated shape in a relatively uniform background. detection device allows point EP, and the normal automatic orientation and a predetermined reference plane 30, where point EP, for example, to detect the end corresponding to the medical equipment, for example the tip 31 end, and corresponds to the normal orientation 々 known X-ray source 32 oriented to 6, in an alternative embodiment, the reference plane 33 is given by the medical instrument 4 detected by at least three non-aligned straight line point EPhEP2, EP3 is specified. specifies two normal undertaking of W, which can advantageously be used to re-orientation of the X-ray source 6, so that the X-ray acquisition with respect to the detected position of the medical instrument 4 is optimal. Referring trapped 6, from the X-ray knowledge and knowledge, the ultrasound probe in the X-ray range of the inner reference (O, x, y, z) supplied by the conversion means 13 of the collection device geometry undertaking of two position 9, it is included in the calculation of the reference plane the point is 30,33 括在2DX射线困像40上的点之间的映射.例如,点EP!按照投影线36被投影在2DX 射线困像40上的点P(EPO.按照本发明的生成和显示装置14预定生成医疗仪器的双模表示, 其中来自2DX射线困像与3D超声数据組的信息被組合,优选地,这样的组合是X射线驱动的,这意味着,它是根据2DX 射线困像40被制作的,如困7所示,在本发明的第一实施例中,医疗仪器的感兴趣区域被包括在参考面30,33.所以,被包含在感兴趣区域中的超声信息相应于2D超声困41,它是通过采样在参考面30,33上的3D超声数据组而得到的.双模表示是这样形成的困像,以使得具有2D超声困41上相应的点的2D X射线投影40的所有的点的强度值被组合.这样的組合例如由2DX射线图像40的点的笫一强度值1,和2D超声图41上相应的点的第二强度值12的标量函数f被规定.这样的标量函数f例如通过按以下方式实施本领域技 Enclosed in 2DX ray mapping between points 40 trapped on the image. For example, point EP! Projected projection line 36 in accordance 2DX trapped ray image points on the 40 P (EPO. Generated according to the present invention and the display device 14 generates a predetermined dual mode medical equipment, where the image from the trapped rays 2DX combined with information of the 3D ultrasound data set, preferably, such a combination of X-ray drive, which means that it is based 2DX trapped ray image 40 is made as trapped 7, in the first embodiment of the present invention, the medical device region of interest is included in the reference plane 30, 33. Therefore, the region of interest is contained in the information corresponding to the ultrasound 2D ultrasound trapped 41 it is through the 3D ultrasound data set of samples 30, 33 on the reference plane obtained. trapped dual-mode image represents is formed, so that the 2D X-ray projection 41 having a 2D ultrasound trapped on corresponding points of all 40 the intensity value of the point are combined. such a combination, for example, Zi intensity value by the 2DX ray image points 40 1, and corresponding points on the 41 2D echocardiography second intensity value of the scalar function f 12 is defined. such scalar function f, for example by the present embodiment skilled in the following manner 人员熟知的、a-混合技术而提供强度值I:If(Ii,l2—I一(la)12如果a等于l,则双棋表示的强度值1等于笫一X射线强度IL相反,如果a等于零,则双模表示的强度值1等于笫二超声强度12,这意味着,2DX射线困像的点的强度值用2D超声困像41的相应的点的强度值替代.超声采集装置提供聚焦到医疗仪器上的3D传输数据组.通过本发明,X射线和超声强度值的組合具有提高医疗仪器周瑰的組织的可视度的优点.本领域技术人员将会看到,由X射线源7给出的医疗仪器在检测器7上的投影具有良好的质量,以及从高分辦率和对比度获益.当3D 超声数据組的感兴趣区域内医疗仪器的检测已由检測装里做成可得到时,可以从医疗仪器在X射线参考范爾(0,x,y,z)内的位置得出在2D X 射线投影40内"也就是在检测器参考范闺(dO,dx,dy)内—医疗仪器4的投影的位置.这个位置例如是相应于2D超 Person known, a- and mixing techniques provide the intensity values ​​I: If (Ii, l2-I a (la) 12 if a is equal to l, the intensity values ​​represented by a double chess Zi is equal to the opposite X-ray intensity IL, if a is equal to zero, then the dual-mode intensity values ​​represented by the two ultrasonic intensity equal to Zi 12, which means that the intensity value of the point image 2DX trapped rays trapped by the 2D ultrasound image corresponding to the intensity value of 41 points instead. focusing ultrasound acquisition device provides the medical instrument to transmit 3D data set. by the present invention, a combination of intensity values ​​of the X-ray and ultrasound has the advantage of increasing the visibility of the organization of medical instruments circumferential Rose skilled in the art will appreciate, the X-ray source 7 shows a medical instrument having a good quality in a projection on the detector 7, and when the detection region of interest of the 3D ultrasound data set of medical instruments made by the detection means in the high gain and contrast ratio do when available, the medical instrument can be drawn from a position in the X-ray reference Vail (0, x, y, z) in the 2D X-ray projection 40 'is in the range of the reference detector Gui (dO, dx, dy ) the - position of the projection of the medical instrument 4, for example, this position corresponding to the super-2D 困41内的点42的組的X 射线投影的点的组43.有利地,属于所检測的医疗仪器的2D X射线投影40的点的强度值被给出为双模表示的相应的点.优点是保持由X射线采集装置提供的医疗仪器的良好的可視度和分辨率.在图8所示的、本发明的笫二实施例中,按照本发明的系统还包括用于分段壁组织区域—例如在医疗仪器4附近的心内壁—的装置.这是通过诸如强度值定阈值那样的图像处理技术达到的,因为像心肌那样的壁组织在超声闺像中比起血液呈现得更亮,另一个可能性是例如通过使用有源轮廊技术(也称为"蛇行(snake)")来检测边界.本领域技术人员熟知的、这种技术首先包含规定初始轮廊,以及笫二,在内部和外部力的影响下使得所迷初始轮廓演进.得到最后的轮廓46.有可能区分位于轮廊46里面的点与位于轮廊46外面的点,仅仅把2D超声图41的相应的点的强度值给 2D intensity value of the point X-ray projection point 40 of X-ray projections of the difficulties in the group 41 of the point 42 of group 43. Advantageously, a medical instrument detected is given to the corresponding point of the dual-mode representation. the advantage is provided by the medical instrument holding the X-ray acquisition device of good visibility and resolution. shown in FIG. 8, undertaking of the second embodiment of the present invention, the system according to the present invention further comprises a tissue wall segment region - for example, in the medical instrument 4 near the inner wall of the heart -. this is done by means such as a predetermined threshold intensity value of an image processing technology to achieve, because as cardiac wall tissue as compared to blood present in an ultrasound image of brighter Gui another possibility is, for example, by using an active contour techniques (also called "meandering (Snake)") to detect the boundary. well known to those skilled in this technology includes a predetermined first initial contour, and two Zi, such that under the influence of external forces and the internal fan initial contour evolution. 46. the resulting final profile is possible to distinguish the point is located inside the contour 46 and 46 located outside contour points, only the point corresponding to 41 of FIG. 2D ultrasound the intensity values ​​to 外部的点,这个笫二实施例的优点是从在医疗仪器4的较大的周围部分中的X射线信息获益.在图9所示的、本发明的笫三实施例中,按照本发明的系统还包括用于生成规定的感兴趣区域35的体积呈现困像51的装置.在本例中,感兴趣区域35是切片50.体积呈现困像51是通过按照一个方向--例如,如圃柱体52所示的,X射线采集装置的取向的方向-积分3D 超声数据而得到的.所述体积呈现困像51代替2D超声困41而被使用, 并与2D X射线图像40相组合,用于以前面描迷的相同的方式生成双模表示53,这个第三方法的优点是提供医疗仪器4附近的透视图,例如它们是心脏.应当指出,生成装置14可以根据3D超声数据組反向生成双棋表示和用超声信息替代X射线信息.然而,它是不太有利的,因为在这种情形下,双模表示具有被减小为3D超声采集装置之一的困像场.系统预定提供实时2DX External point, Zi advantage of this second embodiment is benefited X-ray information around the larger part of the medical instrument 4 from As shown in FIG. 9, undertaking of the present invention in the third embodiment, according to the present invention, the system further includes a volume region of interest 35 for generating a predetermined trapped apparatus 51 as presented in the present embodiment, the region of interest 50. the sections 35 are trapped volume rendering image in one direction by 51 - for example, as and oriented in the direction of X-ray acquisition device shown in FIG garden cylinder 52 -. 3D ultrasound data obtained by integrating the trapped volume rendering 2D ultrasound image 51 instead of being trapped 41 used, and the 2D X-ray image 40 are combined for in the same manner previously described to generate dual-mode represents fans 53, a third advantage of this process is a perspective view of the vicinity of the medical instrument 4, for example, they are the heart. It is noted that device 14 can generate the 3D ultrasound data set generating a reverse double chess represents the X-ray information, and alternatives of ultrasound information. However, it is less advantageous, since in this case, represents a dual-mode is reduced to one of the 3D ultrasound image acquisition device trapped field. The system provides real-time scheduled 2DX 射线闺像和实时3D超声数据組.虽然探头的定位已在近-介入步稞中被执行,但当发生病人运动时,特別是如果必须补偿呼吸运动,可能必须更新这样的位置.亊实上,病人运动可造成X射线参考范围内超声探头的位置的改变,所以,在本发明的第四实施例中,系统包括控制装置,用于周期地触发用于定位X射线330T内超声探头的装置.这样的触发可以当用户判断这是必要时人工 . Gui-ray image and the real-time 3D ultrasound data set although the positioning of the probe has been in the past - are performing an interventional step in wheat, but when the patient motion occurs, especially respiratory motion compensation if necessary, such a position may be updated on a real Shi. , patient motion may cause a change in the position of the X-ray within the reference range of the ultrasound probe, therefore, in the fourth embodiment of the present invention, the system includes control means for periodically triggering the means for positioning the X-ray ultrasound probe 330T such a trigger when the user can determine when it is necessary, artificial

地执行,或按常规的时间间隔自动地执行,对于采集的每个新的2DX 射线图像或3D超声数据组,重新触发这个探头定位.应当指出,在这种情形下,探头定位必须实时执行.优点是当映射2D X射线数据与3D 超声数据时,它避免任何的误差积累。 Performed, or performed automatically by the conventional time interval, for each new 2DX ray image data set or 3D ultrasound acquisition, triggering the re-positioning of the probe should be noted that, in this case, the positioning of the probe must be performed in real time. advantage is that when the 2D X-ray data mapped to the 3D ultrasound data, it avoids any accumulation of errors. 在本发明的笫五实施例中,系统包括用于补偿在两个接连的探头位置之间的时间间隔内超声探头相对于病人心脏的任何相对运动的装置。 In undertaking of the fifth embodiment of the present invention, the system comprises means any relative motion of the patient's heart to compensate in the time between two successive intervals probe position with respect to the ultrasound probe. 这些运动补偿装置预定补偿在当前的时间t0+t采集的当前的3D超声数据组3DUS(to+t)与在以前的时间to采集的以前的3D超声数振组3DUS(to)之间的运动,这两个超声数据组相应于心跳周期的同一个阶段.首先,估计链接当前的3D超声数据组3DUS(to+t)的点与以前的3D 超声数据组3DUS(tc)的点的运动向量以及按照计算的运动向量移位当前的3D超声数据组3DUS(to+t)的点.所以,得到运动补偿的3D超声数据组MC(3DUS(to+t)),它预期为更接近于以前的3D超声数据組3DUS(tO).在第一个方法中,有利地使用在視頻压缩领域中技术人员熟知的块-匹配技术.参照图10,图上为了简单起见显示在2D情形下块匹配的原理,当前的和以前的3D超声数据組3DUS(to+t)和3DUS(to) 被划分成块,例如,具有8x8x8点,以及对于当前的3D超声数据组的每个块Bm,执行以前的3D超声数据组的块Bnn的搜索,这导致最大相关值.得到 The motion between the current 3D ultrasound data set 3DUS (to + t) which motion compensation means compensating the current predetermined time t0 + t and previously acquired 3D ultrasound transducer group number 3DUS (to) at the previous time to the acquisition of corresponding to the same phase of the heart cycle the two sets of ultrasound data. first, the link to the current estimated 3D ultrasound data set 3DUS (to + t) before the dots 3D ultrasound data set 3DUS (tc) of the motion vector and a motion vector calculation according to the current shift 3D ultrasound data set 3DUS (to + t) of the point. Therefore, to obtain the motion-compensated 3D ultrasound data sets MC (3DUS (to + t)), before it is expected to be closer to . the 3D ultrasound data set 3DUS (tO) in the first method, it is advantageous to use the block in the field of video compression is well known in the art - matching technique 10, for simplicity the figure displayed in the 2D case the block matching. principle, the current and previous 3D ultrasound data set 3DUS (to + t) and 3DUS (to) is divided into blocks, e.g., having a 8x8x8 point, and for each current block Bm 3D ultrasound data set before performing Bnn block of the 3D ultrasound data set search, which results in the maximum correlation value was obtained 动向量Ji^-5^.所以,运动补偿装置预定在当前的超声困像上补襟在时间"与时间to+t之间发生的小的运动.应当指出,当在两个3D超声数据組之间存在小的差別时,运动补偿是有效的.本发明的第五实施例的优点是提供用于补偿由于探头相对于要探查的空腔,例如心脏,的小的运动造成的定位误差的解决方案,这是与实时观看兼容的.这个解决方案在不能实时执行探头定位时,例如在牵涉到由C臂提供的几个角庋视图时,是特别有利的.在这种情形下,运动补偿装置可以有利地在两个接连的探头定位的同时被使用.应当指出,按照本发明的系统对于电生理学手术是特别有利的, 它包含生成用于诊断心脏疾病的心脏壁的电的驱动困或烧蚀被认为是异常的壁组织的区域.事实上,通过提供实时观看手术区域的大的视场,其中医疗仪器、骨结构和周闺的壁组织是同时 Trends amount Ji ^ -5 ^. Therefore, the motion compensating means in a predetermined trapped on the current ultrasound image lapel up time "and the time to small movements between t + 1. It is noted that, when the two data sets are 3D ultrasound when there is a small difference between the motion compensation is effective. advantage of the fifth embodiment of the present invention to provide for compensating positioning error due to the probe relative to probe cavities such as the heart, the small movements caused by solution, which is compatible with real time viewing. this solution can not be performed in real time the probe is positioned, for example, when the angle of approach of taking involving several views provided by the C-arm, is particularly advantageous. in this case, the motion compensation means can advantageously be used at the same time two successive probes located. it should be noted that the system according to the present invention for electrophysiology procedures is particularly advantageous in that it comprises an electrical generating a diagnosis of heart disease of the heart wall driving sleepy or ablation is considered to be abnormal regional wall tissue. in fact, by providing a large field of view in real-time viewing of the surgical field, in which medical instruments, bone structure and the peripheral wall of the Inner organization is at the same time 看见的,按照本发明的系统易于生成电的駔动困. Seen, the system according to the present invention is easy to generate powerful horse movable electrical storm.

本发明还涉及把医疗仪器4导入到病人体内的方法.参照困11, 这样的方法包括以下步骤:-通过使用X射线采集系统采集60所迷医疗仪器的二维X射线困像,-通过使用所述探头采集61所述医疗仪器的三维超声数据组, -定位62在所述X射线采集系统的参考范闺内所述超声探头, -选择63在所述3D超声数据组内所述医疗仪器的感兴趣区城和提供超声采集装置的参考范闺内所述感兴趣区域的第一位置,-把3D超声数据組的所迷参考范闺内的所迷笫一位置变换64成X 射线采集系统的所述参考范围内的笫二X射线位置,-生成65和显示所述医疗仪器的双模表示,其中袂包括在所迷感兴趣区城中的2D X射线困像和3D超声数据通过使用笫二位置被組合。 The present invention further relates to a method of a medical instrument 4 introduced into a patient reference 11 trapped, such method comprising the steps of: - collecting storm dimensional X-ray image 60 by use of the medical instrument fans X-ray acquisition system, - by using the probe 61 of the medical instrument collecting three-dimensional ultrasound data set, - positioning the ultrasound probe 62 within a reference range Gui said X-ray acquisition system, - to select the medical instrument 63 within the 3D ultrasound data set within the region of interest and the reference range of the inner City ultrasound acquisition means providing a first position of said region of interest, - the fan is within a reference range of a position Zi Gui fan 3D ultrasound data set 64 is converted into X-ray acquisition Zi two positions within the X-ray range of the reference system, - the dual mode to generate a display 65 and medical instrument, where the X-ray 2D robe including trapped in the fan image region of interest and the city by using 3D ultrasound data Zi two positions are combined. 此前的附图和它们的说明是显示而不是限制本发明.将会看到, 有许多属于所附权利要求的范闺的替换例.在这方面,作出以下结束的附注:有许多藉助于硬件或软件或二者实施功能的方法.因此,虽然附图显示不同的功能作为不同的块,但这决不排除单个硬件或软件项目实行几个功能,也不排除单个功能由硬件或软件或二者的组件来实行.权利要求中的任何标号不应当看作为限制权利要求.动词"包括"和它的配对物的使用不排除除权利要求中阑述的以外的单元或步稞的存在,单元或步骤前面的冠词"一个,,不排除多个这样的单元或步棘的存在. Prior to the accompanying drawings and the description thereof is displayed rather than limit the invention it will be appreciated that there are many alternative embodiments belonging to the Inner scope of the appended claims in this respect, to note the following end: There are many means of hardware or software or both implemented method function. Thus, although the drawing shows different functions as different blocks, this by no means excludes that a single item of hardware or software implementation of several features, does not exclude the individual functions performed by the hardware or software or di- those components to implement. any reference signs in the claims should not be construed as limiting the claims. verb "comprise" and its counterpart does not exclude the presence of other than claims À described elements or steps wheat, the cell or step preceding article "does not exclude the presence of a ,, a plurality of such elements or steps spine.

Claims (14)

  1. 1. 一种医疗系统,包括:-要被导入到病人体内的医疗仪器,-X射线采集装置,用于采集所述医疗仪器的二维X射线图像,-超声采集装置,用于使用超声探头采集所述医疗仪器的三维超声数据组,-定位装置,用于提供所述超声探头在所述X射线采集装置的参考范围内的位置,-选择装置,用于选择在三维超声数据组中在所述医疗仪器周围感兴趣的区域,其规定在所述超声采集装置的参考范围内所述感兴趣区域的第一位置,-转换装置,用于通过使用超声探头的所述位置把在超声采集装置的所述参考范围内所述感兴趣区域的第一位置变换成在所述X射线采集装置的所述参考范围内所述感兴趣区域的第二位置,-生成装置,用于生成和显示所述医疗仪器的双模表示,其中所述二维X射线图像和被包括在所述感兴趣区域中的三维超声数据通过使用所述第二位置被组 A medical system, comprising: - to be introduced into a patient a medical instrument, -X-ray acquisition means for acquiring the medical instrument is a two-dimensional X-ray image, - an ultrasound acquisition device, an ultrasonic probe for use acquiring the medical instrument 3D ultrasound data sets, - positioning means for providing the position of the ultrasound probe in the reference range of the X-ray acquisition device, - selecting means for selecting a three-dimensional ultrasound data set the region of interest surrounding the medical instruments, in which a predetermined reference range of the ultrasound acquisition means position said first region of interest, - conversion means for converting said position by using an ultrasonic probe in the ultrasound acquisition the reference range within the region of interest means a first position into a second position within the reference range of the X-ray acquisition means in the region of interest, - generating means for generating and displaying the dual-mode representation of the medical instrument, wherein the two-dimensional X-ray image and the 3D ultrasound data are included in the region of interest by using the second set of position .
  2. 2. 如在权利要求1中要求的系统,其中所述用于选择感兴趣区域的选择装置设置成限定其中包括所述医疗仪器的一部分的参考面。 2. The system as claimed in claim 1, wherein said selecting means for selecting a region of interest is provided to define a reference surface which comprises a portion of the medical instrument.
  3. 3. 如在权利要求2中要求的系统,其中所述感兴趣区域是通过采样在所述参考面上的所述三维超声数据组而得到的二维超声图像。 3. A system as claimed in claim 2, wherein the region of interest is obtained by sampling the two-dimensional ultrasound image of the reference surface of the three-dimensional ultrasound data set obtained.
  4. 4. 如在权利要求2中要求的系统,其中所述感兴趣区域是通过剪取处在所述参考面后面的三维超声数据子组或通过剪取在所述参考面周围形成的切片而得到的。 4. A system as claimed in claim 2, wherein the region of interest is obtained by clipping in 3D ultrasound data subset of the reference plane or behind the clips obtained by slicing formed around said reference plane of.
  5. 5. 如在权利要求4中要求的系统,其中所述生成装置设置成生成在所述三维超声数据组内的所述感兴趣区域的体积呈现视困。 5. A system as claimed in claim 4, wherein said generating means is arranged to generate the volume of the region of interest within said 3D ultrasound data set is presented visual difficulties.
  6. 6. 如在权利要求1中要求的系统,其中所述定位装置设置成定位被安排在所述超声探头上的有源定位器。 6. A system as claimed in claim 1, wherein said positioning means is arranged to be positioned is provided on the ultrasound probe the active locator.
  7. 7. 如在权利要求1中要求的系统,其中所述超声探头配备有至少三个非排成一直线的相互关联的对射频不透明的标记,以及所述定位装置设置成定位在所述参考范围内具有第一取向角度的至少第一二维X射线图像上的所述标记。 7. A system as claimed in claim 1, wherein the ultrasound probe equipped with at least three non-aligned straight line of interconnected opaque RF tag, and said positioning means is provided to be positioned in the reference range having a first angle of orientation of the indicia on said at least a first two-dimensional X-ray image.
  8. 8. 如在权利要求7中要求的系统,其中所述定位装置设置成定位在所述参考范围内具有第二取向角度的第二二维X射线图象上的所述标记。 8. A system as claimed in claim 7, wherein said positioning means is provided to position said indicia on the second two-dimensional X-ray image having a second orientation angle is within the reference range.
  9. 9. 如在权利要求1中要求的系统,其中所述选择装置包括检测三维超声数据组的所述感兴趣区域内的所述医疗仪器的装置,以及所述生成装置设置成给予在所述双模表示中检测的医疗仪器的点以在二维X射线困像上的相应的点的X射线强度值. 9. A system as claimed in claim 1, wherein said selecting means comprises means of the medical instrument within said region of interest detector three-dimensional ultrasound data set, and the generating means is arranged to give the bis It represents the point in the mold of a medical instrument to detect a corresponding point on the two-dimensional X-ray image of the trapped X-ray intensity values.
  10. 10. 如在权利要求1中要求的系统,包括用于分段在三维超声数据组中壁组织区域的装置,以及所述生成装置设置成给予属于所述壁组织区域的点以相应于所述感兴趣区域的点的超声强度值。 10. The system as claimed in claim 1, comprising means for segment in a tissue wall in the region of three-dimensional ultrasound data set, and the generating means is arranged to give points belonging to said wall tissue region corresponding to the ultrasound intensity value of the point of the region of interest.
  11. 11. 如在权利要求1中要求的系统,其中X射线采集装置设置成提供实时二维X射线图像,以及超声采集装置提供实时三维超声数据组。 11. A system as claimed in claim 1, wherein the X-ray acquisition device arranged to provide real-time two-dimensional X-ray images, and the ultrasound acquisition means for providing real-time three-dimensional ultrasound data set.
  12. 12. 如在权利要求11中要求的系统,包括用于周期地触发定位装置的控制装置。 12. A system as claimed in claim 11, comprising controlling means for periodically triggering the positioning means.
  13. 13. 如在权利要求11中要求的系统,包括用于补偿在当前的时间采集的当前的三维超声数据组与在以前的时间采集的以前的三维超声数据组之间的运动的装置。 Means motion between the current three-dimensional ultrasound data set 13. A system as claimed in claim 11, comprising means for compensating the current time acquired in the previous three-dimensional ultrasound data set is acquired at a previous time.
  14. 14. 一种方法,用于产生和显示人体内医疗仪器的表示,包括以下步猓:-通过使用X射线采集系统采集所述医疗仪器的二维X射线困像,-通过使用超声探头和超声采集系统采集所述医疗仪器的三维超声数据组,-定位在所述X射线采集系统的参考范围内所述超声探头, -选择在所述三维超声数据组内所述医疗仪器的感兴趣区域,它规定所述超声采集系统的参考范围内所述感兴趣区域的第一位置, -把所述超声采集系统的所迷参考范围内的所述第一位置变换成x射线采集系统的所述参考范围内的第二x射线位置,-生成和显示所述医疗仪器的双模表示,其中被包括在所述感兴趣区域中的二维X射线困像和三维超声数据通过使用所述第二位置被组合。 14. A method for generating and displaying the medical instrument body, said Guo comprising the steps: - Acquisition dimensional X-ray image of the medical instrument is trapped by using an X-ray acquisition system, - by using an ultrasonic probe and an ultrasonic acquisition system of the medical instrument of three-dimensional ultrasound data set, - a reference range is positioned within the X-ray acquisition system of the ultrasound probe, - select a region of interest within said 3D ultrasound data set of said medical instrument, it is within a predetermined range of the ultrasound acquisition system, with reference to the first position of the region of interest, - said fan within a reference range of the ultrasound acquisition system into a first position of the x-ray acquisition system of the reference a second x-ray position within the range of - generating and displaying the representation of the dual mode medical device, wherein the image comprises a two dimensional X-ray and 3D ultrasound data trapped in the region of interest by using the second position They are combined.
CN 200480038283 2003-12-22 2004-12-17 System for guiding a medical instrument in a patient body CN100473355C (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP03300279.1 2003-12-22
EP03300279 2003-12-22
EP04300157.7 2004-03-22

Publications (2)

Publication Number Publication Date
CN1897878A true CN1897878A (en) 2007-01-17
CN100473355C true CN100473355C (en) 2009-04-01

Family

ID=37610121

Family Applications (1)

Application Number Title Priority Date Filing Date
CN 200480038283 CN100473355C (en) 2003-12-22 2004-12-17 System for guiding a medical instrument in a patient body

Country Status (1)

Country Link
CN (1) CN100473355C (en)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN100586379C (en) 2008-07-04 2010-02-03 浙江大学;杭州博通胃肠病诊治技术有限公司 Computer simulation scaling biopsy method and apparatus
US20120245458A1 (en) * 2009-12-09 2012-09-27 Koninklijke Philips Electronics N.V. Combination of ultrasound and x-ray systems
CN103313661B (en) * 2011-01-13 2016-05-18 皇家飞利浦电子股份有限公司 Three-dimensional ultrasound visualization of the catheter
US8795178B2 (en) * 2012-12-31 2014-08-05 General Electric Company Ultrasound imaging system and method for identifying data from a shadow region

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5810007A (en) 1995-07-26 1998-09-22 Associates Of The Joint Center For Radiation Therapy, Inc. Ultrasound localization and image fusion for the treatment of prostate cancer
US6351513B1 (en) 2000-06-30 2002-02-26 Siemens Corporate Research, Inc. Fluoroscopy based 3-D neural navigation based on co-registration of other modalities with 3-D angiography reconstruction data
US6546279B1 (en) 2001-10-12 2003-04-08 University Of Florida Computer controlled guidance of a biopsy needle
CN1427377A (en) 2001-12-19 2003-07-02 皇家菲利浦电子有限公司 Method for orienting in vascular system

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5810007A (en) 1995-07-26 1998-09-22 Associates Of The Joint Center For Radiation Therapy, Inc. Ultrasound localization and image fusion for the treatment of prostate cancer
US6351513B1 (en) 2000-06-30 2002-02-26 Siemens Corporate Research, Inc. Fluoroscopy based 3-D neural navigation based on co-registration of other modalities with 3-D angiography reconstruction data
US6546279B1 (en) 2001-10-12 2003-04-08 University Of Florida Computer controlled guidance of a biopsy needle
CN1427377A (en) 2001-12-19 2003-07-02 皇家菲利浦电子有限公司 Method for orienting in vascular system

Also Published As

Publication number Publication date Type
CN1897878A (en) 2007-01-17 application

Similar Documents

Publication Publication Date Title
US6500123B1 (en) Methods and systems for aligning views of image data
US6671538B1 (en) Interface system for use with imaging devices to facilitate visualization of image-guided interventional procedure planning
US7314446B2 (en) Method and apparatus for time gating of medical images
US6669635B2 (en) Navigation information overlay onto ultrasound imagery
US6380958B1 (en) Medical-technical system
US7010080B2 (en) Method for marker-free automatic fusion of 2-D fluoroscopic C-arm images with preoperative 3D images using an intraoperatively obtained 3D data record
US6490473B1 (en) System and method of interactive positioning
US6515657B1 (en) Ultrasonic imager
US7097357B2 (en) Method and system for improved correction of registration error in a fluoroscopic image
US6290648B1 (en) Ultrasonic diagnostic apparatus
US20070078334A1 (en) DC magnetic-based position and orientation monitoring system for tracking medical instruments
US20100094124A1 (en) Combining x-ray with intravascularly acquired data
US8213693B1 (en) System and method to track and navigate a tool through an imaged subject
US5823958A (en) System and method for displaying a structural data image in real-time correlation with moveable body
US20110075912A1 (en) Visualization Method and Imaging System
US6996430B1 (en) Method and system for displaying cross-sectional images of a body
US20070106146A1 (en) Synchronization of ultrasound imaging data with electrical mapping
US7343195B2 (en) Method and apparatus for real time quantitative three-dimensional image reconstruction of a moving organ and intra-body navigation
US20040106869A1 (en) Ultrasound tracking device, system and method for intrabody guiding procedures
US20030231789A1 (en) Computer generated representation of the imaging pattern of an imaging device
US20120004533A1 (en) Optimization of multiple candidates in medical device or feature tracking
US5730129A (en) Imaging of interventional devices in a non-stationary subject
US20120046521A1 (en) Systems, instruments, and methods for four dimensional soft tissue navigation
US20080089566A1 (en) Systems and methods for implant virtual review
US20050085718A1 (en) Systems and methods for intraoperative targetting

Legal Events

Date Code Title Description
C06 Publication
C10 Entry into substantive examination
C14 Grant of patent or utility model