CN102824216B - Noninvasive standard registration device applicable to fusion imaging in ultrasonography, CT (computed tomography), MRI (magnetic resonance imaging), PET (positron emission tomography) and the like - Google Patents
Noninvasive standard registration device applicable to fusion imaging in ultrasonography, CT (computed tomography), MRI (magnetic resonance imaging), PET (positron emission tomography) and the like Download PDFInfo
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Abstract
The invention provides a noninvasive standard registration device applicable to fusion imaging in ultrasonography, CT (computed tomography), MRI (magnetic resonance imaging), PET (positron emission tomography) and the like. The noninvasive standard registration device comprises a carrier bag, a body surface fixator and at least one frame in geometric plane shapes. The carrier bag is rectangular and is fully filled with liquid. The geometric plane shaped frame is disposed in the carrier bag and is constantly perpendicular to the horizontal plane. Spacing more than 0.1cm is reserved between the geometric plane shaped frame and the inner wall of the carrier bag. By the noninvasive standard registration device, the geometric plane shaped frame in the ultrasonic images can be kept in the same standard cross-section direction as the corresponding geometric plane shaped frames in CT, MRI or other imaging methods, and non-regularity of universality and cross section of an ultrasonic probe are controlled. The speed in fusion registration of ultrasonography, CT, MRI or PET images can be greatly increased by using the noninvasive standard registration device while precision registration is guaranteed, and the noninvasive standard registration device is widely applicable and has broad application prospect.
Description
Technical field
The present invention relates to and be a kind ofly convenient to the ultrasonic Noninvasive standard registration apparatus carrying out image co-registration exploitation and clinical practice with CT image, nuclear magnetic resonance image or PET image etc.
Background technology
One, image fusion technology brief introduction
Medical Image Fusion is the hot issue that Now Domestic is studied outward.Medical imaging comprises X-ray, ultrasonic, computer tomography (CT), magnetic resonance (MRI) single photon emission tomographic imaging (SPECT), positron emission tomography (PET), infrared ray, Digital Subtraction (DSA), fluoroscopic visualization etc.The medical image of various mode reflects human body information from different perspectives, cannot obtain comprehensive diagnostic message separately from a certain image.If multiple image only relies on the Space Idea of doctor and supposition to go their desired information of synthetic determination, its accuracy will be subject to subjective impact, more may some information out in the cold.
From the eighties in last century, Medical image fusion starts the concern causing clinical medicine circle gradually.Medical image fusion is that the image of the same focal area obtained by more than 2 or 2 medical imaging devices carries out mating and coinciding, thus acquisition complementary information, increase quantity of information, make clinical diagnosis and treatment more accurately with perfect.The object of Medical image fusion is the advantage in conjunction with various image, reduces uncertain, makes doctor see more direct to diseased region, more clear, thus is conducive to making and judges accurately.Namely occur that part sum is greater than overall effect.
The basic thought of Medical image fusion proposed in the eighties in last century, and created pixel-by-pixel weighting and some simple algorithms such as to be averaging, but effect is unsatisfactory.To the nineties, Medical image fusion starts the advanced subject becoming contemporary medical science image domains, and have made great progress, the medical image development in future is exerted far reaching influence, as Laplacian, Gaussian low repetition system, multiresolutional filter method, Wavelet Transform etc., bring Medical Image Fusion develop rapidly.
Two, the committed step-registration of image co-registration
Medical image fusion is a continuous progressive process, and different fusion methods has different operations and process, but its basic procedure (see figure 9) roughly the same with key step.
Wherein, the degree of accuracy height of image registration directly affects the quality of image co-registration.Because image source imaging pattern is different, imaging orientation, time, spatial resolution, space covering domain all have difference.Therefore first must carry out registration.Medical figure registration take error minimize as principle, by normalized for different images process.Adopt one or more spatial alternations to certain width image subject to registration, the height that the corresponding point on itself and another image subject to registration are reached spatially is consistent.Thisly unanimously refer to that the same anatomic points of human body has identical locus on 2 width matching images, the result of registration should reach all anatomic points on 2 width images, be at least have diagnostic significance, or each point of region of interest all will reach coupling.Image resolution ratio is higher, and details is abundanter, and the corresponding difficulty realized in point-to-point meaning is larger.
Registration process is generally divided into image transformation and framing 2 step.The first step: image transformation.Its objective is and guarantee that the real space territory that multi-source image pixel or voxel are expressed is identical, ensure that multi-source image is to the concordance of same internal organs on space is drawn.Comprise the process such as translation, rotation, calibration, reflection.Conventional basic transformation has rigid transformation, affine transformation, projective transformation, nonlinear transformation etc.Generally automatically completed by computer, and part can be carried out manually revise to improve accuracy.Second step: framing.Its method roughly has 2 large classes, namely based on outside positioning mode and the position labelling method based on internal feature: the fusion based on picture appearance: surface refers to as carrying out image co-registration process, specially various artificial markers that are special, that be additional to patient body.This labeled in vitro all should be high-visible in the image of various amalgamation mode, and can accurately detect.Simple, be also easy to computer disposal, be applicable to the images match of various pattern.Shortcoming is that the arrangement of external labelling requires high, easily produces displacement error between internal organs and body surface marking.2 kinds can be divided into again: (1) invasive outside reference: refer to the fiducial marker be fixed in patient body, as three-dimensional locating frame, the labelling such as screw embedding skull by body surface marking setting.Invasive labelling stationarity is good, and accuracy is high, but has certain wound to patient: (2) non-invasive external benchmark.Referring to the reference mark being fixed on patient skin surface, as head-shield, facial film, facing, braces, framework or framework etc., is that noinvasive is settled.
Three, ultrasonoscopy merges the technological fix of registration
Carry out clinically in the practical operation of image co-registration imaging, between CT and nuclear-magnetism image, or the registration process means that the image co-registration between CT and ECT relies on depend on aforesaid outside positioning mode and internal feature positioning mode.But the process basis of the image registration location between CT, MRI, PET, SPECT etc. is relatively simple, this is because these images are all globality transverse section of the body certain level perpendicular to horizontal plane of standard.The image registration carried out under the prerequisite of this standardized globality transverse section, actual is make to have possessed unified section standard starting point between two kinds of imaging techniques.Therefore be no matter to the locator of the standard region of anatomy a certain in body under the transverse section condition of this standard or aforementioned body surface marking method all only needs single Computer imaging analysis system just can reach image registration requirement accurately, and to the form of labeled in vitro without definitely strict requirement.In fact, it is standard setting point that the body surface marking thing be applied between the standard section imaging techniques such as CT, MRI, ECT, PET, SPECT plays object, does not need the location of carrying out face.
But the image fusion technology each other such as ultrasonoscopy integration technology and aforementioned CT, nuclear-magnetism or PET is completely different, and there is higher technical requirement, its distinctive points is:
1) ultrasonoscopy is not the cross-sectional view of standard, and its image is universal property with any conversion of probe orientation in operator's hands;
2) ultrasonoscopy shortage standard for the cross-section standard section of CT, nuclear-magnetism etc.;
3) narrow and small because of ultrasonic probe sound window of ultrasonic cross-section image, arbitrary ultrasonoscopy is all the local section of certain internal organs instead of all comprises the complete whole body transverse section (the complete anatomical structure that this complete dissection transverse section not only comprises internal organs self also comprises the dissection transverse section of all adjacent internal organs complete and accurates) of certain internal organs place body certain level as arbitrary section of CT or MRI etc.
The existence of above-mentioned distinctive points, makes the image co-registration between ultrasonoscopy and the imaging technique such as CT or nuclear-magnetism and registration more difficult.In order to solve the problem of registration difficulty, inventor studies in conjunction with existing registration technique, finds in the image fusion technology such as ultrasonic-CT/MRI/PET, there is following present situation or problem:
A, ultrasonic be at present all adopt the position labelling method based on internal feature with the image co-registration of other imaging techniques, there is not yet the outside positioning mode adopting body surface marking to settle and carry out technology or the device of registration;
Such as head-shield, facial film, facing, braces, framework or support etc. that the outside positioning mode that B, the body surface marking being applied to CT or nuclear-magnetism are settled adopts are difficult to for ultrasonic probe comprehensive engagement or detection form effective image.Because ultra sonic imaging needs enough soft tissues or fluidity environment to hold could form effective echo interface.The structure such as gas, bone all can cause the remarkable decay of ultrasonic energy and cannot imaging.Therefore the body surface of the above-mentioned CT of being applied to or nuclear-magnetism etc. is fixing head-shield, facial film, facing, braces, framework or framework all cannot reach effective ultrasound image registration section; For this reason, the ultrasonic external registration apparatus needing the uniqueness meeting own physical imaging characteristic;
C, cannot penetrate bone tissue or gas tissue because of ultrasonic, ultrasonoscopy merges and is mainly limited to abdominal part parenchymal viscera, such as liver, kidney etc.It is at head or abdominal organs serious change (after such as major surgery, severe cirrhosis etc.) or the application of the aspect such as EUS or transesophageal ultrasonography, not lack effective registration apparatus, exactly because internal body is difficult to carry out without effective registration anatomical structure;
D, because of skull block and cranium brain internal brain tissue is definite because the limitation of ultrasonic section is difficult to be formed is easy to the standardization anatomical structure corresponding with CT or MRI, be no matter at present to there is no the ultrasonoscopy mixing operation that method carries out effective cranium brain in the preoperative or cranium brain art of cranium brain;
E, ultrasonic fusion of imaging technology are all adopt the anatomic landmark corresponding with CT or nuclear-magnetism standard cross-section of the significant anatomical structure in ultrasonic section or structure to carry out artificial registration.In practical operation, the accuracy of this registration and convenient rapidity are fixed the stenosis of cross-section section and ultrasonic section and are greatly affected because of the universal property of aforementioned ultrasonic image and shortage standard.
Generally speaking, implementing the image registration location that ultrasonoscopy merges needs to be undertaken by two steps, is first utilize electromagnetic to carry out spatial match to the position of ultrasonic probe and CT or nuclear-magnetism image.This step, under the electromagnetic tracking system of advanced person and the help of related sensor, can reach the object accurately realizing the three dimensions between ultrasonic probe with the view data such as CT or nuclear-magnetism and mate.Then, second step is exactly image registration location, i.e. the one_to_one corresponding of the anatomical structure of the image such as ultrasonoscopy and CT or MRI.There is no the stenosis of the transverse section of standard and ultrasonic section as aforementioned because of ultrasonoscopy, cause the registration between ultrasonic and the standard section such as CT or nuclear-magnetism more difficult and time-consuming.
Summary of the invention
Based on above-mentioned technological fix, the object of the present invention is to provide a kind of by ultrasonic section standardization, quick and precisely to carry out the Noninvasive standard registration apparatus of the fusion of imaging such as ultrasonic-CT/MRI/PET.
The invention provides and be a kind ofly convenient to Noninvasive standard registration apparatus that the is ultrasonic and image co-registration such as CT, nuclear magnetic resonance, NMR or PET, it comprises carrier bag, body surface fixture and at least 1 plane geometry framework; Carrier bag is cuboid, and inside is full of liquid; Plane geometry framework is arranged in carrier bag, and keeps vertical with horizontal plane all the time; The distance of more than 0.1cm is kept between plane geometry framework and carrier bag inwall.
Wherein, described plane geometry framework adopts non-metallic material, and wherein, diameter or the thickness of plane geometry framework border are greater than 0.1mm.
Further, described plane geometry framework is circular or polygon.
Wherein, described carrier bag length and width and Gao Jun are at more than 0.5cm.
Wherein, being provided with 2-91 plane geometry framework in carrier bag, is often 1 ~ 90 ° of angle between adjacent two plane geometry frameworks; Angle between two plane geometry frameworks of furthest apart is below 90 °; Each plane geometry framework has difformity.
Further, be often 1 ~ 45 ° of angle between adjacent two plane geometry frameworks, in carrier bag, be provided with 2-46 plane geometry framework; Angle between two plane geometry frameworks of furthest apart is below 45 °.
Further, be often 5-15 ° of angle between adjacent two plane geometry frameworks, in carrier bag, be provided with 4-10 plane geometry framework.
Wherein, be also at least provided with 2 upper floats in carrier bag, the density of upper float is less than the liquid in carrier bag; Each upper float is connected by cotton rope with bottom carrier bag; 2 upper floats are one group, 1 plane geometry framework and one group of upper float are fixed in same plane by cotton rope.
Wherein, be also at least provided with 2 sinking bodies in carrier bag, the density of sinking body is greater than the liquid in carrier bag; Each sinking body is connected by cotton rope with carrier bag top; 2 sinking bodies are one group, 1 plane geometry framework and one group of sinking body are fixed in same plane by cotton rope.
Wherein, fill single density fluid in carrier bag or be filled with liquid level and lower liquid level, two-layer liquid unmixing simultaneously, and density is different; Plane geometry framework is placed in tumbler device top; Through hole is provided with, the opening direction of through hole and plane-parallel in tumbler device; Cotton rope runs through through hole and is connected with carrier bag inwall; Cotton rope is provided with 2 positions and fixes the both sides that card lays respectively at through hole.Tumbler can be fixed like this do not move along cotton rope parallel direction.
Wherein, be filled with liquid level and lower liquid level in carrier bag, two-layer liquid unmixing, and density is different simultaneously; Plane geometry base of frame is also connected with floating base plate, plane geometry framework and floating base plate perpendicular; The density of floating base plate is between upper and lower two-layer liquid; Also hollow pipe is connected with below described floating base plate; Hollow pipe both ends open, opening direction and plane-parallel; Cotton rope runs through hollow pipe and is connected with carrier bag inwall; Cotton rope is provided with 2 positions and fixes the both sides that card lays respectively at hollow pipe.Tumbler can be fixed like this do not move along cotton rope parallel direction.
Further, described upper liquid level is water layer or oil reservoir; Lower liquid level is water layer or oil reservoir.
Wherein, described body surface fixture is fixing band or clamping apparatus.
Further, described clamping apparatus comprises cloth-one-side sheet, suitable clamping joint and bayonet socket; Bayonet socket is positioned at carrier bag bottom outer surface, and clamping joint is positioned at inviscid of cloth-one-side sheet.
Registration apparatus of the present invention has following features:
1) adopt fluidity environment to hold the method for plane geometry framework, solve the ultrasonic technical barrier that cannot form body surface mark image;
2) adopt the method for buoyancy or gravity, make plane geometry framework remain perpendicular to horizontal plane, define the transverse section of standard, the ultrasonoscopy of the plane geometry framework in this case formed is a standard cross-section direction the same with CT or nuclear-magnetism necessarily.This innovation and application controls the nonstandard property of ultrasonic probe universal property and section.By the corresponding geometrical plane framework transverse section rapid registering making the geometrical plane framework ultrasonoscopy of scanning to other CT or nuclear-magnetisms etc.; Meanwhile, the present invention also can install the multiple plane geometry frameworks each other in different angles in one apparatus, to compensate the horizontal error of the different angles existed after apparatus of the present invention are installed on body surface, is more suitable for the formation of standard cross-section.
3) this contrive equipment can be attached at the bony part positions such as human body head, thus reach to ultrasonic cannot form effective intracranial tissue image position carry out image registration, the surgical navigational for neurosurgery provides the fusion of ultrasonic-CT or MRI image more accurately and rapidly; This device also can be attached at the cervical region in esophagus front, or the abdominal part in body of stomach antetheca front, make endoscopic ultrasonic or transesophageal ultrasonography from intracavity scanning formation standard section forward, thus form the fusion of endo-luminal ultrasound image and the image such as CT or nuclear-magnetism, avoid the interference of hollow organ gas and probing depth inadequate and be not enough to be formed with the technical barrier of imitating standard picture.
Registration apparatus of the present invention, can make to form the standard cross-section direction the same with CT or nuclear-magnetism in ultrasonoscopy, control the nonstandard property of ultrasonic probe universal property and section; By this registration apparatus, can, on the basis ensureing accuracy registration, significantly promote ultrasonic and CT, nuclear magnetic resonance, NMR or PET image fusion registration speed, and the scope of application be wide in range, has a good application prospect.
Accompanying drawing explanation
Fig. 1 structural representation of the present invention;
Fig. 2 structural representation of the present invention;
Fig. 3 structural representation of the present invention;
Fig. 4 structural representation of the present invention;
Fig. 5 cross-sectional view of the present invention;
Fig. 6 cross-sectional view of the present invention;
Fig. 7 structural representation of the present invention;
The plan structure schematic diagram of Fig. 8 carrier bag;
Wherein, 1-carrier bag, 2-fixing band, 3-plane geometry framework, the floating base plate of 31-, 32-hollow pipe, 4-upper float, 5-sinking body, 61-cloth-one-side sheet, 62-clamping joint, 63-bayonet socket, 7-tumbler device, 71-through hole, the fixing card in 8-position;
The flow process of Fig. 9 Medical image fusion, block diagram
Detailed description of the invention
Composition graphs 1-is known, the invention provides a kind ofly to be convenient to the ultrasonic Noninvasive registration apparatus merged with nuclear magnetic resonance image, and it comprises carrier bag 1, body surface fixture and at least 1 plane geometry framework 3; Carrier bag 1 is in cuboid, and inside is full of liquid; Plane geometry framework 3 is arranged in carrier bag 1, and keeps vertical with horizontal plane all the time; The distance of more than 0.1cm is kept between plane geometry framework 3 and carrier bag 1 inwall.
Wherein, described plane geometry framework 3 adopts non-metallic material, wherein, for corresponding to the minimum resolution of the imaging techniques such as ultrasonic, CT or MRI, the present invention carry the diameter of plane geometry framework 3 frame or thickness is greater than 0.1mm.
Described plane geometry framework 3 is circular or polygon.
Described carrier bag 1 length and width and Gao Jun are at more than 0.5cm.
Above-mentioned to plane geometry framework and carrier bag inwall distance, the diameter of frame or the restriction of thickness, can effectively be detected in ultrasonic in order to ensure plane geometry support.
Because the angle of partes corporis humani position is different, when detecting some position, a plane geometry framework likely lack of registration, for this reason, also arranges following structure to make up this defect in the present invention:
Be provided with the plane geometry framework 3 of more than 2-91 in carrier bag 1, be often 1 ~ 90 ° of angle between adjacent two plane geometry frameworks 3, the angle between two plane geometry frameworks 3 of furthest apart is below 90 °; Each plane geometry framework 3 has different geometric forms.
The device small skew in the horizontal direction that the different geometric Framework shape calibration that the object of this design is to utilize different angles in device to lay fixedly cause because of body surface.The standard geometric figure that said structure can confirm ultrasonic scan is consistent with the geometric figure corresponding to the standard cross-section that other image technologies such as CT or MRI obtain.
If when using apparatus of the present invention registration, when plane geometry framework differs larger with the angle between objective plane, naked eyes can judge, therefore, in order to save cost, apparatus of the present invention are done further preferably: be often 1 ~ 45 ° of angle between adjacent two plane geometry frameworks 3, be provided with 2-46 plane geometry framework 3 in carrier bag 1, the angle between two plane geometry frameworks 3 of furthest apart is below 45 °;
In order to ensure registration efficiency, further can save the cost of raw material again, in registration apparatus of the present invention, can setting be preferably as follows: be often 5-15 ° of angle between adjacent two plane geometry frameworks 3, in carrier bag 1, be provided with 4-10 plane geometry framework 3.
In order to allow plane geometry framework keep vertical with horizontal plane all the time, to ensure the formation of testing process Plays transverse section, in the present invention, propose following structure:
(1) be also at least provided with 2 upper floats 4 in carrier bag 1, the density of upper float 4 is less than the liquid in carrier bag 1; Each upper float 4 is connected by cotton rope with bottom carrier bag 1; 2 upper floats 4 are one group, are fixed in same plane by cotton rope by 1 plane geometry framework 3 and one group of upper float 4; Or,
(2) be also at least provided with 2 sinking bodies 5 in carrier bag 1, the density of sinking body 5 is greater than the liquid in carrier bag 1; Each sinking body 5 is connected by cotton rope with carrier bag 1 top; 2 sinking bodies 5 are one group, are fixed in same plane by cotton rope by 1 plane geometry framework 3 and one group of sinking body 5; Or,
(3) be filled with liquid level and lower liquid level in carrier bag 1, two-layer liquid unmixing, and density is different simultaneously; Also be connected with floating base plate 31 bottom plane geometry framework 3, plane geometry framework 3 is perpendicular with floating base plate 31; The density of floating base plate 31 is between two-layer liquid; Hollow pipe 32 is also connected with below described floating base plate 31; Hollow pipe 32 both ends open, opening direction and plane-parallel; Cotton rope runs through hollow pipe 32 and is connected with carrier bag 1 inwall; Cotton rope is provided with 2 positions and fixes card 8, lays respectively at the both sides of hollow pipe 32.
(4) fill single density fluid in carrier bag 1, or be filled with liquid level and lower liquid level, two-layer liquid unmixing simultaneously, and density is different; Plane geometry framework 3 is placed in tumbler device 7 top; Through hole 71 is provided with, the opening direction of through hole 71 and plane-parallel in tumbler device 7; Cotton rope runs through through hole 71 and is connected with carrier bag 1 inwall; Cotton rope is provided with 2 positions and fixes card 8, lays respectively at the both sides of through hole 71.
Wherein, described upper liquid level is water layer or oil reservoir; Lower liquid level is water layer or oil reservoir.When using heavy oil, its density is greater than water, then going up liquid level is water layer; When using light oil, its density is less than water, then going up liquid level is oil reservoir.
In the present invention, described body surface fixture is fixing band 2 or clamping apparatus.Both registration apparatus can be fixed on each position of human body.
In order to ensure that registration apparatus is fixed on a certain specific part all the time further, in the present invention, also preferably adopt following setting:
Described clamping apparatus comprises cloth-one-side sheet 61, suitable clamping joint 62 and bayonet socket 63; Bayonet socket 63 is positioned at carrier bag 1 bottom outer surface, and clamping joint 62 is positioned at inviscid of cloth-one-side sheet 61.
The quick accuracy registration of embodiment 1 cerebral surgery operation navigation
One, instantiation
Patient man 45 years old, medical because having a headache, MRI: left parasellar tumor, diameter 3cm.Diagnosis: the other meningioma of left saddle.For accurately carrying out location of operation, carry out ultrasonic-MRI fusion of imaging.Before row MRI scans, patient's horizontal position fixes apparatus of the present invention (this device pedestal is frivolous 3 × 4cm square one side viscosity adhesive plaster, and inviscid one side corner respectively has a clip to correspond to the bayonet socket of corner, apparatus main body lower end) in forehead.MRI carries out standard cross-section scanning to patients head and apparatus of the present invention, obtains the detailed cross-sectional image of intracranial detail image and forehead apparatus of the present invention each geometrical plane framework inner.Next day, this patient MRI DICOM view data is copied in ultrasonic fusion of imaging component computer, in the electromagnetic field of electromagnetic tracking system, ultrasonic probe adheres to electromagnetic field 6DOF sensor.The magnetic field position of impression probe, the spatial correspondence simultaneously between ultrasonic fusion of imaging system matches probe and MRI image.Afterwards, again apparatus of the present invention are snapped in patient's former attaching adhesive plaster position, ultrasonic scan is carried out to this contrive equipment, because this device inside is fluidity environment, therefore corresponding with MRI image in quick obtaining means geometrical plane image, and carried out picture registration registration with MRI image.Thus ultrasonic cannot penetrate the condition of skull under, have also been obtained the accurate corresponding relation that ultrasonoscopy is corresponding with intracranial tissues.Under the guide of ultrasonic probe, determine out cranium position, and make marks, patient enters operation, opens the skull of a 2-3cm, expose cerebral dura mater, ultrasonic probe invests cerebral dura mater, forms the cerebral tissue ultrasonoscopy of real-time intracranial, now ultrasonoscopy and MRI image co-registration, under navigation system helps, find rapidly the position of meningioma.Under ultrasonic guiding in real time, complete the accurate location to this meningioma and Wicresoft's excision.
Two, apparatus of the present invention coordinate 20 routine clinical course of the outer navigation system of ultrasonic-CT/MRI image co-registration brain and the outer navigation system of infrared ray brain to contrast
Table 1.
| Ultrasonic-CT/MRI | Infrared rays navigation | |
| Registration speed | 1 point+15 seconds | 17 minutes ± 29 seconds |
| Program step number | 3 steps | 5-7 walks |
| Accuracy | 100% | 100% |
| Anti-interference | Do not block by soft tissue | Easily blocked by soft tissue or operating theater instruments |
| Precision | Precision 0.5-1mm | Precision 2-3mm |
Brief summary: as seen from the results in Table 1, when using registration apparatus of the present invention to carry out image registration to brain shell, can when ensureing high accuracy, significantly improve registration speed, shorten registration time and operating procedure, and degree of accuracy and capacity of resisting disturbance are better, are significantly better than existing infrared rays navigation technology.
The radio-frequency (RF) ablation of embodiment 2 liver tumor under liver cirrhosis background guides
One, instantiation
Patient man 50 years old, hepatitis B 20 years, liver cirrhosis, conventional Ultrasound and CT all find right liver Space-occupying lesion tumor, diameter 2cm.Diagnosis: right liver primary hepatocarcinoma.Intend the radio-frequency ablation procedure adopting ultrasound guidance.For accurately carrying out location of operation, carry out ultrasonic-CT fusion of imaging.Before row CT scan, patient's horizontal position fixes apparatus of the present invention (this device pedestal is frivolous 3 × 4cm square one side viscosity adhesive plaster, and inviscid one side corner respectively has a clip to correspond to the bayonet socket of corner, apparatus main body lower end) in hepatic region.CT carries out standard cross-section scanning to patient's abdominal part and apparatus of the present invention, obtains the detailed cross-sectional image of liver and liver neoplasm detail image and hepatic region body surface apparatus of the present invention each plane geometry framework inner.Next day, this patient CT DICOM view data is copied in ultrasonic fusion of imaging component computer, in the electromagnetic field of electromagnetic tracking system, ultrasonic probe adheres to electromagnetic field 6DOF sensor.The magnetic field position of impression probe, the spatial correspondence simultaneously between ultrasonic fusion of imaging system matches probe and CT image.Afterwards, again apparatus of the present invention are snapped in patient's former attaching adhesive plaster position, ultrasonic scan is carried out to apparatus of the present invention, because this device inside is fluidity environment, therefore corresponding with CT image in quick obtaining means geometrical plane image, and carried out picture registration registration with CT image.Insert three radio frequency ablation needle at ultrasonic and CT fusion image Guided Percutaneous through liver accurately to locate and cloth pin.After cloth pin, arrange and melt 15 minutes time, reach the Minimally Invasive Surgery object of local fixed point deactivation liver tumor completely.
Two, under liver cirrhosis background, apparatus of the present invention quick and precisely carry out the contrast of liver image registration
When patient because of excessive drinking or HBV infection when, the pathological change of liver generation liver cirrhosis, liver volume reduces, and the anatomical structure inside and outside liver is mixed and disorderly, skew, makes the conventional method positioning registration according to internal organs of the body and anatomical structure become loaded down with trivial details time-consuming and without accuracy.
The contrast of this device registration efficiency and conventional method registration efficiency under table 2. liver cirrhosis background
(20 routine clinical case contrast)
Brief summary: as shown in Table 2, when to image registration under liver cirrhosis background, with dissect compared with registration technique in conventional body, registration apparatus of the present invention is used can effectively to accelerate registration speed, shorten the registration time, and accuracy is higher, capacity of resisting disturbance and precision also significantly improve, and show that using registration apparatus of the present invention to carry out the image co-registration such as ultrasonic-CT/MRI is significantly better than dissecting registration technique in body.Embodiment 3 apparatus of the present invention successfully form endo-luminal ultrasound or the ultrasonic fusion with CT image of esophagus
One, endo-luminal ultrasound instantiation
Patient man 35 years old, analyses of complicating acute pancreatitis after excessive drinking, conventional Ultrasound and CT find the cystic occupy-place of tail of pancreas portion, diameter 5 × 7cm.Diagnosis: tail of pancreas portion pseudocyst.Intend the stomach-tail of pancreas puncture drainage adopting gastroscope ultrasound guidance.For accurately carrying out location of operation, carry out ultrasonic-CT fusion of imaging.Before row CT scan, patient's horizontal position, hits exactly nearly paries anterior gastricus in abdominal part and fixes apparatus of the present invention (this device pedestal is frivolous 2 × 3cm square one side viscosity adhesive plaster, and inviscid one side corner respectively has a clip to correspond to the bayonet socket of corner, apparatus main body lower end).CT carries out standard cross-section scanning to patient's abdominal part and apparatus of the present invention, obtains the detailed cross-sectional image of abdominal part pancreas and tail of pancreas portion cystic occupy-place detail image and center abdomen body-surface apparatus of the present invention each geometrical plane framework inner.Next day, this patient CT DICOM view data is copied in ultrasonic fusion of imaging component computer, in the electromagnetic field of electromagnetic tracking system, gastroscope ultrasonic probe adheres to electromagnetic field 6DOF sensor.The magnetic field position of impression probe, the spatial correspondence simultaneously between ultrasonic fusion of imaging system matches probe and CT image.Again after apparatus of the present invention are snapped in patient's former attaching adhesive plaster position, per os-esophagus routine inserts gastroscope ultrasonic probe, gastroscope ultrasonic probe is made to be close to paries anterior gastricus, find the image of apparatus of the present invention, ultrasonic scan is carried out to this contrive equipment, because this device inside is fluidity environment, therefore corresponding with CT image in quick obtaining means geometrical plane image, and carried out picture registration registration with CT image.Puncture to tail of pancreas portion pseudocyst through paries posterior gastricus under ultrasonic and CT fusion image guide after registration, put pipe, be successfully drained to gastral cavity.
Two, the ultrasonic instantiation of esophagus
Patient man 35 years old, atrial septal defect is suspected in transthoracic echocardiography inspection.Intend adopting transesophageal ultrasonography to make a definite diagnosis, intend carrying out ultrasonic-CT fusion of imaging simultaneously, observe heart external structure.Before row CT scan, patient's horizontal position, fixing apparatus of the present invention (this device pedestal is frivolous 2 × 3cm square one side viscosity adhesive plaster, and inviscid one side corner respectively has a clip to correspond to the bayonet socket of corner, apparatus main body lower end) before on the left of pars cervicalis esophagi.CT carries out standard cross-section scanning to patient's cervical region and apparatus of the present invention, obtains the detailed cross-sectional image of heart and throat, left side body surface apparatus of the present invention each geometrical plane framework inner.Next day, this patient CT DICOM view data is copied in ultrasonic fusion of imaging component computer, in the electromagnetic field of electromagnetic tracking system, transesophageal ultrasonography probe upper attachment electromagnetic field 6DOF sensor.The magnetic field position of impression probe, the spatial correspondence simultaneously between ultrasonic fusion of imaging system matches probe and CT image.Again after apparatus of the present invention are snapped in patient's former attaching adhesive plaster position, per os-esophagus routine inserts transesophageal ultrasonography probe, transesophageal ultrasonography is popped one's head in and is close to esophagus antetheca, find the image of apparatus of the present invention, ultrasonic scan is carried out to this contrive equipment, because this device inside is fluidity environment, therefore corresponding with CT image in quick obtaining means geometrical plane image, and carried out picture registration registration with CT image.The outer such as pulmonary vein of clear display heart is guided in ultrasonic and CT fusion image, the heart external structures such as superior and inferior vena cava after registration.
Three, when endo-luminal ultrasound-CT/MRI merges, this device joins the contrast with conventional method registration
This device registration efficiency of table 3. endo-luminal ultrasound-CT/MRI fusion and the contrast of conventional method registration efficiency
(13 routine clinical case contrast)
Brief summary:
At present, intracavity-transesophageal ultrasonography is at intracavity because the irregularities of operation, gas interference and local are corresponding with CT without definitely stable anatomical structure, and the section being therefore difficult to formation standard carries out image co-registration operation.
Use apparatus of the present invention, successfully can form the fusion of transesophageal ultrasonography and CT image, reach the object of transesophageal ultrasonography display heart external structure.Conventional transthoracic echocardiography and the display of transesophageal echocardiography to intracardiac structural deformities have than the better resolution of CT and display advantage.But do not have CT effective to the deformity outside heart or structure.Therefore intracavity, esophagus is ultrasonic has significant clinical meaning with the fusion of CT image.Therefore apparatus of the present invention provide effective enhancement techniques for this type of image co-registration.
As can be seen from the various embodiments described above, registration apparatus of the present invention, easily extensible is to the technical field of various ultrasonic fusion of imaging, and adaptability is more more extensive than traditional method for registering, in table 4:
Table 4
| Apparatus of the present invention registration | Anatomical structure registration in conventional body | |
| Abdominal organs image co-registration | + | + |
| Serious cirrhotic liver image co-registration | + | |
| Remarkable abdominal part flatulence | + | |
| Abdomen is opened comparatively after major operation in abdominal cavity | + | + |
| After peritoneum after major operation | + | + |
| Cranium brain | + | |
| Endoscopic ultrasonic or gastroscope ultrasonic | + | |
| Transesophageal ultrasonography | + | + |
Note :+can implement-can not implement ± suspicious
In sum, registration apparatus of the present invention, can make to form the standard cross-section direction the same with CT or nuclear-magnetism in ultrasonoscopy, solves the technology barrier being difficult to registration that ultrasonic probe universal property and the nonstandard property of section are brought; By this registration apparatus, on the basis ensureing accuracy registration, can significantly promote ultrasonic and CT, nuclear magnetic resonance, NMR or PET image fusion registration speed, and the scope of application is wider, has a good application prospect.
Claims (1)
1. be suitable for a Noninvasive standard registration apparatus for ultrasonic-CT/MRI/PET fusion of imaging, it is characterized in that: it comprises carrier bag (1), body surface fixture and at least 1 plane geometry framework (3); Carrier bag (1) is in cuboid, and inside is full of liquid; Plane geometry framework (3) is arranged in carrier bag (1), and keeps vertical with horizontal plane all the time; The distance of more than 0.1cm is kept between plane geometry framework (3) and carrier bag (1) inwall.
2. Noninvasive standard registration apparatus according to claim 1, is characterized in that: described plane geometry framework (3) adopts non-metallic material, and wherein, diameter or the thickness of plane geometry framework (3) frame are greater than 0.1mm.
3. Noninvasive standard registration apparatus according to claim 1, is characterized in that: described plane geometry framework (3) is circular or polygon.
4. Noninvasive standard registration apparatus according to claim 1, is characterized in that: described carrier bag (1) length and width and Gao Jun are at more than 0.5cm.
5. Noninvasive standard registration apparatus according to claim 1, is characterized in that: be provided with 1-91 plane geometry framework (3) in carrier bag (1), is often 1 ~ 90 ° of angle between adjacent two plane geometry frameworks (3); Angle between two plane geometry frameworks (3) of furthest apart is below 90 °; Each plane geometry framework (3) has difformity.
6. Noninvasive standard registration apparatus according to claim 5, is characterized in that: be often 1 ~ 45 ° of angle between adjacent two plane geometry frameworks (3), be provided with 2-46 plane geometry framework (3) in carrier bag (1); Angle between two plane geometry frameworks (3) of furthest apart is below 45 °.
7. Noninvasive standard registration apparatus according to claim 6, is characterized in that: be often 5-15 ° of angle between adjacent two plane geometry frameworks (3), be provided with 4-10 plane geometry framework (3) in carrier bag (1).
8. the Noninvasive standard registration apparatus according to claim 1-7 any one, is characterized in that: be also at least provided with 2 upper floats (4) in carrier bag (1), and the density of upper float (4) is less than the liquid in carrier bag (1); Each upper float (4) is connected by cotton rope with carrier bag (1) bottom; 2 upper floats (4) are one group, 1 plane geometry framework (3) and one group of upper float (4) are fixed in same plane by cotton rope.
9. the Noninvasive standard registration apparatus according to claim 1-7 any one, is characterized in that: be also at least provided with 2 sinking bodies (5) in carrier bag (1), and the density of sinking body (5) is greater than the liquid in carrier bag (1); Each sinking body (5) is connected by cotton rope with carrier bag (1) top; 2 sinking bodies (5) are one group, 1 plane geometry framework (3) and one group of sinking body (5) are fixed in same plane by cotton rope.
10. the Noninvasive standard registration apparatus according to claim 1-7 any one, is characterized in that: be filled with liquid level and lower liquid level in carrier bag (1), two-layer liquid unmixing, and density is different simultaneously; Plane geometry framework (3) bottom is also connected with floating base plate (31), and plane geometry framework (3) is perpendicular with floating base plate (31); The density of floating base plate (31) is between two-layer liquid; Described floating base plate (31) below is also connected with hollow pipe (32); Hollow pipe (32) both ends open, opening direction and plane-parallel; Cotton rope runs through hollow pipe (32) and is connected with carrier bag (1) inwall; Cotton rope is provided with the fixing card (8) in 2 positions, lays respectively at the both sides of hollow pipe (32).
11. Noninvasive standard registration apparatus according to claim 10, is characterized in that: described upper liquid level is water layer or oil reservoir; Lower liquid level is water layer or oil reservoir.
12. Noninvasive standard registration apparatus according to claim 1-7 any one, is characterized in that: fill single density fluid in carrier bag (1), or be filled with liquid level and lower liquid level, two-layer liquid unmixing simultaneously, and density is different; Plane geometry framework (3) is placed in tumbler device (7) top; Through hole (71) is provided with, the opening direction of through hole (71) and plane-parallel in tumbler device (7); Cotton rope runs through through hole (71) and is connected with carrier bag (1) inwall; Cotton rope is provided with the fixing card (8) in 2 positions, lays respectively at the both sides of through hole (71).
13. Noninvasive standard registration apparatus according to claim 12, is characterized in that: described upper liquid level is water layer or oil reservoir; Lower liquid level is water layer or oil reservoir.
14. Noninvasive standard registration apparatus according to claim 1, is characterized in that: described body surface fixture is fixing band (2) or clamping apparatus.
15. Noninvasive standard registration apparatus according to claim 14, is characterized in that: described clamping apparatus comprises cloth-one-side sheet (61), suitable clamping joint (62) and bayonet socket (63); Bayonet socket (63) is positioned at carrier bag (1) bottom outer surface, and clamping joint (62) is positioned at inviscid of cloth-one-side sheet.
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| CN103054646B (en) * | 2012-12-25 | 2015-06-17 | 周翔 | Non-invasive standard configuration device suitable for ultrasound-computed tomography (CT)/magnetic resonance imaging (MRI)/position emission tomography (PET) and other fusion imaging |
| CN105596029B (en) * | 2015-10-26 | 2018-08-14 | 深圳市海豚医疗科技有限公司 | Sound transparency and the good soft attaching fixing device of elasticity for ultrasonic scanning |
| CN106780451A (en) * | 2016-12-07 | 2017-05-31 | 西安电子科技大学 | X-ray, ultrasound, infrared image fusion breast lump image detecting method |
| US10402969B2 (en) * | 2017-03-10 | 2019-09-03 | General Electric Company | Methods and systems for model driven multi-modal medical imaging |
| CN109215023B (en) * | 2018-09-17 | 2021-11-05 | 青岛海信医疗设备股份有限公司 | Method and device for determining contact area between organ and tumor |
| CN110169820A (en) * | 2019-04-24 | 2019-08-27 | 艾瑞迈迪科技石家庄有限公司 | A kind of joint replacement surgery pose scaling method and device |
| US11992706B2 (en) | 2019-07-02 | 2024-05-28 | Our United Corporation | Simulation phantom |
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| CN102178526A (en) * | 2011-05-12 | 2011-09-14 | 上海交通大学医学院附属新华医院 | Ultrasonic and nuclear magnetic resonance image fusion transluminal registration device and method |
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| US5368030A (en) * | 1992-09-09 | 1994-11-29 | Izi Corporation | Non-invasive multi-modality radiographic surface markers |
| CN201578259U (en) * | 2009-09-29 | 2010-09-15 | 北京亿仁赛博医疗设备有限公司 | Multimode image registering auxiliary device |
| CN102178526A (en) * | 2011-05-12 | 2011-09-14 | 上海交通大学医学院附属新华医院 | Ultrasonic and nuclear magnetic resonance image fusion transluminal registration device and method |
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