CN108362192B - Aortic arch tangent line position angle measuring scale and measuring method - Google Patents
Aortic arch tangent line position angle measuring scale and measuring method Download PDFInfo
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- CN108362192B CN108362192B CN201810126068.2A CN201810126068A CN108362192B CN 108362192 B CN108362192 B CN 108362192B CN 201810126068 A CN201810126068 A CN 201810126068A CN 108362192 B CN108362192 B CN 108362192B
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- G01—MEASURING; TESTING
- G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
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Abstract
The invention provides an aortic arch tangent line position angle measuring scale and a measuring method. The measuring scale is provided with a protractor and a positioning ruler; the protractor is provided with a bottom edge indicating line and a zero degree indicating line which is perpendicular to the bottom edge indicating line and passes through the midpoint of the bottom edge, subdivision scale marks are arranged close to the inner side of the arc-shaped edge of the protractor and are provided with scale numerical values, the scale numerical value corresponding to the zero degree indicating line is 0, and the scale numerical values of the clockwise direction and the anticlockwise direction of two sides of 0 are used for indicating 0-90 degrees; the positioning ruler is provided with a long axis indicating line, and the middle point of the long axis indicating line is hinged with the middle point of the bottom edge indicating line through a hinge shaft. The measuring method is to use the measuring scale to measure the aortic arch tangent line position angle. The invention solves the problems of poor operation effect and more complications caused by the fact that the DSA projection angle does not conform to the reality in the thoracic aorta intracavity repair operation at present, and can realize the personalized measurement of the aortic arch projection angle.
Description
Technical Field
The invention relates to the technical field of medical instruments and clinical parameter measurement, in particular to an aortic arch tangent line angle measuring scale and a measuring method.
Background
Currently, thoracic aortic endoluminal repair (TEVAR) is widely applied to treatment of thoracic aortic dilated diseases (including thoracic aortic aneurysm, aortic dissection and thoracic aortic pseudoaneurysm), and is an important surgical operation.
In thoracic aorta endoluminal repair, most of the bulbs requiring DSA machines are vertically projected to the aortic arch part, and the aortic arch part is expanded on a two-dimensional image to the maximum extent so as to accurately measure the distance of an anchoring zone (Landing zone) of a lesion and accurately position a stent. The empirical projection angle (45 degrees inclined from the front left) is adopted in the previous operation process. The anatomical parameter research of the Chinese aortic dilatation disease discovers that the aortic arch tangent line angle (namely the optimal projection angle of the aortic arch DSA radiography) of most patients is larger than 45 degrees, and the retrospective research simultaneously discovers that more than 95 percent of cases of releasing the stent under the angle are not ideal positioning, so that the catastrophic consequences of insufficient proximal anchoring area or mistakenly covering branch arteries on the arch and the like are caused.
Patent document CN103892799A, published japanese patent No. 2014.07.02, discloses an aortic blood vessel measuring probe, device, and method for measuring aortic diameter. The aortic blood vessel measuring device comprises an aortic blood vessel measuring probe and a signal processing module which are electrically connected with each other. The aorta blood vessel measuring probe comprises a flexible substrate and a detector array (sensor array) arranged on the flexible substrate, wherein the detector array comprises MXN ultra-wide band radio wave detectors (ultra-wide band sensors), and the ultra-wide band radio wave detectors (ultra-wide band sensors) contact with an object to be measured so that the flexible substrate can adapt to deformation along with the outline of the object to be measured. The ultra-wideband radio wave detector emits radio waves to the object to be detected, the radio waves are reflected when being emitted to the tissue interface of the wall of the aorta vessel of the object to be detected, and the ultra-wideband radio wave detector receives echo signals and is analyzed by the signal processing module to define the diameter of the aorta.
Patent document CN106580327A, published japanese patent No. 2017.04.26, discloses an angle gauge for measuring the angle of aortic sinus, which comprises a bottom dial, a rotating needle, a rotating rod; the rotating needle is vertically connected with the rotating rod, is arranged at the bottom of the rotating rod and can rotate along with the rotating rod; the bottom of the rotating rod is vertically arranged on the dial, and the rotating needle can be driven to rotate on the dial by rotating the rotating rod, so that the angle to be measured is marked; furthermore, a clamping structure is arranged on the rotating rod and used for fixing the rotating rod after the rotating rod rotates to a specific position. Further, the rotating needle is also provided with a marking structure. The invention can conveniently measure the angle of the aortic sinus, and mark the initial cutting part by the rotary needle marking structure, thereby saving the operation time.
However, in the current clinical thoracic aorta endoluminal repair, DSA angiography of the aortic arch still adopts an empirical projection angle, namely 45 degrees of left forward inclination, and does not realize the technical problem that the DSA angiography does not conform to the actual aortic arch tangent position angle in most cases, so that a measuring device capable of measuring the aortic arch projection angle in an individualized manner, accurately positioning a release point at the proximal end of the stent and reducing the occurrence of complications is not available.
Disclosure of Invention
The invention aims to provide an aortic arch tangent position angle measuring scale aiming at the defects in the prior art.
It is still another object of the present invention to provide a tangential position angle measurement method for an aortic arch.
In order to achieve the first purpose, the invention adopts the technical scheme that:
an aortic arch tangent position angle measuring ruler is provided with a protractor and a positioning ruler; one side of the protractor is provided with a bottom edge indicating line at a position close to the bottom edge, and is also provided with a zero degree indicating line which is perpendicular to the bottom edge indicating line and passes through the midpoint of the bottom edge, the arc edge of the protractor is provided with subdivided scale lines at a position close to the inner side, the protractor is also provided with scale numerical values for indicating angles, and the scale numerical values corresponding to the zero degree indicating line are '0'; the positioning ruler is provided with a long axis indicating line, and the middle point of the long axis indicating line is hinged with the middle point of the bottom edge indicating line through a hinge shaft, so that the protractor and the positioning ruler can rotate relatively.
Preferably, the scale values in the clockwise and counterclockwise directions on both sides of the scale value "0" are "10", "20", "30", "40", "50", "60", "70", "80", "90", in that order.
Preferably, a rough graduation mark is further arranged between the bottom edge indication line and the zero degree indication line, and an angle between adjacent rough graduation marks is 10 degrees.
Preferably, the scale value is arranged between the rough scale mark and the fine scale mark.
Preferably, the protractor is provided with a concentric circle indicating line.
More preferably, the number of the concentric circle indicating lines is one, and the concentric circle indicating lines are located at the inner end point of the subdivision graduation line.
More preferably, the number of the concentric circle indicating lines is three, the outermost concentric circle indicating line is located at the inner end point of the subdivided scale line, the middle concentric circle indicating line is located at the outer end point of the roughly divided scale line, and the innermost concentric circle indicating line is located at a position close to the middle point of the bottom edge.
Preferably, the angle between adjacent subdivided graduation marks is 1 °.
Preferably, the protractor and the positioning ruler are both made of transparent materials.
In order to achieve the second object, the invention adopts the technical scheme that:
the method for measuring the tangent position angle of the aortic arch by using the aortic arch tangent position angle measuring ruler specifically comprises the following steps:
a) placing the aortic arch tangent position angle measuring scale at the aortic arch part, enabling the bottom edge indicating line of the protractor to be connected with the end points of the two sides of the aortic arch, enabling the plane where the protractor is located to be parallel to the plane where the aortic arch is located, and enabling the direction indicated by the zero degree indicating line of the protractor to be the projection direction of the C arm;
b) and rotating the positioning ruler to enable the long axis indicating line of the positioning ruler to be positioned in the longitudinal axis direction of the cross section of the human body, and determining the included angle between the long axis indicating line of the positioning ruler and the zero degree indicating line of the protractor as the aortic arch tangent line angle.
The invention has the advantages that:
1. based on long-term clinical experience and systematic research and analysis, the inventor of the application recognizes that the aortic arch tangent angle of most patients is larger than 45 degrees, and the current thoracic aorta endoluminal repair adopts an empirical projection angle (45 degrees forward left), which is an important reason for poor surgical effect and serious complications;
2. the shape of the aortic arch tangent position angle measuring scale, and the design of each indicating line and scale numerical value provide the reference for measurement and reading for the operator during operation, so that the accuracy and the quick identification are facilitated, and the use experience is good;
3. the aortic arch tangent line position angle measuring scale only comprises the protractor and the positioning ruler, and has the advantages of simple structure, convenience in use and low manufacturing cost;
4. the invention provides a method for measuring the tangent position angle of an aortic arch, which can realize the clinical individualized measurement of the aortic arch projection angle and obviously improve the effect of thoracic aortic intracavity repair;
5. the aortic arch tangent angle measuring method can be popularized and used under the condition of no workstation, for example, a patient may take a film from an outside hospital to see a doctor, and the optimal projection angle of the case can be measured by using a ruler and a protractor; in addition, the reconstruction of the radiology department generally does not provide the projection angle image concerned by the clinician in the operation, and the images seen clinically are all the screenshot and the original cross-sectional images of the three-dimensional reconstruction of the radiology department, so the method can be used for the clinician to measure the optimal projection angle under the existing resources.
Drawings
Fig. 1 is a schematic structural view of an aortic arch tangent position angle measuring ruler in example 1.
Fig. 2-4 are schematic diagrams of the use method of the aortic arch tangent position angle measuring scale of the invention. Fig. 2 and 3 are schematic drawings, and fig. 4 is a schematic view of an aortic arch CT cross-sectional image.
Fig. 5 is a schematic diagram of aortic arch tangent angle measurements for a particular case where the aortic arch exhibits curvature.
Fig. 6 is a schematic diagram of aortic arch tangent angle measurements taken in cases of aortic dissection with the true lumen of the descending aorta on the medial or lateral side.
Fig. 7 is a structural diagram of the aortic arch tangent position angle measuring ruler in example 2.
Detailed Description
The following detailed description of the present invention will be made with reference to the accompanying drawings.
The reference numerals and components referred to in the drawings are as follows:
1. protractor 11, bottom edge indicating line
12. Bottom edge midpoint 13, zero degree indicating line
14. Rough graduation line 15, fine graduation line
16. Scale number 17, concentric circle indicating line
2. Positioning ruler 21, major axis indicating line
3. Articulated shaft 4. aortic arch
Example 1
Referring to fig. 1, fig. 1 is a schematic structural view of an aortic arch tangent position angle measuring ruler in embodiment 1. The aortic arch tangent line position angle measuring scale is provided with a protractor 1 and a positioning ruler 2. The protractor 1 is semicircular, and one surface of the protractor is provided with an indication mark, specifically: a bottom edge indicating line 11 is arranged at a position close to the bottom edge of the protractor 1, the bottom edge indicating line 11 is parallel to the bottom edge of the protractor 1, and the midpoint of the bottom edge indicating line 11 is a bottom edge midpoint 12; a zero degree indicating line 13 is arranged in the direction which is perpendicular to the bottom edge indicating line 11 and passes through the midpoint 12 of the bottom edge; rough scale marks 14 are further arranged between the bottom edge indicating line 11 and the zero degree indicating line 13, and the angle between every two adjacent rough scale marks 14 is 10 degrees; subdivided scale lines 15 are arranged at the position, close to the inner side, of the arc-shaped edge of the protractor 1, and the angle between every two adjacent subdivided scale lines 15 is 1 degree; scale values 16 are arranged between the rough scale marks 14 and the subdivided scale marks 15, each scale value 16 corresponds to the rough scale marks 14, the zero degree indicating lines 13 and the bottom edge indicating lines 11, wherein the scale value corresponding to the zero degree indicating line 13 is '0', and the scale values on both sides of the scale value '0' in the clockwise and counterclockwise directions are '10', '20', '30', '40', '50', '60', '70', '80', '90'; the protractor 1 is further provided with three concentric circle indicating lines 17, the outermost concentric circle indicating line 17 is located at the inner side end point of the subdivided scale line 15, the middle concentric circle indicating line 17 is located at the outer side end point of the rough divided scale line 14, and the innermost concentric circle indicating line 17 is located at a position close to the bottom side midpoint 12; the concentric circle indicating lines 17 are all centered on the bottom edge midpoint 12. The positioning ruler 2 is provided with a long axis indicating line 21, the long axis indicating line 21 is parallel to the long edge of the positioning ruler 2, the middle point of the long axis indicating line 21 is the middle point of the long axis, and the middle point of the long axis is just overlapped with the central point of the positioning ruler 2. The middle point of the long shaft and the middle point 12 of the bottom edge are hinged by a hinge shaft 3, so that the protractor 1 and the positioning ruler 2 can freely rotate along the hinge shaft 3360 degrees. The length of the positioning ruler 2 is less than or equal to the length of the bottom edge of the protractor 1.
Referring to fig. 2-4, fig. 2-4 are schematic diagrams of the method for measuring the aortic arch tangent angle according to the present invention, and a B-type sandwich patient is taken as an example to illustrate the specific operation steps of measuring the aortic arch tangent angle by using the aortic arch tangent angle measuring ruler according to the present invention. (1) Referring to fig. 2 and 4, firstly, a cross-sectional image of the aortic arch CT is selected, the bottom edge of the protractor 1 is placed at the aortic arch 4, the bottom edge indicating line 11 of the protractor 1 is connected with the two side end points of the aortic arch 4, and the plane of the protractor 1 is substantially parallel to the plane of the aortic arch 4. At this moment, the direction pointed by the zero degree indicating line 13 of the protractor 1 is the projection direction of the C arm. (2) Referring to fig. 3 and 4, the positioning ruler 2 is rotated to make the long axis indication line 21 of the positioning ruler 2 be in the longitudinal axis direction of the cross section of the human body, and at this moment, the included angle between the long axis indication line 21 of the positioning ruler 2 and the zero degree indication line 13 of the protractor 1 is the aortic arch tangent line position angle of the patient, namely the optimal projection angle of the aortic arch DSA radiography. However, in some cases, such as the case of fig. 5, the curvature of the aortic arch is clinically observed, and the line a (i.e., the position of the bottom indicating line) is not a regular position, but should be the position indicated in fig. 5. Referring to fig. 6, in case of aortic dissection, if the true lumen of descending aorta is located inside the patient, the tangent to the medial edge is made; if the true lumen of the descending aorta is outside the patient, a tangent to the lateral edge is made.
It should be noted that, based on long-term clinical experience and systematic research, the inventor of the present invention recognizes that the aortic arch tangential position angle of most patients is greater than 45 degrees, and the current thoracic aortic endoluminal repair adopts an empirical projection angle (45 degrees forward left), which is an important reason for poor surgical effect and serious complications. The protractor 1 is not limited to be semicircular, however, the protractor can meet the measuring range requirement under the shape, and meanwhile, the protractor is convenient to operate in operation due to the appearance. The zero-degree indicating line 13 is used for indicating the projection direction of the C-arm in the measurement process, and the optimal projection angle of the aortic arch DSA radiography can be read out through the scale numerical values on the two sides of the zero-degree indicating line 13, wherein the scale numerical values on the two sides of the zero-degree indicating line 13 are respectively '10', '20', '30', '40', '50', '60', '70', '80' and '90', and direct reading is also facilitated. The protractor 1 is provided with rough dividing scale lines 14 and subdivided scale lines 15, the scale numerical values 16 are located between the rough dividing scale lines 14 and the subdivided scale lines 15, and concentric circle indicating lines 17 are arranged, so that the angle numerical values can be distinguished and identified under a complex background. The long axis indicating line 21 is used for indicating the longitudinal axis direction of the cross section of a human body, and then the numerical value of the optimal projection angle of the DSA radiography of the aortic arch is judged, therefore, the positioning ruler 2 is not limited to be rectangular, the midpoint of the long axis on the long axis indicating line 21 is not necessarily overlapped with the central point of the positioning ruler 2, however, the design can ensure that the whole device is more balanced and coordinated, and the operation and accurate reading are easy. The length of the positioning ruler 2 is preferably equal to the length of the bottom edge of the protractor 1, so that the long axis indication line 21 can be directly overlapped with the subdivided scale marks, the rough scale marks and the scale values on the protractor 1 for accurate reading. The articulated shaft 3 can be a screw or a rivet, and the like, as long as the flexible rotation of the protractor 1 and the positioning ruler 2 can be ensured.
In terms of manufacturing process, the protractor 1 is preferably made of colorless and transparent organic glass, and transparent materials can ensure that the aortic arch behind the protractor 1 can be clearly observed through the protractor 1. The positioning ruler 2 is preferably made of light yellow transparent organic glass, so that the view field is not blocked, and the positioning ruler is convenient to distinguish from the protractor 1. The angle of the protractor 1 and the corner of the positioning ruler 2 are preferably designed into a rounded angle, so that the tissue is prevented from being damaged by touch.
Example 2
Referring to fig. 7, fig. 7 is a schematic structural view of the aortic arch tangent angle measuring ruler in embodiment 2. The aortic arch tangent line angle measuring scale is basically the same as the aortic arch tangent line angle measuring scale described in embodiment 1, except that the protractor 1 is provided with only one concentric circle indicating line 17, and the concentric circle indicating line 17 is located at the end point of the inner side of the subdivided scale line 15.
The present embodiment illustrates that the concentric circle indicator lines 17 are provided on the protractor 1 for the purpose of facilitating accurate readings, however, they are not essential and may be omitted, and likewise, their number may be increased.
The above description is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, several modifications and additions can be made without departing from the method of the present invention, and these modifications and additions should also be regarded as the protection scope of the present invention.
Claims (8)
1. A method for measuring the tangent position angle of an aortic arch is characterized in that the measurement is carried out by using an aortic arch tangent position angle measuring ruler;
the aortic arch tangent line position angle measuring scale is provided with a protractor and a positioning ruler; one side of the protractor is provided with a bottom edge indicating line at a position close to the bottom edge, and is also provided with a zero degree indicating line which is perpendicular to the bottom edge indicating line and passes through the midpoint of the bottom edge, the arc edge of the protractor is provided with subdivided scale lines at a position close to the inner side, the protractor is also provided with scale numerical values for indicating angles, and the scale numerical values corresponding to the zero degree indicating line are '0'; the positioning ruler is provided with a long axis indicating line, and the middle point of the long axis indicating line is hinged with the middle point of the bottom edge indicating line through a hinge shaft, so that the protractor and the positioning ruler can rotate relatively; the protractor and the positioning ruler are both made of transparent materials;
the aortic arch tangent position angle measuring method specifically comprises the following steps:
a) placing the aortic arch tangent position angle measuring scale at the aortic arch part, enabling the bottom edge indicating line of the protractor to be connected with the end points of the two sides of the aortic arch, enabling the plane where the protractor is located to be parallel to the plane where the aortic arch is located, and enabling the direction indicated by the zero degree indicating line of the protractor to be the projection direction of the C arm;
b) and rotating the positioning ruler to enable the long axis indicating line of the positioning ruler to be positioned in the longitudinal axis direction of the cross section of the human body, and determining the included angle between the long axis indicating line of the positioning ruler and the zero degree indicating line of the protractor as the aortic arch tangent line angle.
2. The method of claim 1, wherein the scale values in clockwise and counterclockwise directions on both sides of the scale value "0" are "10", "20", "30", "40", "50", "60", "70", "80", "90", respectively.
3. The method of claim 1, wherein a rough graduation mark is disposed between the bottom indicator and the zero indicator, and an angle between adjacent rough graduation marks is 10 °.
4. The method of claim 3, wherein the graduation values are located between coarse and fine graduation lines.
5. The method for measuring the tangential position angle of the aortic arch as claimed in claim 3, wherein the angle gauge is provided with concentric circle indicating lines.
6. The method according to claim 5, wherein the number of concentric indicator lines is one at the inner end of the subdivided graduation line.
7. The aortic arch tangential position angle measurement method according to claim 5, wherein the number of the concentric circle indicator lines is three, the outermost concentric circle indicator line is located at the inner end of the subdivided scale line, the middle concentric circle indicator line is located at the outer end of the rough divided scale line, and the innermost concentric circle indicator line is located at a position near the middle of the bottom edge.
8. The aortic arch tangential position angle measurement method of claim 1, wherein an angle between adjacent subdivided graduation lines is 1 °.
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| CN201810126068.2A CN108362192B (en) | 2018-02-08 | 2018-02-08 | Aortic arch tangent line position angle measuring scale and measuring method |
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| CN201810126068.2A CN108362192B (en) | 2018-02-08 | 2018-02-08 | Aortic arch tangent line position angle measuring scale and measuring method |
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| CN108362192B true CN108362192B (en) | 2020-11-24 |
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| CN111643088A (en) * | 2019-03-04 | 2020-09-11 | 刘帅 | Measuring scale for rapidly measuring soft and hard tissue characteristics of lateral skull tablet |
| CN112729040A (en) * | 2021-01-19 | 2021-04-30 | 余光明 | Angle ruler |
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| CN2559325Y (en) * | 2002-08-21 | 2003-07-09 | 利津县中心医院 | Medical skull angle measuring positioner |
| CN102908148B (en) * | 2012-10-17 | 2014-08-06 | 夏和桃 | Orthopedic measuring scale and application method thereof |
| CN204698556U (en) * | 2015-06-08 | 2015-10-14 | 奚少东 | Goniometry chi is used in a kind of cornu frontale ventriculi lateralis puncture |
| CN206556569U (en) * | 2017-03-21 | 2017-10-13 | 新疆医科大学第一附属医院 | Rule for medical measurement |
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