CN109498106A - A kind of positioning and air navigation aid of the intramedullary needle nail hole based on 3-D image - Google Patents
A kind of positioning and air navigation aid of the intramedullary needle nail hole based on 3-D image Download PDFInfo
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- CN109498106A CN109498106A CN201811602009.4A CN201811602009A CN109498106A CN 109498106 A CN109498106 A CN 109498106A CN 201811602009 A CN201811602009 A CN 201811602009A CN 109498106 A CN109498106 A CN 109498106A
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- intramedullary needle
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1717—Guides or aligning means for drills, mills, pins or wires for applying intramedullary nails or pins
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/102—Modelling of surgical devices, implants or prosthesis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
Abstract
The positioning and air navigation aid for the intramedullary needle nail hole based on 3-D image that the present invention relates to a kind of realize the accurate positionin without using X-ray and sighting device to intramedullary needle nail hole, and bone drill insertion nail hole is guided to carry out reduction；It realizes and intramedullary needle and its 3-D image links one by one；The real-time relative position of bone drill and intramedullary needle can be showed in image workstation；The Distance Judgment and angle judgement between bone drill axis and intramedullary needle nail hole central axes can accurately be completed.Compared to traditional intramedullary needle nail hole localization method, the present invention can not only accurately indicate the spatial position of nail hole, and can by 3-D image, show the relative tertiary location of bone drill and intramedullary needle on the screen in real time, bone drill drill point can not only be positioned, and can also precisely provide bone drill and pierce angle, it guides doctor to carry out intramedullary needle reduction simple and clearly, substantially reduces error rate, operating time is saved, the pain of patient is mitigated.
Description
Technical field
The present invention relates to the positioning and air navigation aid of a kind of intramedullary needle nail hole, in especially a kind of marrow based on 3-D image
The positioning and air navigation aid of needle nail hole, belong to 3 d medical images process field.
Background technique
Fracture is a kind of clinically relatively common disease, wound or it is other due to cause the fracture of sclerotin, sternly
Weight affects people's health and life.As outdoor sports type increases, the wound of sports type is more and more, while traffic
The raising of accident rate also increases fracture patient gradually.More and more people are carried out using method fixed in intramedullary needle
Fractures.Traditional intramedullary needle reconstructive surgery method is that intramedullary needle is inserted into patient's knochenbruch under the guidance of X-ray, in intramedullary needle
Outer end increase the fixed instrument of guide rod, sighting device etc., reuse bone drill according to the guide of sighting device and bore osteoclastic wall, lead directly to intramedullary needle
On nail hole, finally steel nail is squeezed into the nail hole of intramedullary needle and locking is fixed.During this, the guidance of x-ray image be will cause
The radiation of doctor and patient.The fixed instrument such as guide rod, sighting device is possible to meeting in connection, and deformation occurs, causes position that can not take aim at
It is quasi-.In addition, operation doctor can not understand the position in the instruments such as intramedullary needle, bone drill insertion knochenbruch in real time, cause operation not straight
It sees.
In order to solve clinically to guide bone drill to be directed at this problem of intramedullary needle nail hole, the present invention devises a set of based on three-dimensional
The positioning and air navigation aid of the intramedullary needle nail hole of image.The tracking of use space position indicator is fixed in surgical instrument in this method
The location information of rigid body is positioned, and is transmitted in image workstation in real time.It is realized in real space by positioning rigid body registration
Intramedullary needle and image workstation in intramedullary needle linkage, i.e., in real space intramedullary needle occur change in location, then scheming
As corresponding change in location also occurs for the intramedullary needle image in work station.Doctor can pass through intramedullary needle in observation image workstation
Position, find the position of intramedullary needle nail hole, bone wall corresponding position drill, in favor of steel nail is accurately squeezed into intramedullary needle
In nail hole.
Localization method completes intramedullary needle registration first, calculates image coordinate system and positioning rigid body using Characteristic points match method
Transition matrix between coordinate system, so that intramedullary needle and intramedullary needle image be connected.Intramedullary needle three of the present invention in foundation
Each nail hole of dimension module is implanted into a cylinder model, represents the position and direction of nail hole.
Surgical navigational is tracked to bone drill, bone drill is judged at a distance from intramedullary needle nail hole and angle, to guide bone
Bore the correct position drilling on bone wall.Distance Judgment refers to that the distance between bone drill tip and intramedullary needle nail hole central axes are less than
Certain threshold value.Angle judgement refers to that the angle between bone drill axis and intramedullary needle nail hole central axes is less than certain threshold value, only
Have when distance and angle all meet condition, can accurately just find the position of intramedullary needle nail hole, the corresponding position on bone wall
Drilling.
Summary of the invention
For the above-mentioned prior art, the technical problem to be solved in the present invention is to provide one kind can be realized intramedullary needle pin hole essence
Certainly position and the positioning and air navigation aid that accurately guide bone drill drilling, operate the intuitively intramedullary needle nail hole based on 3-D image.
In order to solve the above technical problems, positioning and the navigation side of a kind of intramedullary needle nail hole based on 3-D image of the present invention
Method, including position portion and navigational portions, position portion the following steps are included:
Step 1: institute's intramedullary needle to be used being scanned using medical imaging devices, obtains 3-D image, and to marrow
Interior needle carries out three-dimensional reconstruction, obtains the threedimensional model of intramedullary needle；It is apparent to choose n feature manually on intramedullary needle 3-D image
Point is used as source feature point set, wherein n >=3；In positioning rigid body coordinate system, chosen and source feature point set one from practical intramedullary needle
One corresponding n characteristic point, as target signature point set；
Step 2: rigid body will be positioned and be fixed on the top that intramedullary needle is provided with screw thread side, utilize the source chosen in step 1
Feature point set and target signature point set calculate the rotation between intramedullary needle and intramedullary needle 3-D image using iteration closest approach algorithm
Turn matrix K and translation matrix L, calculate registration matrix L*K, image coordinate system is uniformly transformed under positioning rigid body coordinate system, it is complete
At registration；Space position indicator completes chasing after to the real-time spatial position of intramedullary needle by the positioning bead on tracing and positioning rigid body
Track realizes the linkage of intramedullary needle and intramedullary needle 3-D image；
Step 3: a cylinder identical with nail hole diameter is added in the nail hole of intramedullary needle, and will be in intramedullary needle nail hole
Axis shows that cylinder represents the position and direction of nail hole together, and one and nail hole diameter are added in the nail hole of intramedullary needle
Identical cylinder specifically: measurement target nail hole internal diameter first generates the identical cylinder of a diameter in image space, and length is super
Nail hole depth is crossed, the initial position of cylinder is arranged in the Y-axis of image coordinate system, the center of the central axes of cylinder and origin weight
It closes；Next a rotational translation matrix is sought, so that intramedullary needle nail hole central axes are moved to cylinder central axes and are overlapped；Then
The inverse matrix for calculating rotational translation matrix makes cylinder reach the position of intramedullary needle nail hole by inverse transformation；
The real-time transform matrix between rigid body and space position indicator will be positioned on the rotational translation matrix premultiplication intramedullary needle sought,
Realize the linkage of the central axes and intramedullary needle that assign into cylinder and intramedullary needle in intramedullary needle nail hole.
Navigational portions the following steps are included:
Step 1: Distance Judgment: installing a positioning rigid body on bone drill, realizes tracking bone drill point using space position indicator
The position and direction at end calculate bone drill tip to the vertical range of a certain nail hole central axes of intramedullary needle, set when the distance is less than
Threshold value when, the color of cylinder becomes color one, indicates that bone drill tip is located on nail hole central axes；
Step 2: angle judgement: angle judgement is carried out after distance is less than the threshold value of setting, when the axis of intramedullary needle nail hole
When line and bone drill axis angulation γ are less than critical value, the color of cylinder becomes color two from color one, indicates bone drill axis
It is overlapped with cylinder axis, the color of color one, color two and cylinder is three kinds of different colors；
Step 3: when cylinder keep color two-state under, indicate bone drill is overlapped with nail hole central axes height, distance at
Angle is met the requirements, and squeezes into bone drill by bone drill axis at this time.
The invention also includes:
1. the manual selection of source feature point set described in position portion step 1 meets:
Intramedullary needle threedimensional model is read in, the point on the apparent side of feature or angle is selected, chooses the point with mouse, and by the point
It is stored in source point to concentrate, obtains SourcePoint (xi,yi,zi), i=1 ... n；
The manual selection of target signature point set described in position portion step 1 meets:
Using space position indicator be equipped with can positioning probe selected on intramedullary needle it is corresponding with characteristic point on its threedimensional model
The point of position is stored in target point set, obtains target point set TargetPoint (x corresponding with source feature point seti,yi,zi), i
=1 ... n.
2. the step of seeking of rotational translation matrix described in position portion step 3 includes:
Step 3.1: calculating nail hole central axes: seeking the midpoint of the disc of a certain nail hole two sides first, in intramedullary needle three-dimensional
The side of the nail hole evenly over the circumference takes four points on model, calculates midpoint of the arithmetic mean of instantaneous value as the side of four points,
Other side midpoint measures in the same way, and two midpoints determine straight line, the central axes as the nail hole；
Step 3.2: translation: assuming that the nail hole central axes P on intramedullary needle threedimensional model under image coordinate system0Rise
Point is v1=(x1,y1,z1), terminal v2=(x2,y2,z2), the starting point of the central axes of intramedullary needle nail hole is moved into image coordinate
The origin O of system, translation matrix areThe central axes of intramedullary needle nail hole are P=(x, y, z) after translation,
InThen OP is the central axes obtained after translating；
Step 3.3: by P=(x, y, z) around X-axis rotated counterclockwise by angle α, rotating to OP on XOY plane, be denoted as OP2,
P1To rotate preceding P in the subpoint in the face YOZ, coordinate is (0, y, z), P2Point is located in XOY plane, P2Subpoint of the point in Y-axis
For P3, P3It is P1Position in YOZ plane after X-axis rotated counterclockwise by angle α, then OP1Length be equal to OP3Length, P2
The Y axis coordinate of point is the subpoint OP in Y-axis1Length, beThen P2Putting coordinate isOP1With
OP3Angle be α, andThen the angle value of α is obtained using inverse cosine function；
Step 3.4: by OP2Angle beta is rotated clockwise about the z axis, is OP after rotation4, P2Point coordinate be The angle value of β then is obtained using inverse cosine function, arrives this, intramedullary needle nail hole
Central axes and cylinder central axes have been overlapped；
Step 3.5: cylinder central axes are carried out to the inverse transformation of step 3.4,3.3 and 3.2, specifically: firstly, cylinder axis
Line rotated counterclockwise by angle β, i.e. central axes and OP about the z axis2It is overlapped, spin matrix TZ(-β)；Then, by cylinder central axes around X
Axis rotates clockwise angle [alpha], and cylinder central axes are overlapped with OP at this time, spin matrix TX(α)；Finally, by cylinder central axes
Translation is carried out, translation matrix T, so far, the central axes of cylinder are overlapped with the central axes of intramedullary needle nail hole, final
Rotational translation matrix is TTX(α)·TZ(-β)；
3. the vertical range for calculating bone drill tip to a certain nail hole central axes of intramedullary needle described in navigational portions step 1 is specific
Are as follows:
Registration of the intramedullary needle nail hole central axes under image coordinate system in Origin And Destination coordinate premultiplication position portion step 2
Matrix L * K obtains the coordinate under positioning rigid body coordinate system, and then premultiplication positions the transformation square between rigid body and space position indicator again
Battle array obtains coordinate of the central axes Origin And Destination under space position indicator coordinate system, and bone drill tip coordinate is by space position indicator reality
When capture, this 3 points coordinate is located under space position indicator coordinate system, is calculated in bone drill tip to marrow by this 3 coordinates
The vertical range of a certain nail hole central axes of needle, specifically:
Assuming that the coordinate that tip T is bored in space position indicator coordinate system sending down the fishbone is (t1,t2,t3), intramedullary needle central axes starting point A1It sits
It is designated as (a1,b1,c1), terminal A2Coordinate is (a2,b2,c2), d is required distance, and ω isWithBetween angle,Cos ω, sin ω, d meet:
D=| A1T|·sinω
4. the critical value of the central axes of intramedullary needle nail hole described in navigational portions step 2 and bone drill axis angulation γ are full
Foot:
Assuming that cylinder cy1 radius where nail hole is r, height is unlimited；Cylinder cy2 diameter where bone drill is dD, height is unlimited,
When bone drill is inserted into nail hole, one end of cy2 and the inner wall of cy1 intersect at point cp1, and the central axes phase of the central axes of cy1 and cy2
It hands over, then the other side inner wall of cy2 and cy1 intersects at point cp2, and one is intercepted from cy1 by two cylindrical cross-sections of cp1 and cp2
Duan Yuanzhu, the cylinder height are h, then the central axes angle of the central axes of cy1 and cy2 are central axes and the bone of intramedullary needle nail hole
Auger spindle line angulation γ meets:
If nail hole actual height is hn, then when h is equal to hnWhen, γ is critical value, the critical value of γ are as follows:
Beneficial effects of the present invention: the present invention is realized without using X-ray and sighting device to intramedullary needle nail hole
Accurate positionin, and guide bone drill insertion nail hole carry out reduction；It realizes and intramedullary needle and its 3-D image links one by one；
The real-time relative position of bone drill and intramedullary needle 3-D image can be showed in image workstation；Bone can accurately be completed
Distance Judgment and angle judgement between auger spindle line and intramedullary needle nail hole central axes；The precise positioning of intramedullary needle nail hole is realized, and
Guidance operation is precisely completed under 3-D image real-time navigation.Compared to traditional intramedullary needle nail hole localization method, the present invention is not only
Can accurately indicate the spatial position of nail hole, and can by 3-D image, show bone drill on the screen in real time
With the relative tertiary location of intramedullary needle, bone drill drill point can not only be positioned and (be realized by Distance Judgment), but also
Bone drill can precisely be provided and pierce angle (judging to realize by angle), doctor is finally guided to carry out intramedullary needle fracture simple and clearly
Reduction greatly reduces error rate, saves operating time, alleviates the pain of patient.
Detailed description of the invention
Fig. 1 is intramedullary needle three-dimensional reconstruction；
Fig. 2 is the manual selected characteristic point on intramedullary needle image；
Fig. 3 is that positioning rigid body and intramedullary needle rigid connection are schemed；
Fig. 4 is the schematic diagram of intramedullary needle pin hole central axes；
Fig. 5 (a) is to move to the intramedullary needle central axes of origin to rotate schematic diagram around X-axis；
Fig. 5 (b) is the calculating schematic diagram for rotating angle [alpha]；
Fig. 6 (a) is that intramedullary needle central axes rotate schematic diagram about the z axis；
Fig. 6 (b) is the calculating schematic diagram for rotating angle beta；
Fig. 7 is that distance calculates schematic diagram；
When Fig. 8 (a) is that bone drill is inserted into nail hole, bone drill central axes and nail hole central axes angle schematic diagram；
Fig. 8 (b) is the critical state schematic diagram for being inserted into bone drill；
Fig. 9 is to implement manually femur model；
Figure 10 is cylinder and central axes；
Figure 11 is range estimation；
Figure 12 is angle judgement；
Specific embodiment
The specific embodiment of the invention is specifically described with reference to the accompanying drawing.
Positioning
Step 1 is scanned institute's intramedullary needle to be used using medical imaging devices, obtains 3-D image, and to marrow
Interior needle carries out three-dimensional reconstruction, obtains the threedimensional model of intramedullary needle, as shown in Figure 1,；N is chosen manually on intramedullary needle 3-D image
A apparent point of feature, as source feature point set, as shown in Figure 2；In space position indicator coordinate system, selected from practical intramedullary needle
Take with the one-to-one n characteristic point of source feature point set, as target signature point set.
The manual selection of step 1.1, source feature point set:
Intramedullary needle threedimensional model is read in, the point on the apparent side of feature or angle is selected, chooses the point with mouse, and by the point
It is stored in source point to concentrate, obtains SourcePoint (xi,yi,zi), i=1 ... n.
The manual selection of step 1.2, target signature point set:
Using space position indicator be equipped with can positioning probe selected on intramedullary needle it is corresponding with characteristic point on its 3-D image
The point of position is stored in target point set, obtains corresponding target point set TargetPoint (xi,yi,zi), i=1 ... n.
Step 2, the top that positioning rigid body is fixed on to intramedullary needle proximal end, rigid body connect as shown in figure 3, utilizing previous step
The n group characteristic point of middle selection calculates intramedullary needle and its 3-D image using ICP (Iterative Closest Point) algorithm
Between spin matrix K and translation matrix L, calculate registration matrix L*K, so that image coordinate system uniformly to be transformed to positioning rigid body
Under coordinate system, registration is completed；Positioning bead on positioning rigid body can be tracked by space position indicator, due to intramedullary needle and positioning
Rigid body is rigid body connection, so the real-time spatial position of intramedullary needle can also be tracked to, completes tracking.Marrow is just realized at this time
The linkage one by one of interior needle and its 3-D image.
Step 3 adds a translucent grey columns identical with nail hole diameter in the nail hole of intramedullary needle, and will be in marrow
The central axes of needle nail hole are shown together.Cylinder can represent the position and direction of nail hole, to do distance and angle judgement
When provide prompt for operator.When distance and angle meet threshold condition, operator can be by current bone drill direction along axial direction
It pierces.When cylinder is added on intramedullary needle threedimensional model, target nail hole internal diameter is measured first, generates a diameter in image space
Identical cylinder, length will be more than nail hole depth.The initial position of cylinder is arranged in the Y-axis of image coordinate system, in cylinder
The center of axis is overlapped with origin.Next a rotational translation matrix is sought, so that in cylinder central axes and intramedullary needle nail hole
Axis is overlapped.Due to the position comparison rule of cylinder, we seek a rotational translation matrix here, make intramedullary needle nail hole axis
Line is overlapped by transformation with cylinder central axes, finally calculates the inverse matrix of the rotational translation matrix, so that it may allow cylinder by inversion
Change to the position up to intramedullary needle nail hole.It is the specific steps for seeking rotational translation matrix below:
Step 3.1 calculates nail hole central axes.By taking a certain nail hole as an example, the midpoint of the disc of nail hole two sides is sought first.?
The side of the nail hole evenly over the circumference takes four points on intramedullary needle threedimensional model, and the arithmetic mean of instantaneous value for calculating four points, which is used as, to be somebody's turn to do
The midpoint of side, other side midpoint measure in the same way, and two midpoints determine straight line, as the central axes of nail hole, such as Fig. 4
It is shown.
Step 3.2, translation.Assuming that nail hole central axes P on intramedullary needle threedimensional model under image coordinate system0Starting point
For v1=(x1,y1,z1), terminal v2=(x2,y2,z2).The central axes of intramedullary needle nail hole are moved to using origin as starting point,
Translation matrix isThe central axes of intramedullary needle nail hole are P=(x, y, z) after translation, whereinIf the OP in Fig. 5 (a) is the central axes obtained after translating.
Step 3.3, by P=(x, y, z) around X-axis rotated counterclockwise by angle α, rotate to OP on XOY plane, be denoted as OP2,
P1Subpoint for P in the face YOZ, coordinate are (0, y, z), P2Point coordinate beCross P1Point does hanging down for Y-axis
Line hands over Y-axis in P3Point.WhereinFig. 5 is to rotate schematic diagram for the first time.
Step 3.4, by OP2Angle beta is rotated clockwise about the z axis, is OP after rotation4, P2Point coordinate be This is arrived, intramedullary needle nail hole central axes and circle
Column central axes have been overlapped.Fig. 6 (a) is second of rotation schematic diagram.
Step 3.5, cylinder central axes rotated counterclockwise by angle β, i.e. central axes and OP about the z axis2It is overlapped.Spin matrix is TZ
(-β)。
The cylinder executed after step 3.5 is rotated clockwise angle [alpha] around X-axis by step 3.6, and cylinder central axes have been at this time
It is overlapped with OP.Spin matrix is TX(α)。
Step 3.7, again by execute step 3.6 after cylinder carry out translation.Translation matrix is T.So far, cylinder
Central axes are overlapped with the central axes of intramedullary needle nail hole.Final rotational translation matrix is TTR(α)·TZ(-β)。
One shares seven nail hole on intramedullary needle, and the translation rotation matrix of each nail hole can be found out according to above-mentioned steps.
The translation rotation matrix premultiplication intramedullary needle real-time transform matrix acquired in step 3.7 (is positioned rigid body and space is fixed on intramedullary needle
Transformation matrix between the instrument of position), assign into this way the central axes of the cylinder and intramedullary needle in intramedullary needle nail hole just can and marrow
Interior needle realizes linkage.
Navigation
Step 1, Distance Judgment.One positioning rigid body is installed on bone drill, to track the spatial position of bone drill, by sky
Between the Pivot function of position indicator can directly track the position and direction at bone drill tip.Distance Judgment, which refers to, calculates bone drill tip
To the vertical range of a certain nail hole central axes of intramedullary needle, when the distance is less than a certain threshold value, cylinder becomes green, indicates bone drill
Tip is located on nail hole central axes, just only needs to adjust bone drill angle later.
The calculating of distance:
Bone drill tip coordinate can be captured in real time by position indicator, and intramedullary needle nail hole central axes Origin And Destination coordinate can be by fixed
Position method be calculated, then we can be calculated by this 3 coordinates bone drill tip to nail hole central axes projection away from
From:
Assuming that the coordinate of bone drill tip T is (t1,t2,t3), intramedullary needle central axes starting point A under space position indicator coordinate system1It sits
It is designated as (a1,b1,c1), terminal A2Coordinate is (a2,b2,c2).Fig. 7 is schematic diagram, and d is required distance in figure, and ω isWithBetween angle,Cos ω, sin ω, d are shown in
Formula is (1-1), (1-2), (1-3).
D=| A1T|·sinω (1-3)
Step 2, angle judgement.Angle judgement is carried out after distance is less than given threshold, by calculating bone drill axis and nail
Axially bored line angulation is as angle measurement.Angle judgement refers to central axes and bone drill axis institute angulation when intramedullary needle nail hole
When degree is less than critical value, cylinder is reddened by green, is indicated that bone drill axis is overlapped with cylinder axis, can be pierced by when front direction.By
It can be captured in real time by position indicator in the direction of bone drill axis, the starting point space coordinate of nail hole central axes is also in real time it is known that angle
Degree measurement can be transformed into the angle problem between seeking two vectors.
By taking one of nail hole as an example, when bone drill will be inserted into intramedullary needle nail hole, the central axes of intramedullary needle nail hole and bone drill axis
Line angulation γ should be less than critical angle θ.Fig. 8 (a) is the schematic diagram of angle judgement.Assuming that cylinder cy1 radius where nail hole
It is highly unlimited for r；Cylinder cy2 diameter where bone drill is dD, highly unlimited.When bone drill is inserted into nail hole, one end of cy2 and cy1
Inner wall intersect at point cp1, and the central axes of cy1 are intersected with the central axes of cy2, then the other side inner wall of cy2 and cy1 intersects at
Point cp2.So, a Duan Yuanzhu can be intercepted from cy1 by two cylindrical cross-sections of cp1 and cp2, which is h.That
, the central axes of cy1 and the central axes angle γ of cy2 are as follows:
If nail hole actual height is hn, such as Fig. 8 (b), then when h is equal to hnWhen, critical angle are as follows:
When bone drill and cylinder axis angle γ are less than θ, as meet angle conditions.
Step 3 under cylinder holding red status, indicates that bone drill is overlapped with nail hole central axes height, distance and institute at this time
It is angled to meet the requirements, squeeze into bone drill.
The present invention is studied for the positioning and guidance of nail hole in the operation of intramedullary needle reduction, with manual manufacture femur
For model, as shown in Figure 9.Particular hardware is made of space position indicator, computer and bone drill etc..Space position indicator is clinically
Common optical navigation device positions rigid body equipped with several sets, includes that 4 position distributions are different reflective small on each positioning rigid body
Ball, position indicator can capture the spatial position of positioning rigid body in real time and be transmitted to computer；Computer passes through as hardware supported
The making softwares such as VC, MATLAB realize the three-dimensional reconstruction of intramedullary needle and its visual；Positioning rigid body is fixed on intramedullary needle
On, the spatial position by positioning rigid body can calculate the spatial position of intramedullary needle.Equally, rigid by installing positioning on bone drill
Body can calculate the position and direction at bone drill tip by the Pivot function of position indicator.It is mating used here as space position indicator
Can positioning probe simulate bone drill, tip can be positioned.
The positioning of intramedullary needle nail hole:
Step 1,
CT scan is carried out to intramedullary needle, obtains three-dimensional CT image.
A, which is rebuild, to be drawn:
The contour surface of 3-D image is extracted using the isosurface function of MATLAB.Three-dimensional reconstruction and iso-surface patch result are such as
Shown in Fig. 1.
B. the intramedullary needle 3-D image rebuild is opened using 3D Slicer, chooses the apparent point of 5 features manually, as
Source feature point set, as shown in Fig. 2, obtaining SourcePoint (xi,yi,zi).Source_points=[0.387-3.263-
7.464 -3.807 8.863；-81.731 -78.692 -80.392 -91.147 -90.208；-575.478 -620.389
-881.355 -840.975 -592.380]。
C. using space position indicator it is matched can positioning probe is chosen on practical intramedullary needle and a pair of source feature point set one
The n characteristic point answered, as target signature point set TargetPoint.Target_points=[- 22.2-37.5-97.8-
79.8 -15.1；77.75 122.3 376.6 336.1 96.9；-86.6 -82.8 -68.5 -74.4 -83.8].
Step 2 calculates spin matrix K and translation square using ICP algorithm to the target point set and source point collection of step 1 acquisition
Battle array L:
It is transformed under positioning rigid body coordinate system after intramedullary needle image is carried out corresponding rotation translation, to complete to register.
Step 3, by taking a certain nail hole as an example, centered on origin, Y-axis is central axes, and nail hole internal diameter is that diameter does cylinder, circle
Column central axes are a blue solid lines, seek rotational translation matrix T using location algorithm of the invention1, by gray translucent cylinder
And at the translation rotation to intramedullary needle nail hole of central axes, effect is as shown in Figure 10:
It navigates in art:
Step 1 carries out Distance Judgment
The real-time navigation process in art carries out the judgement of distance first.Distance threshold is set in the present embodiment as 2mm.Such as figure
Shown in 11, the cylinder greening when bone drill tip is less than 2mm with intramedullary needle nail hole central axes distance of the big figure in left side, right side is in image
Work station and in real space between intramedullary needle nail hole central axes and bone drill tip apart from gap comparative effectiveness.
Step 2 carries out angle judgement
Each nail hole angle critical value of intramedullary needle, each nail of the intramedullary needle are calculated first, in accordance with angle judgment method of the invention
Orifice angle critical value θ is as shown in the table:
In art during real-time navigation, after distance meets condition, the adjustment of Yao Jinhang angle turns by adjusting bone drill
The direction of axis is realized, until the angle between bone drill shaft and intramedullary needle central axes is less than critical angle θ.As shown in figure 12, left
The big figure in side is that cylinder reddens when the angle between bone drill shaft and intramedullary needle central axes is less than critical angle θ, and right side is in image work
It stands and in the differential seat angle in real space between intramedullary needle nail hole central axes and bone drill shaft away from comparative effectiveness.
Step 3 under cylinder holding red status, indicates that bone drill is overlapped with nail hole central axes height, distance and institute at this time
It is angled to meet clinical requirement, squeeze into bone drill.
Claims (5)
1. a kind of positioning and air navigation aid of the intramedullary needle nail hole based on 3-D image, including position portion and navigational portions,
Be characterized in that, position portion the following steps are included:
Step 1: institute's intramedullary needle to be used being scanned using medical imaging devices, obtains 3-D image, and to intramedullary needle
Three-dimensional reconstruction is carried out, the threedimensional model of intramedullary needle is obtained；It chooses n feature manually on intramedullary needle 3-D image and significantly puts work
For source feature point set, wherein n >=3；In positioning rigid body coordinate system, chosen from practical intramedullary needle a pair of with source feature point set one
The n characteristic point answered, as target signature point set；
Step 2: rigid body will be positioned and be fixed on the top that intramedullary needle is provided with screw thread side, utilize the source feature chosen in step 1
Point set and target signature point set calculate the spin moment between intramedullary needle and intramedullary needle 3-D image using iteration closest approach algorithm
Battle array K and translation matrix L, calculate registration matrix L*K, image coordinate system are uniformly transformed under positioning rigid body coordinate system, complete note
Volume；Space position indicator completes the tracking to the real-time spatial position of intramedullary needle by the positioning bead on tracing and positioning rigid body, real
The linkage of existing intramedullary needle and intramedullary needle 3-D image；
Step 3: a cylinder identical with nail hole diameter is added in the nail hole of intramedullary needle, and by the central axes of intramedullary needle nail hole
It shows together, cylinder represents the position and direction of nail hole, and addition one is identical as nail hole diameter in the nail hole of intramedullary needle
Cylinder specifically: measurement target nail hole internal diameter first generates the identical cylinder of a diameter in image space, and length is more than nail
The initial position of hole depth, cylinder is arranged in the Y-axis of image coordinate system, and the center of the central axes of cylinder is overlapped with origin；It connects
Get off to seek a rotational translation matrix, so that intramedullary needle nail hole central axes are moved to cylinder central axes and are overlapped；Then it calculates
The inverse matrix of rotational translation matrix makes cylinder reach the position of intramedullary needle nail hole by inverse transformation；
The real-time transform matrix between rigid body and space position indicator will be positioned on the rotational translation matrix premultiplication intramedullary needle sought, realize
Assign into the central axes of the cylinder and intramedullary needle in intramedullary needle nail hole and the linkage of intramedullary needle；
Navigational portions the following steps are included:
Step 1: Distance Judgment: installing a positioning rigid body on bone drill, realizes tracking bone drill tip using space position indicator
Position and direction, the vertical range at calculating bone drill tip to a certain nail hole central axes of intramedullary needle, when the distance is less than the threshold of setting
When value, the color of cylinder becomes color one, indicates that bone drill tip is located on nail hole central axes；
Step 2: angle judgement: when distance be less than setting threshold value after carry out angle judgement, when intramedullary needle nail hole central axes with
When bone drill axis angulation γ is less than critical value, the color of cylinder becomes color two from color one, indicates bone drill axis and circle
Mast axis is overlapped, and the color of color one, color two and cylinder is three kinds of different colors；
Step 3: when cylinder is kept under color two-state, expression bone drill is overlapped with nail hole central axes height, distance and angulation
It meets the requirements, squeezes into bone drill by bone drill axis at this time.
2. the positioning and air navigation aid of a kind of intramedullary needle nail hole based on 3-D image according to claim 1, feature
Be: the manual selection of source feature point set described in position portion step 1 meets:
Intramedullary needle threedimensional model is read in, the point on the apparent side of feature or angle is selected, chooses the point with mouse, and the point is stored in
Source point is concentrated, and SourcePoint (x is obtainedi,yi,zi), i=1 ... n；
The manual selection of target signature point set described in position portion step 1 meets:
Using space position indicator be equipped with can positioning probe select on intramedullary needle and its threedimensional model on characteristic point corresponding position
Point, be stored in target point set, obtain target point set TargetPoint (x corresponding with source feature point seti,yi,zi), i=1 ...
n。
3. the positioning and air navigation aid of a kind of intramedullary needle nail hole based on 3-D image according to claim 1, feature
Be: the step of seeking of rotational translation matrix described in position portion step 3 includes:
Step 3.1: calculating nail hole central axes: the midpoint of the disc of a certain nail hole two sides is sought first, in intramedullary needle threedimensional model
The side of the upper nail hole evenly over the circumference takes four points, calculates midpoint of the arithmetic mean of instantaneous value as the side of four points, another
Side midpoint measures in the same way, and two midpoints determine straight line, the central axes as the nail hole；
Step 3.2: translation: assuming that the nail hole central axes P on intramedullary needle threedimensional model under image coordinate system0Starting point be
v1=(x1,y1,z1), terminal v2=(x2,y2,z2), the starting point of the central axes of intramedullary needle nail hole is moved into image coordinate system
Origin O, translation matrix areThe central axes of intramedullary needle nail hole are P=(x, y, z) after translation, whereinThen OP is the central axes obtained after translating；
Step 3.3: by P=(x, y, z) around X-axis rotated counterclockwise by angle α, rotating to OP on XOY plane, be denoted as OP2, P1For
For P in the subpoint in the face YOZ, coordinate is (0, y, z), P before rotating2Point is located in XOY plane, P2Point is in the subpoint of Y-axis
P3, P3It is P1Position in YOZ plane after X-axis rotated counterclockwise by angle α, then OP1Length be equal to OP3Length, P2Point
Y axis coordinate be subpoint OP in Y-axis1Length, beThen P2Putting coordinate isOP1With OP3
Angle be α, andThen the angle value of α is obtained using inverse cosine function；
Step 3.4: by OP2Angle beta is rotated clockwise about the z axis, is OP after rotation4, P2Point coordinate be The angle value of β then is obtained using inverse cosine function, arrives this, in intramedullary needle nail hole central axes and cylinder
Axis has been overlapped；
Step 3.5: by cylinder central axes carry out step 3.4,3.3 and 3.2 inverse transformation, specifically: firstly, cylinder central axes around
Z axis rotated counterclockwise by angle β, i.e. central axes and OP2It is overlapped, spin matrix TZ(-β)；Then, cylinder central axes are suitable around X-axis
Hour hands rotate angle [alpha], and cylinder central axes are overlapped with OP at this time, spin matrix TX(α)；Finally, cylinder central axes are carried out
Translation, translation matrix T, so far, the central axes of cylinder are overlapped with the central axes of intramedullary needle nail hole, final rotation
Translation matrix is TTX(α)·TZ(-β)。
4. the positioning and air navigation aid of a kind of intramedullary needle nail hole based on 3-D image according to claim 1, feature
It is: vertical range of the calculating bone drill tip to a certain nail hole central axes of intramedullary needle described in navigational portions step 1 specifically:
Registration matrix of the intramedullary needle nail hole central axes under image coordinate system in Origin And Destination coordinate premultiplication position portion step 2
L*K obtains the coordinate under positioning rigid body coordinate system, and then premultiplication positions the transformation matrix between rigid body and space position indicator again, obtains
To coordinate of the central axes Origin And Destination under space position indicator coordinate system, bone drill tip coordinate is caught in real time by space position indicator
It obtains, this 3 points coordinate is located under space position indicator coordinate system, calculates bone drill tip to intramedullary needle by this 3 coordinates
The vertical range of one nail hole central axes, specifically:
Assuming that the coordinate that tip T is bored in space position indicator coordinate system sending down the fishbone is (t1,t2,t3), intramedullary needle central axes starting point A1Coordinate is
(a1,b1,c1), terminal A2Coordinate is (a2,b2,c2), d is required distance, and ω isWithBetween angle,Cos ω, sin ω, d meet:
D=| A1T|·sinω。
5. the positioning and air navigation aid of a kind of intramedullary needle nail hole based on 3-D image according to claim 1, feature
Be: the critical value of the central axes of intramedullary needle nail hole described in navigational portions step 2 and bone drill axis angulation γ meet:
Assuming that cylinder cy1 radius where nail hole is r, height is unlimited；Cylinder cy2 diameter where bone drill is dD, height is unlimited, works as bone
When boring insertion nail hole, one end of cy2 and the inner wall of cy1 intersect at point cp1, and the central axes of cy1 are intersected with the central axes of cy2,
Then the other side inner wall of cy2 and cy1 intersects at point cp2, and a Duan Yuan is intercepted from cy1 by two cylindrical cross-sections of cp1 and cp2
Column, the cylinder height are h, then the central axes angle of the central axes of cy1 and cy2 are central axes and the bone drill axis of intramedullary needle nail hole
Line angulation γ meets:
If nail hole actual height is hn, then when h is equal to hnWhen, γ is critical value, the critical value of γ are as follows:
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