CN109805990B - Auxiliary positioning device and positioning system for puncture - Google Patents
Auxiliary positioning device and positioning system for puncture Download PDFInfo
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- CN109805990B CN109805990B CN201910185242.5A CN201910185242A CN109805990B CN 109805990 B CN109805990 B CN 109805990B CN 201910185242 A CN201910185242 A CN 201910185242A CN 109805990 B CN109805990 B CN 109805990B
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Abstract
The invention provides an auxiliary positioning device and a positioning system for puncture, wherein the auxiliary positioning device is provided with a first surface and a second surface, a plurality of first-class positioning points and a plurality of second-class positioning points are distributed on the first surface and the second surface respectively, one first-class positioning point is determined to be a puncture point by collecting image data comprising a target point and the first-class positioning points, a connecting line of the target point and the puncture point extends to the second surface and one second-class positioning point is determined through an intersection point, and the puncture point and the puncture angle are determined through the determined first-class positioning points and the determined second-class positioning points which are positioned on the same straight line with the target point; the positioning system comprises the auxiliary positioning device, the medical imaging equipment and the data processing device. The auxiliary positioning device and the positioning system for puncture can accurately position the target point by determining the puncture point and the puncture angle before puncture, and improve the puncture accuracy; and puncture can be performed in a state of stopping scanning, so that the safety of the puncture process is improved.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to an auxiliary positioning device and a positioning system for puncture.
Background
When lesions occur in internal tissues and organs of a human body, the lesions are often required to be accurately positioned by means of modern medical imaging technologies such as CT (Computed Tomography ) technology or MRI (Magnetic Resonance Imaging, nuclear resonance imaging) technology, and then directly reached to the lesions by using interventional instruments such as a puncture needle, a catheter, a guide wire and the like, and biopsied or treated. The details of the focus or organ can be determined by utilizing CT technology and MRI technology, so that the puncture point, puncture angle and puncture depth can be accurately determined, the damage to blood vessels, nerves and spinal cord can be avoided, and the method has the advantages of safety, accuracy, rapidness, simple and convenient operation, less pain of patients and the like, and has become an important means for a clinician to obtain primary diagnosis. Compared with the CT technology, the MRI technology has no ionizing radiation, no artifact and higher soft tissue resolution; but has poor spatial resolution and high price, and can generate inspection contraindications on in-vivo metal foreign matters. When a puncture is needed, the two imaging techniques are often selected according to the actual condition of the patient.
The existing puncture technology guided by the medical imaging technology mainly comprises two types, namely real-time puncture guiding and conventional puncture guiding.
The real-time guided puncture is to determine the optimal puncture point, angle and depth of the puncture needle by means of the image data output by the CT or MRI system, and then the doctor punctures the puncture needle and observe the position between the puncture needle and the kitchen range by means of the real-time CT or MRI image so as to adjust the direction at any time. The puncture is guided in real time, so that the accuracy and safety of the puncture are improved, and the pain of a patient is reduced. However, when the real-time CT guided puncture is performed, the doctor and the patient are irradiated by rays at the same time, so that the risk of the doctor being damaged by the rays is increased, and the operation times are limited. For example, one provision is that if the hands of a physician are directly exposed to radiation during each puncture, each exposure to a radiation dose of up to 120mSV, the same physician should puncture no more than four times per year. For real-time MRI guided puncture, although the risk of radiation is avoided, MRI imaging time is long, magnetic field compatibility requirements are high, the real-time MRI guided puncture is not suitable for intra-operative navigation of real-time images, and in addition, the real-time MRI guided puncture also limits the material of interventional instruments.
The conventional guided puncture is the most clinically used method at present, and after the optimal puncture point, puncture angle and puncture depth of the puncture needle are obtained by using the conventional CT or MRI technology, a doctor adopts a freehand experience method (Free hand Technique) to puncture the needle in a state of stopping scanning, then confirms the position through CT or MRI images, and readjusts the direction of the puncture needle to puncture the needle again until the puncture target point is hit. The technique has higher dependence on doctors' experience, great difficulty in clinical operation technique, lower accuracy and safety of puncture, and increased possibility of complications caused by puncture.
Disclosure of Invention
In order to avoid possible ray damage during puncture by acquiring images in real time through medical imaging equipment and improve puncture accuracy, the invention provides an auxiliary positioning device for puncture.
The auxiliary positioning device comprises a main body, wherein the main body is provided with a first surface and a second surface which are opposite, a plurality of first-class positioning points which can be positioned by using medical imaging equipment are distributed in the first surface, a plurality of second-class positioning points are distributed in the second surface, and connecting lines between the first-class positioning points and the second-class positioning points are used for determining a puncture angle, wherein before puncture, the first surface of the auxiliary positioning device is attached to a preset area on the skin surface, image data of a target point and the first-class positioning points are acquired by using the medical imaging equipment, one first-class positioning point is set as a puncture point, and one second-class positioning point at the intersection point of a straight line determined by the puncture point and the target point and the second surface is obtained.
Optionally, first grid lines are distributed in the first surface to determine the position of each locating point in the first surface, and the image data comprises a pattern of the first grid lines; and/or second grid lines are distributed in the second surface so as to determine the position of each second-class locating point in the second surface.
Optionally, the shape of the grid defined by the first grid line and the second grid line includes at least one of triangle, quadrangle, pentagon, hexagon, circle, ellipse.
Optionally, a distance between two adjacent grids defined by the first grid line and the second grid line is 0.05mm-2mm.
Optionally, the image device is a CT device, and the material of the first grid line includes at least one of lead, gold, tungsten, silver, copper, zinc, cobalt, cadmium, and chromium; or alternatively
The imaging device is MRI equipment, and the material of the first grid line is copper sulfate, cod liver oil or diluent of lard.
Optionally, the main body is of a cavity structure, and the main body is made of hot melt plastic.
Optionally, the cavity has a first inner wall near and parallel to the first surface and a second inner wall near and parallel to the second surface, a distance between the first surface and the first inner wall is 0.1mm-5mm, a distance between the first inner wall and the second inner wall is 5mm-50mm, and a distance between the second inner wall and the second surface is 0.1-5mm.
Optionally, the main body is made of transparent material, and the plurality of positioning points of one type in the first surface are visible to naked eyes from one side of the second surface.
Optionally, the adhesive further comprises a pressure-sensitive adhesive layer covering the first surface, and a side surface of the pressure-sensitive adhesive layer away from the first surface is covered with a release paper layer.
The present invention still further provides a positioning system for puncturing comprising:
The auxiliary positioning device for puncture;
The medical imaging equipment is used for acquiring image data of a target point and a type of positioning point in the first surface after attaching the first surface of the auxiliary positioning device to a preset area on the skin surface; and
The data processing device is used for outputting information of one type of locating point and one type of locating point for locating the puncture point and the puncture angle according to the image data, and the data processing device obtains the two types of locating points at the intersection point of the straight line determined by the puncture point and the target point and the second surface by setting the one type of locating point as the puncture point and taking the angle between the connecting line of the two types of locating points at the intersection point and the puncture point and the first surface as the puncture angle.
The auxiliary positioning device for puncture provided by the invention has a simple structure, and comprises a main body, wherein the main body is provided with a first surface and a second surface which are oppositely arranged and are respectively provided with a plurality of first-class positioning points and a plurality of second-class positioning points, one first-class positioning point is determined to be a puncture point by collecting image data comprising a target point and the plurality of first-class positioning points, a connecting line of the target point and the puncture point extends to the second surface, one second-class positioning point is determined through an intersection point, and the puncture point and a puncture angle can be positioned through one first-class positioning point and one second-class positioning point which are determined to be positioned on the same straight line with the target point. The auxiliary positioning device for puncture provided by the invention can be used for determining the puncture point and the puncture angle in advance so as to guide the puncture process, so that compared with the puncture action by collecting images in real time through medical imaging equipment, the risk of a doctor from being damaged by rays is greatly reduced, the puncture position is accurate, and the puncture effect is good. The auxiliary positioning device is simple in structure and convenient to operate, and can be suitable for different puncture occasions.
The positioning system for puncture provided by the invention comprises the auxiliary positioning device, the medical image equipment and the data processing device connected with the medical image equipment, wherein the data processing device can be used for obtaining one type of positioning point serving as a puncture point on the auxiliary positioning device and one type of positioning point corresponding to the connection line of the target point and the puncture point on the auxiliary positioning device extending to the intersection point of the second surface according to the image data of the target point acquired by the medical image equipment and one type of positioning point on the auxiliary positioning device, and the puncture angle can be determined through the obtained connection line of the one type of positioning point and the one type of positioning point, so that the positioning of the puncture point and the puncture angle is completed. The positioning system provided by the invention can determine one first-class positioning point and one second-class positioning point in the auxiliary positioning device, so that the puncture point and the puncture angle are determined before puncture, accurate positioning of a target point is realized, and the puncture accuracy is improved; and the positioning system can be used for puncturing in a state of stopping scanning, so that the safety of the puncturing process is improved.
Drawings
Fig. 1 is a schematic view of an auxiliary positioning device for puncturing according to an embodiment of the present invention.
Fig. 2 is a schematic view of a first surface of an auxiliary positioning device for puncturing according to an embodiment of the present invention.
Fig. 3 is a schematic view of puncturing using an auxiliary positioning device for puncturing in an embodiment of the present invention.
The reference numerals are as follows:
1-an auxiliary positioning device; 2-puncture needle; 11-a first surface; 12-a second surface; 21-a first mark; 22-a second mark; 31-target point; 32-puncture points; 33-intersection; 111-a class of anchor points; 121-class ii anchor points.
Detailed Description
Specific embodiments of the present invention will be described in more detail below with reference to the drawings. The advantages and features of the present invention will become more apparent from the following description. It should be noted that the drawings are in a very simplified form and are all to a non-precise scale, merely for convenience and clarity in aiding in the description of embodiments of the invention.
The embodiment of the invention provides an auxiliary positioning device for puncture, which has a simple structure and is convenient to operate, and the puncture point and the puncture angle are determined before puncture, so that the target point can be accurately positioned, and the puncture accuracy is improved; and the doctor can puncture under the state of stopping scanning, so that the risk of the doctor being damaged by rays is greatly reduced, and the safety of the puncture process is improved. As shown in fig. 1, a schematic view of an auxiliary positioning device for puncture according to an embodiment of the present invention is provided, where the auxiliary positioning device 1 includes a main body, and the main body has a first surface 11 and a second surface 12 opposite to each other.
In order to locate the puncture point, the auxiliary locating device 1 of the present embodiment has a plurality of locating points 111 distributed in the first surface 11, where the locating points 111 may be located by using a medical imaging device, such as CT or MRI, that is, image data of the locating points 111 may be acquired by the medical imaging device. For example, an imaging-facilitating material may be disposed within the first surface 11, such that the first surface 11 may be displayed in, for example, a CT or MRI photograph, and the plurality of one-type anchor points 111 may be obtained by patterning (e.g., gridding) the imaging material to obtain positions within the first surface 11, but is not limited thereto, and in another embodiment, the first surface 11 is located within a plane of a two-dimensional coordinate system, and the positions of the plurality of one-type anchor points 111 within the first surface 11 may also be obtained by coordinates thereof in the two-dimensional coordinate system.
In this embodiment, the first surface 11 is the auxiliary positioning device 1 is used for being attached to skin to be punctured of a human body (or an animal), and after the auxiliary positioning device 1 is attached to the skin surface, image data of a target point and the plurality of positioning points 111 are acquired by using a medical imaging device, and one positioning point 111 is determined to be a puncturing point. Wherein the target point is a target point of puncture, such as a focus point located at a certain distance under the skin. The image data is selected from at least one of two-dimensional image data, three-dimensional image data, and three-dimensional reconstruction data. Here, the two-dimensional image data is, for example, image data obtained by imaging a cross-sectional image of any of the coronary, sagittal, transverse, and oblique axes of the tissue and organ; the three-dimensional image data are three-dimensional images formed by combining two-dimensional section data obtained by shooting through a three-dimensional imaging function of the medical imaging equipment, and the three-dimensional image data usually have coordinates and are directly visible on a display device of the medical imaging equipment; the three-dimensional reconstruction data refers to the data collected by the medical imaging equipment, and is combined with other three-dimensional modeling and three-dimensional visualization software to perform more accurate three-dimensional reconstruction, so that the structure of the tissue organ can be more clearly presented. In this embodiment, the type of the graphics data may be flexibly selected according to the actual situation.
In this embodiment, the first surface 11 may have first grid lines distributed therein, and the first grid lines are used to facilitate clear and direct acquisition of the positions of all the positioning points 111 on the first surface 11, for example, the first grid lines may be used to assist in determining one positioning point 111 as a puncture point.
Fig. 2 is a schematic view of the first surface 11 of the auxiliary positioning device 1 according to an embodiment of the present invention. As shown in fig. 2, the first grid line preferably includes a plurality of transverse straight lines parallel to each other and a plurality of longitudinal straight lines parallel to each other, and the positions of the plurality of positioning points 111 may be in one-to-one correspondence with intersections formed by the plurality of transverse straight lines and the plurality of longitudinal straight lines, or may be in one-to-one correspondence with a plurality of grids defined by the transverse straight lines and the longitudinal straight lines. In another embodiment, the first grid line may also include multiple sets of parallel straight lines or arcs with different angles, for example, the shape of the grid defined by the first grid line may include at least one of triangle, quadrangle, pentagon, hexagon, circle, ellipse.
In this embodiment, the edge of the first surface 11 may be provided with scales to determine (or quantify) the positions of the positioning points 111 of one type by coordinates in a two-dimensional coordinate system, for example, but not limited to, two coordinate axes of the two-dimensional coordinate system may be disposed at two mutually perpendicular edges of the first surface 11, and the two coordinate axes of the two-dimensional coordinate system may also form an angle with the edge of the first surface 11, so that the positions of the positioning points 111 of each type may be determined according to the coordinate values, so as to facilitate the identification of the positions of the positioning points 111 of one type as the puncture points in, for example, three-dimensional image data or three-dimensional reconstruction data. Of course, the edge of the first surface 11 may further be provided with a distinguishing mark, for example, each row and each column of the first grid line corresponds to a different distinguishing mark, and the distinguishing mark is also collectable under the medical imaging device, so that the row and the column corresponding to one type of positioning point 111 serving as the puncture point can be determined according to the two-dimensional image data, and thus the position of one type of positioning point 111 serving as the puncture point can be more conveniently and definitely determined. The distinguishing marks may be different patterns, for example, each row or each column corresponds to a pattern which can be distinguished from each other under two-dimensional image data, such as a rectangle, a star or a different number of lines, or may be graduations or graduation numerals. In addition, instead of positioning by means of the first grid lines, a plurality of the positioning points 111 of one type may be arranged on the first surface 11 in a scattered developing point manner, and each positioning point 111 of one type may be directly developed according to, for example, three-dimensional image data or three-dimensional reconstruction data obtained from a medical imaging device, so as to mark each positioning point 111 of one type. The distribution manner of the plurality of point-shaped positioning points 111 on the first surface 11 can be designed according to the requirement, for example, the distribution manner can be array distribution or divergent distribution, etc.
In order to acquire data of a type of positioning points 111 on the first surface 11, in this embodiment, the acquisition is assisted by a first grid line, for example, so that the image data includes a pattern of the first grid line. When the imaging device is a CT device, the material of the first grid line may include at least one of metals such as lead, gold, tungsten, silver, copper, zinc, cobalt, cadmium, and chromium, or may also be at least one of alloys including metal elements such as lead, gold, tungsten, silver, copper, zinc, cobalt, cadmium, and chromium; in the case of an MRI apparatus, for example, the material of the first grid line may be copper sulfate, cod liver oil or a diluent of lard or a combination thereof, but is not limited thereto, and an appropriate material may be selected to form the first grid line according to the imaging principle of a medical imaging apparatus specifically adopted. In the case of the image apparatus, for example, a CT apparatus, the first grid line material is metal, and thus, the method of forming the first grid line may be bonding the wire of the material to the first surface 11, plating the material on the first surface 11, or other methods disclosed in the art. In the case of the imaging device, for example, the MRI device, the first gridline material is in a liquid state, so that the first gridline may be formed by injecting the material into a hollow thin rubber tube, and applying the thin rubber tube to the first surface 11, for example, by bonding. A similar method may be used when the first type of positioning points 111 are arranged on the first surface 11 in a dispersed developing point manner.
A plurality of second-class positioning points 121 are distributed in the second surface 12, and the puncture angle is determined by the connection line between the determined second-class positioning point 121 and the puncture point. Specifically, after the target point is obtained and the puncture point is determined by the medical imaging device, the connection line between the puncture point and the target point is extended to the second surface 12 to obtain a uniquely determined intersection point, where the intersection point corresponds to one second-class positioning point 121. The angle of penetration is determined by the angle of the line between the determined one type of anchor point 121 and the determined one type of anchor point 111 with the first surface 11.
In this embodiment, the second grid lines on the second surface 12 may also be similar to the arrangement of fig. 2, where the second grid lines preferably include a plurality of parallel transverse lines and a plurality of parallel longitudinal lines, and the positions of the second type positioning points 121 may be in one-to-one correspondence with intersections formed by the transverse lines and the longitudinal lines, or may be in one-to-one correspondence with a plurality of grids defined by the transverse lines and the longitudinal lines. In another embodiment, the grid lines may also include a plurality of sets of parallel straight lines or arcs with different angles, and the shape of the grid defined by the second grid lines may include at least one of triangle, quadrangle, pentagon, hexagon, circle, ellipse. The edges of the second surface 12 may be provided with scales so as to determine (or quantify) the positions of the second-class positioning points 121 in a two-dimensional coordinate system, for example, two coordinate axes of the two-dimensional coordinate system may be provided at two edges of the second surface 12 perpendicular to each other, but not limited thereto, and the two coordinate axes of the two-dimensional coordinate system may also form an angle with the edges of the second surface 12, so that the positions of the second-class positioning points 121 may be quantified according to the coordinate values, so as to, for example, correspond the coordinates of the intersection point between the puncture point and the target point obtained by calculation and the second surface 12 to one second-class positioning point 121.
One type of anchor point 121 corresponding to the intersection of the line of the puncture point and the target point with the second surface 12 may be determined, for example, by coordinate calculation of the puncture point and the target point, so that information of the type of anchor point 121 may not be acquired when obtaining image data by the medical image device. Thus, the second grid lines may be printed on the second surface 12 using ink, or may be formed directly during the molding of the second surface 12. Of course, the second grid line may also be acquirable in the medical imaging device, and the material constituting the second grid line may be the same as the material constituting the first grid line, for example, so that the intersection point obtained by extending the line connecting the puncture point and the target point to the second surface 12 may be directly obtained in three-dimensional image data or three-dimensional reconstruction data, for example.
After the puncture point and the puncture angle are obtained by the auxiliary positioning device 1, the skin can be punctured from the position of the puncture point at the puncture angle. In a preferred embodiment, after the puncture point and the puncture angle are obtained by using the auxiliary positioning device 1 of the present embodiment, the positions of the determined one-class positioning point 111 (as the puncture point) and one-class positioning point 121 (for determining the puncture angle together with the puncture point) may be marked on the auxiliary positioning device 1, and when the puncture is performed, the auxiliary positioning device 1 may be reattached to the previous position (i.e., the original preset position of the skin) again, and then a puncture needle sequentially passes through the determined one-class positioning point 121 and one-class positioning point 111 marked on the auxiliary positioning device 1 to perform the puncture.
Specifically, the puncture needles commonly used in the art for puncturing are 6, 7, 8, 9, 12, 14 and 16 (corresponding to the outer diameters of the needle tubes of 0.6, 0.7, 0.8, 0.9, l.2, l.4 and 1.6mm respectively), for example, a puncture needle commonly used for arterial puncture of 12, 14 or 16, a puncture needle commonly used for lumbar puncture of 8, a puncture needle commonly used for amniotic fluid puncture of 8 or 12, and a puncture needle commonly used for radioactive particles must be used for puncturing. Since the puncture needle in one embodiment needs to pass through one determined first-class positioning point 111 and one determined second-class positioning point 121 located at the intersection point of the first grid line and the intersection point of the second grid line, the distance between two adjacent grids defined by the first grid line and the second grid line needs to be reasonably set correspondingly, and the distance between the two adjacent grids is preferably larger than the outer diameter of the puncture needle, so that, for example, multiple puncture (such as taking biopsies at multiple areas of one focal zone or taking biopsies or treatments at multiple focal zones) needs to be performed, or when the auxiliary positioning device 1 is to be used for multiple times, interference to use of other first-class positioning points 111 and second-class positioning points 121 can be avoided. However, the puncture needle is not limited to this, and may be of a conventional size, and may be of a smaller size when performing a precise puncture or a puncture for some smaller animals. In addition, according to the purpose of puncture, other interventional instruments such as a metal guide wire and a catheter with a puncture function can be used for puncture in the art.
In addition, the distribution of the first-class positioning points 111 and the second-class positioning points 121 on the auxiliary positioning device 1 can be designed according to factors such as the object for implementing the puncture, the puncture position and the like. For example, if the distance between two adjacent grids is set too large, the distribution of the first-class anchor points 111 and the second-class anchor points 121 is sparse, and when determining one first-class anchor point 111, it may be difficult to find an appropriate first-class anchor point 111 as a puncture point; in determining one of the two types of anchor points 121, the determined coordinates may not correspond to one of the intersections on the second grid line or be too far from two adjacent intersections to be corrected, thereby affecting the positioning of the puncture point and the puncture angle and affecting the puncture accuracy.
In the embodiment of the invention, the distance between two adjacent grids defined by the first grid line and the second grid line is preferably set to be 0.05mm-2mm in consideration of the use effect and the positioning accuracy of the puncture needle, so that the better use effect and the positioning accuracy are obtained.
In addition, in this embodiment, the first surface 11 and/or the second surface 12 may be further partitioned, and the adjacent two grid intervals in the first grid line or the second grid line in different areas may be set to the same or different values, so as to meet the needs of different puncture occasions on the same auxiliary positioning device 1. In general, in order to facilitate obtaining the puncture points and the puncture angles, the grids of the first grid line and the second grid line are uniformly arranged, and in order to facilitate the uniformity of quantization of the first-type positioning points 111 and the second-type positioning points 121, the adjacent two grids in different directions are preferably arranged to be equal in pitch.
After completing the selection of one type of positioning point 111 as a puncture point and one type of positioning point 121 for determining a puncture angle, a doctor can pass through the two types of positioning points 121 and the one type of positioning point 111 in sequence by using a puncture needle under the condition of stopping scanning and then reach a target point, so as to accurately puncture from a predetermined puncture point according to a predetermined puncture angle. In order to make the puncture needle accurately reach the positioning points 111, the positioning points 111 of the first type in the first surface 11 are preferably visible from the second surface 12, for example, the main body of the auxiliary positioning device 1 may be made of transparent material. In a preferred embodiment of the present invention, in order to enable the puncture needle to smoothly reach a type of positioning point 111, the main body of the auxiliary positioning device 1 may also have a cavity structure, where the cavity has a first inner wall close to and parallel to the first surface 11 and a second inner wall close to and parallel to the second surface 12. In order to reduce the penetration error and prevent interference with the penetration needle, the distance between the first surface 11 and the first inner wall is preferably 0.1mm-5mm, and the distance between the second inner wall and the second surface 12 is preferably 0.1mm-5mm; in order to facilitate the direction of the lancet adjustment, a distance is maintained between the first inner wall and the second inner wall, which is preferably 5mm to 50mm. In the case of performing a puncture by attaching the auxiliary positioning device 1 with a cavity to the skin, a through hole may be formed in the auxiliary positioning device 1 through the determined one type of positioning point 111 and one type of positioning point 121 before performing the puncture, and the through hole is preferably formed after the one type of positioning point 111 and one type of positioning point 121 are determined. In this embodiment, the main body of the auxiliary positioning device 1 is, for example, a hot-melt plastic material, so that the positions of the first type of positioning points 111 and the second type of positioning points 121, which are correspondingly determined on the plastic, can be conveniently penetrated by using hot-pressing pliers, or can be penetrated by using laser or a drill, so that the time cost generated by forming a hole site in advance at each intersection point of the first grid line and the second grid line is reduced, the interference generated by other hole sites can be reduced, the positions of the determined first type of positioning points 111 and the determined second type of positioning points 121 are more obvious, and the possibility of misoperation of doctors is reduced. However, the present invention is not limited thereto, and a person skilled in the art may form a hole in advance at each intersection point of the first grid line and the second grid line, for example, a grid formed by the first grid line or the second grid line on the auxiliary positioning device 1 may be set as a mesh, and the puncture needle may directly penetrate through the mesh to puncture.
In this embodiment, after determining the first-class positioning point 111 and the second-class positioning point 121 for positioning the puncture point and the puncture angle before puncturing, the auxiliary positioning device 1 may be fixed at the same preset position on the skin during puncturing, so as to puncture with the determined first-class positioning point 111 and second-class positioning point 121. For this reason, it is preferable in this embodiment to cover the pressure-sensitive adhesive layer on the first surface 11, and to cover a release paper layer on a side surface of the pressure-sensitive adhesive layer remote from the first surface 11 to protect the pressure-sensitive adhesive layer. The auxiliary positioning device 1 can be adhered and fixed on the skin surface of a human body by lightly pressurizing, is simple and convenient, and can be repeatedly used. In addition, the auxiliary positioning device 1 may be fixed in other manners, such as medical adhesive tape, etc., and the first surface 11 of the auxiliary positioning device 1 may be provided with a suction cup to be stably attached to a predetermined area to be pierced.
The auxiliary positioning device 1 provided by the embodiment of the invention is used before puncture, and puncture points and puncture angles are obtained by combining images shot by medical imaging equipment; on the other hand, the auxiliary positioning device 1 is used for navigating the needle inserting position and angle of the puncture needle and even the puncture depth during puncture, has simple structure and lower manufacturing cost, can be repeatedly used, and can also be used as a disposable medical tool. Specifically, referring to fig. 3, in an embodiment of the present invention, a schematic diagram of performing puncturing with the auxiliary positioning device 1 for puncturing, a method for positioning and puncturing with the auxiliary positioning device 1 for puncturing may include the following steps:
step S1, fixing the first surface 11 of the auxiliary positioning device 1 in a preset area of the skin surface;
step S2, stopping scanning after obtaining image data around a preset area by medical image equipment, wherein the image data comprises position data of a target point 31 and position data of a locating point 111 in the first surface 11;
step S3, setting a first-class positioning point 111 as a puncture point 32 according to image data, and obtaining a second-class positioning point 121 at an intersection point 33 of a straight line determined by the puncture point 32 and the target point 31 and the second surface 12, wherein an angle between a connecting line of the determined second-class positioning point 121 and the determined first-class positioning point 111 and the first surface 11 is used as a puncture angle;
Step S4, the auxiliary positioning device 1 is fixed on the original preset area of the skin surface again, so that the puncture needle 2 passes through the auxiliary positioning device 1 from one type of positioning point 121 of the corresponding intersection point 33, and advances from one type of positioning point 111 of the corresponding puncture point 32 to the target point 31.
In step S1, the first surface 11 of the auxiliary positioning device 1 in this embodiment may be fixed to a predetermined area of the skin surface by pressure-sensitive adhesive bonding. When the auxiliary positioning device 1 is used, the release paper layer is covered on the surface of the pressure-sensitive adhesive so as to prevent the adhesiveness of the pressure-sensitive adhesive from being reduced, thereby facilitating the re-adhesion of the auxiliary positioning device 1 to the original preset area or the repeated use of other puncture occasions in the step S4. The predetermined area refers to a range of the skin surface to be pierced, and for example, a range for the insertion of the puncture needle 2 after rough judgment by a doctor can be taken as the predetermined area.
In step S3, the manner in which the puncture point 32 is obtained is: the doctor evaluates the patient on the basis of the image data and selects a type of anchor point 111 to form an optimal penetration path with the target point 31. Further, when the image data is two-dimensional image data, as described above, each of the positioning points 111 of one type may be distinguished by further setting a distinguishing mark for distinguishing each row and each column of the first grid line around the first grid line, so that one positioning point 111 of one type corresponding to the puncture point 32 may be correspondingly determined by different distinguishing marks displayed on the two-dimensional image data; if the image data is three-dimensional image data or three-dimensional reconstruction data, an appropriate type of anchor point 111 can be intuitively selected as the puncture point 32 based on the image data.
The method of obtaining the two-class anchor point 121 corresponding to the intersection point 33 is, for example, by calculating, to set an orthogonal coordinate system, where the first surface 11 is located in an XY plane of the orthogonal coordinate system, and the second surface 12 is parallel to the first surface 11, so that each two-class anchor point 111 in the first surface 11 and each two-class anchor point 121 in the second surface 12 correspond to three-dimensional coordinate values determined in the orthogonal coordinate system. As an example, obtaining the position of the intersection 33 may include the following process: with the direction perpendicular to the first surface 11 being the Z-axis direction and the first surface 11 being the plane with z=0, the coordinates of the target point 31 in the orthogonal coordinate system being (X1, Y1, Z1) and the coordinates of the puncture point 32 in the orthogonal coordinate system being (X2, Y2, 0) are obtained, and a straight line in a three-dimensional space formed by connecting the target point 31 and the puncture point 32 can be uniquely determined, and the following straight line formula (1) is satisfied:
（X-X2)/(X1-X2)=(Y-Y2)/(Y1-Y2)=Z/Z1 （1）
Wherein X, Y, Z refers to the coordinate values of the points on the uniquely determined straight line on the X-axis, Y-axis, and Z-axis, respectively. The Z-axis coordinate z3=h of the intersection point 33 is obtained according to the distance H between the first surface 11 and the second surface 12, that is, the coordinates of the intersection point 33 are (X3, Y3, H), and the X-axis and Y-axis coordinate values of the intersection point 33 are obtained by taking the coordinates into the linear formula (1), so as to obtain a second-class positioning point 121 corresponding to the coordinate values of the intersection point 33.
In another embodiment, one second-class positioning point 121 corresponding to the intersection point 33 may be obtained by modeling, for example, an additional model may be further added based on the obtained three-dimensional image data and three-dimensional reconstruction data, in this embodiment, even if the obtained image data does not include the second-class positioning point 121 on the second surface 12, for example, when the second-class positioning point 121 on the second surface 12 cannot be acquired by the medical imaging device due to factors such as materials, the obtained three-dimensional image data and the three-dimensional reconstruction data may be further modeled and a pattern corresponding to the second grid line of the second surface 12 may be added, then, a connecting line between the target point 31 and the puncture point 32 may be extended to the second surface 12 in the model, and coordinate values of the second-class positioning point 121 corresponding to the intersection point 33 may be directly read out, and in this manner, a path of the puncture needle 2 punctured by the auxiliary positioning device 1 may be further intuitively simulated.
In yet another embodiment, the second grid lines of the second surface 12 may also be formed as lines that are developable under the medical imaging device, so that the modeling step is omitted, and the coordinates of the intersection points 33 in the three-dimensional image data and the three-dimensional reconstruction data may be read directly by the data processing device, for example.
In addition, for example, in the case where the coordinates of the intersection 33 are not exactly at a certain intersection of the second grid line, the coordinate value needs to be corrected so as to correspond to the nearest intersection for the convenience of observation and operation. Here, the puncture error due to correction can be reduced by setting the interval between adjacent two grids in the second grid line small enough.
In step S4, before performing the puncture, a through hole is also formed at the position of one type of positioning point 111 and one type of positioning point 121 determined on the auxiliary positioning device 1 so as to pass through the puncture needle 2. As described above, for example, in one embodiment, the main body of the auxiliary positioning device 1 is made of hot melt plastic, and after the positions of one first-class positioning point 111 and one second-class positioning point 121 for determining the puncture angle are obtained as the puncture point 32, the positions of the first-class positioning point 111 and the second-class positioning point 121 corresponding to the obtained positions on the plastic main body can be penetrated by heating with a pair of hot clamps, or laser or drill bit can be used for penetration. Of course, a hole site may be formed in advance at each intersection of the grid-like pattern of the first surface 11 and the second surface 12.
In step S4, it is determined that the puncture needle 2 reaches the target point 31 by the following method:
The distance between the puncture point 32 and the target point 31 is obtained, which can be used as the puncture depth. In addition, the puncture needle 2 may be provided with a plurality of scales, for example, a first mark 21 is provided on the puncture needle 2, the distance between the first mark 21 and the tip of the puncture needle 2 is equal to the puncture depth, and when the first mark 21 reaches the puncture point 32, the puncture needle 2 is judged to reach the target point 31; or a second mark 22 is arranged on the puncture needle 2, the distance between the second mark 22 and the needle tip of the puncture needle 2 is equal to the total length value of the puncture depth plus the distance between the intersection point 33 and the puncture point 32, and when the second mark 22 reaches the intersection point 33, the puncture needle 2 is judged to reach the target point 31.
The auxiliary positioning device 1 for puncture provided in this embodiment may also be used in the case of multipoint puncture, for example, when a biopsy needs to be taken from multiple areas of a focal zone or when a biopsy or treatment needs to be taken from multiple focal zones in one operation, multiple target points 31 may be sequentially recorded, multiple corresponding puncture points 32 and intersection points 33 may be obtained, and then multiple determined first-class positioning points 111 and second-class positioning points 121 on the auxiliary positioning device 1 may be respectively corresponding to each other, and puncture may be sequentially performed by using the auxiliary positioning device 1.
The auxiliary positioning device for puncture provided by the embodiment of the invention has a simple structure, and comprises a main body, wherein the main body is provided with a first surface and a second surface which are oppositely arranged and are respectively distributed with a plurality of first-class positioning points and a plurality of second-class positioning points, one first-class positioning point is determined to be a puncture point by collecting image data comprising a target point and the plurality of first-class positioning points, a connecting line of the target point and the puncture point extends to the second surface, one second-class positioning point is determined through an intersection point, and the puncture point and a puncture angle can be positioned through the one first-class positioning point and the one second-class positioning point which are determined to be positioned on the same straight line with the target point. The auxiliary positioning device for puncture provided by the embodiment of the invention can be used for determining the puncture point and the puncture angle in advance so as to guide the puncture process, so that compared with the puncture action by collecting images in real time through medical imaging equipment, the risk of the doctor being damaged by rays is greatly reduced, the puncture position is accurate, and the puncture effect is good. The auxiliary positioning device is simple in structure and convenient to operate, and can be suitable for different puncture occasions.
The embodiment of the invention also provides a positioning system for puncture, which comprises the auxiliary positioning device 1, the medical image equipment and a data processing device connected with the medical image equipment. The medical imaging device is used for acquiring image data of a target point 31 and a locating point 111 in the first surface 11 after attaching the first surface 11 of the auxiliary locating device 1 to a preset area of the skin surface; the data processing device is used for outputting information of one first-class positioning point 111 and one second-class positioning point 121 for positioning the puncture point 32 and the puncture angle according to the image data, and the data processing device obtains the second-class positioning point 121 at the intersection point 33 of the straight line determined by the puncture point 32 and the target point 31 and the second surface 12 by setting the first-class positioning point 111 as the puncture point 32, and takes the angle between the connecting line of the second-class positioning point 121 and the puncture point 32 at the intersection point 33 and the first surface 11 as the puncture angle.
The data processing means may for example comprise a calculation module for calculating the position of the intersection point 33; for example, a modeling module may be further included, and the modeling module may further add an additional model based on the obtained three-dimensional image data and the three-dimensional reconstruction data, so as to directly read out the position of the intersection point 33; for example, a correction module may be further included for correcting the coordinate value to be the nearest intersection point for the case where the coordinate of the intersection point 33 is not located exactly at a certain intersection point of the second grid line.
The positioning system for puncture can be applied to the prepositioning of various puncture occasions such as lumbar puncture, cervical vertebra puncture, amniotic fluid puncture, arterial puncture, radioactive particle puncture and the like, and can be used for puncture under the condition that the medical image equipment stops scanning.
The positioning system for puncture provided by the embodiment of the invention comprises the auxiliary positioning device, the medical image equipment and the data processing device connected with the medical image equipment, wherein the data processing device can be used for obtaining one type of positioning point serving as a puncture point on the auxiliary positioning device and one type of positioning point extending to the intersection point of the second surface corresponding to the connecting line of the target point and the puncture point on the auxiliary positioning device according to the image data of the target point acquired by the medical image equipment and one type of positioning point on the auxiliary positioning device, and the puncture angle can be determined through the obtained connecting line of the one type of positioning point and the one type of positioning point, so that the positioning of the puncture point and the puncture angle is completed. The positioning system provided by the embodiment of the invention can determine one first-class positioning point and one second-class positioning point in the auxiliary positioning device, so that the puncture point and the puncture angle are determined before puncture, accurate positioning of a target point is realized, and the puncture accuracy is improved; and the positioning system can be used for puncturing in a state of stopping scanning, so that the safety of the puncturing process is improved.
The foregoing is merely a preferred embodiment of the present invention and is not intended to limit the scope of the claims. Any person skilled in the art may make any equivalent substitution or modification to the technical solution and technical content disclosed in the present invention without departing from the spirit and scope of the present invention. Therefore, any simple modification, equivalent variation and modification of the above embodiments according to the technical substance of the present invention fall within the protection scope of the present invention.
Claims (9)
1. The auxiliary positioning device for puncture comprises a main body, wherein the main body is provided with a first surface and a second surface which are opposite and solid, and is characterized in that a plurality of first-class positioning points which can be positioned by using medical imaging equipment are distributed in the first surface, a plurality of second-class positioning points are distributed in the second surface, a connecting line between the first-class positioning points and the second-class positioning points is used for determining a puncture angle, the first surface of the auxiliary positioning device is attached to a preset area of the skin surface before puncture, the medical imaging equipment is used for acquiring image data of a target point and the first-class positioning points, one first-class positioning point is set as a puncture point, and one second-class positioning point at the intersection point of a straight line determined by the puncture point and the target point and the second surface is obtained; the main body is of a cavity structure, and the main body is made of hot melt plastics.
2. The auxiliary positioning device for puncture of claim 1, wherein first grid lines are distributed in the first surface to determine the position of each of the one type of positioning points in the first surface, the image data including a pattern of the first grid lines; and/or second grid lines are distributed in the second surface so as to determine the position of each second-class locating point in the second surface.
3. The auxiliary positioning device for puncture of claim 2, wherein the shape of the mesh defined by the first and second mesh lines comprises at least one of triangle, quadrangle, pentagon, hexagon, circle, ellipse.
4. The auxiliary positioning device for puncture as set forth in claim 2, wherein a distance between two adjacent grids defined by the first grid line and the second grid line is 0.05mm to 2mm.
5. The auxiliary positioning device for puncture according to claim 2, wherein the imaging device is a CT device, and the material of the first grid line includes at least one of lead, gold, tungsten, silver, copper, zinc, cobalt, cadmium, and chromium; or alternatively
The imaging device is MRI equipment, and the material of the first grid line is copper sulfate, cod liver oil or diluent of lard.
6. The auxiliary positioning device for puncture according to claim 1, wherein the cavity has a first inner wall near and parallel to the first surface and a second inner wall near and parallel to the second surface, a distance between the first surface and the first inner wall is 0.1mm to 5mm, a distance between the first inner wall and the second inner wall is 5mm to 50mm, and a distance between the second inner wall and the second surface is 0.1mm to 5mm.
7. The auxiliary positioning device for puncture according to claim 1, wherein the main body is made of transparent material, and the plurality of positioning points of one kind in the first surface are visible to the naked eye from the side of the second surface.
8. The auxiliary positioning device for puncture as set forth in claim 1, further comprising a pressure-sensitive adhesive layer covering the first surface, a side surface of the pressure-sensitive adhesive layer remote from the first surface being covered with a release paper layer.
9. A positioning system for puncturing, comprising:
The auxiliary positioning device as claimed in any one of claims 1 to 8;
The medical imaging equipment is used for acquiring image data of a target point and a type of positioning point in the first surface after attaching the first surface of the auxiliary positioning device to a preset area on the skin surface; and
The data processing device is used for outputting information of one type of locating point and one type of locating point for locating the puncture point and the puncture angle according to the image data, and the data processing device obtains the two types of locating points at the intersection point of the straight line determined by the puncture point and the target point and the second surface by setting the one type of locating point as the puncture point and taking the angle between the connecting line of the two types of locating points at the intersection point and the puncture point and the first surface as the puncture angle.
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| CN111134798A (en) * | 2020-02-12 | 2020-05-12 | 山东航维骨科医疗器械股份有限公司 | Spine minimally invasive guider |
| CN112651963B (en) * | 2021-01-08 | 2024-02-20 | 中国大熊猫保护研究中心 | Data processing method, device and storage medium for panda lumbar puncture |
| CN113081188A (en) * | 2021-03-02 | 2021-07-09 | 四川大学华西医院 | CT and nuclear magnetic resonance auxiliary positioning identification point device and using method thereof |
| CN113662592B (en) * | 2021-08-13 | 2023-11-21 | 深圳大学 | Puncture path planning method, medical image acquisition system, device and medium |
| CN113907879A (en) * | 2021-10-08 | 2022-01-11 | 上海市杨浦区中心医院(同济大学附属杨浦医院) | Personalized cervical endoscope positioning method and system |
| CN114305612B (en) * | 2021-12-28 | 2023-12-29 | 天津市胸科医院 | CT guided puncture positioning device |
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