CN110464460B - Method and system for cardiac intervention operation - Google Patents

Method and system for cardiac intervention operation Download PDF

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CN110464460B
CN110464460B CN201910641609.XA CN201910641609A CN110464460B CN 110464460 B CN110464460 B CN 110464460B CN 201910641609 A CN201910641609 A CN 201910641609A CN 110464460 B CN110464460 B CN 110464460B
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CN110464460A (en
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章东
孙嘉康
赵东生
张冬宇
王静
缪莹莹
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Jiangsu Tingsn Technology Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2063Acoustic tracking systems, e.g. using ultrasound
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2576/00Medical imaging apparatus involving image processing or analysis
    • A61B2576/02Medical imaging apparatus involving image processing or analysis specially adapted for a particular organ or body part
    • A61B2576/023Medical imaging apparatus involving image processing or analysis specially adapted for a particular organ or body part for the heart

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Abstract

The embodiment of the invention discloses a method and a system for cardiac interventional surgery, which comprises the following steps of S1, radiating high-frequency ultrasonic waves to a heart cavity, acquiring a two-dimensional cardiac ultrasonic image, and constructing a three-dimensional model of the heart according to the two-dimensional ultrasonic image; s2, determining the real-time position of the low-frequency ultrasound generating device in the heart; s3, acquiring the distance between the position of the heart needing to be treated and the ultrasonic blade; s4, controlling the equipment for low-frequency ultrasound to perform targeted therapy, and placing the ultrasound transmitting device on the interventional catheter to realize the acquisition of a three-dimensional image of the heart and the realization of the function of performing the operation on the focus position.

Description

Method and system for cardiac intervention operation
Technical Field
The embodiment of the invention relates to the technical field of cardiac surgery equipment, in particular to a method and a system for cardiac interventional surgery.
Background
Ultrasound (US) medicine is a subject that combines acoustics, medicine, optics, and electronics. Ultrasound medicine is the application of acoustic technology in the medical field where frequencies higher than audible sound are studied. Including ultrasonic diagnosis, ultrasonic treatment and biomedical ultrasonic engineering, so that the ultrasonic medicine has the characteristics of combining medical science, theory and engineering, has wide related contents and has high value in preventing, diagnosing and treating diseases.
Ultrasonic imaging is to scan human body with ultrasonic sound beam, receive and process reflected signal to obtain image of internal organs. There are a number of commonly used ultrasound instruments: the type a (amplitude modulation type) indicates the strength of the reflected signal with the amplitude, and a "echo diagram" is shown. The M-mode (spot scanning mode) represents the spatial position from shallow to deep in the vertical direction and time in the horizontal direction, and is shown as a graph of the movement of the spot at different times. The two types are displayed in one dimension, and the application range is limited. Type B (brightness modulation type), namely ultrasonic section imager, is called B-ultrasonic for short. The light spots with different brightness are used for representing the strength of the received signal, when the probe moves along the horizontal position, the light spots on the display screen also move synchronously along the horizontal direction, and the light spot tracks are connected into a sectional view scanned by the ultrasonic sound beams, so that two-dimensional imaging is realized. The D-mode is made according to the ultrasonic Doppler principle, and the C-mode is a scanning mode similar to a television and displays a transverse section acoustic image perpendicular to an acoustic beam. In recent years, ultrasonic imaging techniques such as gray scale display and color display, real-time imaging, ultrasonic holography, transmission ultrasonic imaging, ultrasound parallel tomography, three-dimensional imaging, ultrasonic imaging in body cavities, and the like have been developed.
The ultrasonic imaging method is commonly used for judging the position, size and shape of an organ, determining the range and physical properties of a focus, providing an anatomical map of glandular tissues and identifying the normality and abnormality of a fetus, and is widely applied to ophthalmology, obstetrics and gynecology, cardiovascular systems, digestive systems and urinary systems.
Cardiovascular diseases, also called circulatory system diseases, are a series of diseases related to the circulatory system, the circulatory system refers to organs and tissues in the human body which transport blood, mainly including heart and blood vessels (artery, vein and micro blood vessel), the cardiovascular diseases are always the first killers threatening human health, and the incidence rate, disability rate and lethality rate are high. In the last decade, cardiac intervention surgery is widely applied to clinic, greatly improving the cure rate and survival rate of cardiovascular diseases, and enabling countless patients to benefit. Because the anatomical structure and the size of the heart have larger individual difference, the three-dimensional heart structure model of each patient is acquired before the operation, which is favorable for improving the safety and the success rate of the operation.
However, the most common method for performing three-dimensional modeling on the heart in clinical practice is a method for performing three-dimensional reconstruction on the heart based on CT, but this method cannot acquire a three-dimensional model of the heart in real time during the operation, and is also inconvenient for assisting in therapy, so that there is a need for a device for performing modeling on the heart in real time and performing therapy at the same time.
Disclosure of Invention
Therefore, the embodiment of the invention provides a method and a system for cardiac interventional surgery, which aim to solve the problem that in the prior art, a focus cannot be treated while a heart cannot be modeled in real time in an intraoperative process due to immature technology.
In order to achieve the above object, the embodiments of the present invention provide the following technical solutions:
according to a first aspect of an embodiment of the present invention, a method for cardiac interventional surgery includes step S1, radiating preset high-frequency ultrasonic waves to a heart cavity, acquiring a two-dimensional cardiac ultrasound image, and constructing a three-dimensional model of a heart according to the two-dimensional cardiac ultrasound image; s2, determining the real-time position of equipment for radiating preset high-frequency ultrasonic waves in the heart; s3, acquiring the distance between the position of the heart to be treated and the radiation low-frequency ultrasonic generating equipment; and S4, controlling the low-frequency ultrasound generating equipment to perform targeted therapy.
Further, the device for radiating the high-frequency ultrasonic wave and the device for radiating the low-frequency ultrasonic wave are two ultrasonic transducers respectively.
Further, both of the ultrasound transducers are fixed to the tip of the interventional catheter.
Further, the step S1 further includes the following steps S1.1, acquiring cardiac ultrasound two-dimensional images at different angles; s1.2, establishing an ultrasonic heart three-dimensional model for the obtained heart ultrasonic two-dimensional image based on a three-dimensional reconstruction technology; s1.3, obtaining a heart CT photograph, performing three-dimensional reconstruction on the heart CT photograph to obtain a CT heart three-dimensional model, comparing the CT heart three-dimensional model with the ultrasonic heart three-dimensional model based on a big data learning mode to obtain a comparison result, and optimizing the ultrasonic heart three-dimensional model according to the comparison result to obtain an optimized heart three-dimensional model.
Further, performing heart three-dimensional reconstruction on the obtained heart ultrasonic two-dimensional photograph by adopting a surface rendering algorithm to obtain an ultrasonic heart three-dimensional model.
Further, the acquiring a cardiac CT photograph and performing three-dimensional reconstruction on the cardiac CT photograph to obtain a CT cardiac three-dimensional model includes:
and acquiring cardiac CT pictures at different angles, and performing three-dimensional reconstruction on the cardiac CT pictures at different angles to obtain a CT cardiac three-dimensional model.
Further, when the device for generating low-frequency ultrasound performs targeted therapy, the interventional catheter is controlled to approach the position of the targeted therapy, and the position of the targeted therapy is highlighted in the three-dimensional model.
According to a second aspect of an embodiment of the present invention, a system for cardiac interventional procedures comprises
An ultrasonic three-dimensional modeling module: radiating high-frequency ultrasonic waves to a heart cavity to obtain a two-dimensional heart ultrasonic image, and constructing a three-dimensional model of the heart according to the two-dimensional ultrasonic image;
a positioning module: determining a real-time location within the heart at which a device of low frequency ultrasound generation is located;
a distance determination module: acquiring the distance between the position of the heart to be treated and an ultrasonic knife;
a targeted therapy module: and controlling the equipment for generating the low-frequency ultrasound to perform targeted therapy.
According to a third aspect of embodiments of the present invention, an electronic device of a method of cardiac interventional surgery comprises: the processor and the memory are communicated with each other through a bus; the memory stores program instructions executable by the processor, which when called by the processor are capable of performing the method as described above.
According to a fourth aspect of embodiments of the present invention, a computer-readable storage medium of a method of cardiac interventional surgery is characterized in that a computer program is stored thereon, which computer program, when being executed by a processor, realizes the steps of the method as described above.
The embodiment of the invention has the following advantages: through putting ultrasonic emission device on interveneeing the pipe, not only can realize acquireing the three-dimensional image of heart, can also acquire the function that realizes the operation to the focus position simultaneously, only need change ultrasonic transducer transmission ultrasonic wave frequency can, through to heart position transmission high frequency ultrasonic wave, carry out three-dimensional modeling to heart position, confirm ultrasonic emission device's position again, and then can realize accurate, quick, efficient and realize ultrasonic operation, need not to inject the contrast medium.
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In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below. It should be apparent that the drawings in the following description are merely exemplary, and that other embodiments can be derived from the drawings provided by those of ordinary skill in the art without inventive effort.
The structures, ratios, sizes, and the like shown in the present specification are only used for matching with the contents disclosed in the specification, so as to be understood and read by those skilled in the art, and are not used to limit the conditions that the present invention can be implemented, so that the present invention has no technical significance, and any structural modifications, changes in the ratio relationship, or adjustments of the sizes, without affecting the effects and the achievable by the present invention, should still fall within the range that the technical contents disclosed in the present invention can cover.
Fig. 1 is a flowchart of a method of cardiac interventional procedure according to embodiment 1 of the present invention;
fig. 2 is a system block diagram of a system for cardiac interventional procedure according to embodiment 2 of the present invention.
In the figure: 1. an ultrasonic three-dimensional modeling module; 2. a positioning module; 3. a distance determination module; 4. a targeted therapy module.
Detailed Description
The present invention is described in terms of particular embodiments, other advantages and features of the invention will become apparent to those skilled in the art from the following disclosure, and it is to be understood that the described embodiments are merely exemplary of the invention and that it is not intended to limit the invention to the particular embodiments disclosed. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Example (b): a heart intervenes the method of the operation, as shown in figure 1, radiate the high-frequency ultrasonic wave to the heart cavity at first, obtain the two-dimentional heart ultrasonic image, and construct the three-dimensional model of the heart according to the said two-dimentional ultrasonic image, in this embodiment, the apparatus of the heart intervenes the operation is intervened through an interventional catheter, there is an ultrasonic probe at the end of the interventional catheter, namely an ultrasonic transducer, can change the frequency that the ultrasonic wave launches according to the demand, and then finish obtaining the heart ultrasonic image and carrying on the ultrasonic therapeutic purpose to the heart.
The method for constructing the three-dimensional model of the heart comprises the steps of firstly obtaining heart ultrasonic two-dimensional photographs at different angles; in the operation, a plurality of ultrasonic two-dimensional radiographs of different heart angles are acquired in real time and used as the heart ultrasonic two-dimensional radiograph, and an ultrasonic heart three-dimensional model is established for the acquired heart ultrasonic two-dimensional radiographs based on a three-dimensional reconstruction technology.
In the embodiment of the invention, the heart three-dimensional reconstruction is carried out on the basis of a surface rendering algorithm such as a Marching Cubes algorithm aiming at the heart ultrasonic two-dimensional radiographs acquired in real time at different angles of the heart, so as to obtain an ultrasonic heart three-dimensional model.
And then, based on a Marching Cubes algorithm, respectively taking a two-dimensional image of the cardiac ultrasound at each angle, and distributing the extraction of the isosurface in each voxel (voxel). And for each processed voxel, approximating an internal isosurface by a triangular surface patch, calculating normal vectors of each vertex of the triangular surface patch, and establishing a three-dimensional model.
Then obtaining a heart CT photograph, carrying out three-dimensional reconstruction on the heart CT photograph to obtain a CT heart three-dimensional model, comparing the CT heart three-dimensional model with the ultrasonic heart three-dimensional model based on a big data learning mode to obtain a comparison result, and optimizing the ultrasonic heart three-dimensional model according to the comparison result to obtain an optimized heart three-dimensional model.
In the embodiment of the invention, the heart three-dimensional reconstruction is carried out on the heart CT photograph to obtain the CT heart three-dimensional model, and then the CT heart three-dimensional model is compared with the ultrasonic heart three-dimensional model based on a big data learning mode, so that the precision of the ultrasonic heart three-dimensional model is improved.
In addition, the optimized heart three-dimensional model is generated based on the ultrasonic heart three-dimensional model, the ultrasonic heart three-dimensional model can be generated in real time in an operation, the optimized heart three-dimensional model is further ensured to be generated in real time, further, the ultrasonic heart three-dimensional model is established based on the ultrasonic two-dimensional photograph, the requirement on equipment is not high, a contrast medium is not required to be injected, the cost is saved, the consumed time is greatly shortened compared with that of a traditional CT mode, and the problem that the CT heart three-dimensional model has larger difference due to different states of an organism, such as different blood volumes and different nerve regulation levels, when the traditional CT heart three-dimensional model is established is solved. In conclusion, the defects of the traditional CT three-dimensional reconstruction method for obtaining the CT heart three-dimensional model can be overcome.
And finally, displaying the optimized three-dimensional model of the heart, wherein in the embodiment of the invention, medical staff in the operation can obtain the three-dimensional model of the heart in real time for reference in the operation process by displaying the optimized three-dimensional model of the heart in real time.
The second step is to determine the real-time location within the heart where the device of low frequency ultrasound generation is located. In the embodiment of the invention, the low-frequency ultrasonic generating equipment and the high-frequency ultrasonic generating equipment are the same equipment, so that the position of the low-frequency ultrasonic generating equipment in the heart is the central position of the three-dimensional modeling. The position of the ultrasonic probe can also be determined based on the feedback position of the ultrasound.
Then, according to the three-dimensional model, the position of the focus can be found, when the catheter is close to the focus of the heart, the original imaging ultrasound can make the part be highlighted, and when the treatment is started, the part is the target point of the treatment. According to the distance between the ultrasonic probe and the focus to be treated, the position of the ultrasonic probe which needs to be focused is determined, the distance between the position of the heart which needs to be treated and the ultrasonic knife is obtained, and the target point which needs to be treated is treated.
Since the high-frequency ultrasonic waves are emitted before, the frequency of the ultrasonic waves of the ultrasonic generating device needs to be changed into low-frequency ultrasonic waves to perform targeted therapy on the target point. In this embodiment, the high frequency is selected from 5MHz to 15MHz, and the low frequency is selected from 1MHz to 3 MHz.
Through putting ultrasonic emission device on interveneeing the pipe, not only can realize acquireing the three-dimensional image of heart, can also acquire the function that realizes the operation to the focus position simultaneously, only need change ultrasonic transducer transmission ultrasonic wave frequency can, through to heart position transmission high frequency ultrasonic wave, carry out three-dimensional modeling to heart position, confirm ultrasonic emission device's position again, and then can realize accurate, quick, efficient and realize ultrasonic operation, need not to inject the contrast medium.
Example 2: a system for cardiac interventional surgery, as shown in fig. 2, comprises an ultrasound three-dimensional modeling module: radiating high-frequency ultrasonic waves to a heart cavity to obtain a two-dimensional heart ultrasonic image, and constructing a three-dimensional model of the heart according to the two-dimensional ultrasonic image; a positioning module: determining a real-time location within the heart at which a device of low frequency ultrasound generation is located; a distance determination module: acquiring the distance between the position of the heart to be treated and an ultrasonic knife; a targeted therapy module: and controlling the equipment for generating the low-frequency ultrasound to perform targeted therapy. The ultrasonic three-dimensional modeling module comprises an ultrasonic photograph acquisition module 401, which is used for acquiring cardiac ultrasonic two-dimensional photographs at different angles;
in the embodiment of the present invention, the ultrasound radiography acquiring module 401 is configured to acquire, in real time, a plurality of ultrasound two-dimensional radiography of the heart at different angles as the cardiac ultrasound two-dimensional radiography during the operation.
An ultrasonic heart three-dimensional model reconstruction module 402, configured to build an ultrasonic heart three-dimensional model for the acquired cardiac ultrasonic two-dimensional photograph based on a three-dimensional reconstruction technique;
in the embodiment of the present invention, the ultrasonic heart three-dimensional model reconstruction module 402 is configured to perform three-dimensional cardiac reconstruction on the basis of a surface rendering algorithm, such as a Marching Cubes algorithm, for cardiac ultrasonic two-dimensional radiographs acquired in real time from different angles of the heart, so as to obtain an ultrasonic heart three-dimensional model.
Further, based on a Marching cube algorithm, extraction of an isosurface is distributed in each voxel (voxel) for cardiac ultrasound two-dimensional shooting of each angle. And for each processed voxel, approximating an internal isosurface by a triangular surface patch, calculating normal vectors of each vertex of the triangular surface patch, and establishing a three-dimensional model.
The optimizing module 403 is configured to perform cardiac three-dimensional reconstruction on the cardiac CT photograph to obtain a CT cardiac three-dimensional model, compare the CT cardiac three-dimensional model with the ultrasound cardiac three-dimensional model based on a big data learning manner to obtain a comparison result, and optimize the ultrasound cardiac three-dimensional model according to the comparison result to obtain an optimized cardiac three-dimensional model.
In this embodiment of the present invention, the optimization module 403 includes:
the CT heart three-dimensional reconstruction unit 4031 is used for acquiring cardiac CT photographs at different angles and performing three-dimensional reconstruction on the cardiac CT photographs at different angles to obtain a CT heart three-dimensional model;
the optimization unit 4032 is configured to compare the CT cardiac three-dimensional model with the ultrasound cardiac three-dimensional model based on a big data learning manner to obtain a comparison result, optimize the ultrasound cardiac three-dimensional model according to the comparison result, improve the precision of the ultrasound cardiac three-dimensional model, and obtain the optimized cardiac three-dimensional model.
In addition, the optimized heart three-dimensional model is generated based on the ultrasonic heart three-dimensional model, the ultrasonic heart three-dimensional model can be generated in real time in an operation, the optimized heart three-dimensional model is further ensured to be generated in real time, further, the ultrasonic heart three-dimensional model is established based on the ultrasonic two-dimensional photograph, the requirement on equipment is not high, a contrast medium is not required to be injected, the cost is saved, the consumed time is greatly shortened compared with that of a traditional CT mode, and the problem that the CT heart three-dimensional model has larger difference due to different states of an organism, such as different blood volumes and different nerve regulation levels, when the traditional CT heart three-dimensional model is established is solved. In conclusion, the defects of the traditional CT three-dimensional reconstruction method for obtaining the CT heart three-dimensional model can be overcome.
And a display module 404 for displaying the optimized three-dimensional model of the heart.
In the embodiment of the invention, the optimized three-dimensional model of the heart is displayed in real time through the display module 404, so that medical personnel in the operation can obtain the three-dimensional model of the heart immediately, and simultaneously, the position of the interventional catheter is displayed in the three-dimensional model of the heart for reference in the operation process.
Although the invention has been described in detail above with reference to a general description and specific examples, it will be apparent to one skilled in the art that modifications or improvements may be made thereto based on the invention. Accordingly, such modifications and improvements are intended to be within the scope of the invention as claimed.

Claims (1)

1. A system for cardiac interventional procedures, comprising: comprises that
An ultrasonic three-dimensional modeling module: radiating high-frequency ultrasonic waves to a heart cavity to obtain a two-dimensional heart ultrasonic image, and constructing a three-dimensional model of the heart according to the two-dimensional heart ultrasonic image;
a positioning module: determining a real-time location within the heart at which a device of low frequency ultrasound generation is located;
a distance determination module: acquiring the distance between the position of the heart to be treated and the ultrasonic knife;
a targeted therapy module: controlling the equipment for generating the low-frequency ultrasound to perform targeted therapy;
the device for radiating the high-frequency ultrasonic waves and the low-frequency ultrasonic waves to the heart cavity is an ultrasonic transducer arranged at the end part of an interventional catheter, the ultrasonic transducer transforms the frequency of ultrasonic wave emission according to requirements, and then the purposes of obtaining heart ultrasonic images and carrying out ultrasonic treatment on the heart are achieved, the high frequency selects the ultrasonic waves with the frequency of 5MHz-15MHz, and the low frequency selects the ultrasonic waves with the frequency of 1MHz-3 MHz;
the ultrasonic three-dimensional modeling module comprises an ultrasonic photograph acquisition module used for acquiring heart ultrasonic two-dimensional photographs at different angles, an ultrasonic heart three-dimensional model reconstruction module used for establishing an ultrasonic heart three-dimensional model for the acquired heart ultrasonic two-dimensional photographs based on a surface rendering algorithm, the optimization module comprises a CT heart three-dimensional reconstruction unit used for acquiring the heart CT photographs at different angles and performing three-dimensional reconstruction for the heart CT photographs at different angles, and the optimization unit used for comparing the CT heart three-dimensional model with the ultrasonic heart three-dimensional model based on a big data learning mode to obtain a comparison result and optimizing the ultrasonic heart three-dimensional model according to the comparison result to obtain an optimized heart three-dimensional model.
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CN112843506B (en) * 2019-11-28 2023-07-04 重庆西山科技股份有限公司 Surgical system and ultrasonic suction knife system
CN114879144B (en) * 2022-05-24 2023-04-18 深圳心寰科技有限公司 Acoustic positioning method, system, readable storage medium and terminal equipment

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